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[Tracheobronchial aspiration of foreign bodies in children]
J Sánchez Echániz1, J Pérez García, S Mintegui Raso
1Urgencias de Pediatría, S. Cirugía Infantil, Hospital Infantil de Cruces, Baracaldo, Vizcaya.
Insights
Foreign body (FB) inhalation in children is a significant risk, particularly for toddlers and 11-year-olds. Delayed presentation to the Pediatric Emergency Room (PER) highlights the need for increased public awareness and prevention strategies.
Area of Science:
- Pediatric Emergency Medicine
- Otolaryngology
- Pulmonology
Context:
- Tracheobronchial foreign body (FB) inhalation is a common pediatric emergency.
- Delayed presentation to the Pediatric Emergency Room (PER) can complicate diagnosis and treatment.
- Understanding risk factors and FB types is crucial for prevention.
Purpose:
- To characterize children admitted to the PER for tracheobronchial FB inhalation.
- To analyze the demographics, clinical presentation, and outcomes of these cases.
- To identify specific age groups at higher risk for FB aspiration.
Summary:
- A retrospective review of 55 children with confirmed FB inhalation in the PER over five years was conducted.
- Peak incidence occurred in 1-2 year olds, with a secondary peak at 11 years.
- Nuts were the most common FB in younger children, while inorganic materials predominated in older children.
Impact:
- Delayed presentation (only 25% within 24 hours) indicates a need for greater public awareness.
- Identified distinct risk groups (toddlers and pre-teens) with different FB types.
- Emphasizes the critical importance of ongoing prevention education for foreign body aspiration.
Objective:
Our objective was to study the characteristics and follow-up of children admitted to our Pediatric Emergency Room (PER) due to tracheobronchial inhalation of foreign bodies (FB).
Patients And Methods:
We have reviewed retrospectively the 55 cases admitted over the last five years to our PER in whom the diagnosis of FB inhalation was confirmed.
Results:
Mean age was 4 years with the peak incidence (25) occurring between 1 and 2 years of age. The second risk group was 11 years (8). In 84% of the patients (46), there was a history of FB aspiration. Twenty-five percent of the children (14) presented at the hospital within 24 hours, and 18% (10) more than 1 week after inhaling the FB. Physical examination was normal in 5%. The X-ray findings were: air trapping (74%), atelectasis (13%), in cases admitted more than 1 week after aspiration, and were normal in 13%. Rigid bronchoscopy and subsequent removal of the FB was the treatment instituted in 53 cases. There were no deaths. The FB was located at the right bronchus in 67%. The ingestion of nuts accounted for the highest incidence (72%), occurring mainly in younger children. Inorganic bodies constituted the majority of the cases in children older than 9 years (p = 0.0000).
Conclusions:
1. Tracheobronquial inhalation of FB continues to not alarm the general population since only 25% presented at the hospital within 24 hours. 2. There are two risk groups, the second year of life (the largest) and the eleventh year, and they are different in the type of FB inhaled. 3. It is necessary to keep insisting on the methods of prevention.