Bronchoschopy should always be performed in children on suspicion of foreign body aspiration

Dan Med J. 2013 Oct;60(10):A4715.

Abstract

Introduction: Foreign body aspiration (FBA) can have a fatal outcome, and the diagnosis is challenging since symptoms and signs may vary. We therefore investigated whether it was possible to identify predictors indicating the presence of a foreign body.

Material and methods: The medical records of children undergoing bronchoscopy at Odense University Hospital for suspected FBA in the period from 1977 to 2010 were reviewed and analyzed.

Results: A total of 143 children underwent bronchoscopy due to suspected FBA. The medical records of 137 of these children were accessible. Their median age was 1.84 years, 62.8% were male and foreign bodies were found in 76 cases (55.5%). The only variable that statistically significantly predicted the presence of a foreign body was a radiologic finding (any abnormal chest X-ray or fluoroscopy) (p = 0.023). A foreign body was found in 22 out of 47 (46.8%) patients with no radiologic findings and in three of 11 (27%) patients with neither symptoms at admission nor radiologic or physical findings.

Conclusion: Parental suspicion of an FBA indicates acute bronchoscopy in children regardless of signs, symptoms and findings.

MeSH terms

  • Adolescent
  • Bronchoscopy*
  • Child
  • Child, Preschool
  • Esophagus*
  • Female
  • Foreign Bodies / complications
  • Foreign Bodies / diagnosis*
  • Foreign Bodies / surgery
  • Humans
  • Infant
  • Male
  • Respiratory Aspiration / etiology*
  • Respiratory System*
  • Retrospective Studies