Foreign Body Aspiration in Children-a Diagnostic Challenge

Abstract

The clinical presentation of foreign body aspiration in children is variable. Clinicians should maintain a high index of suspicion in order to make a prompt and correct diagnosis. In this paper,we present a case of foreign body aspiration that had gone unrecognized for 54 days. Foreign body aspiration should be considered whenever a previously healthy child suddenly exhibits unexplained symptoms usually consistent with airway obstruction which is refractory to medical treatment. Turkish Başlık: Çocuklarda Yabancı Cisim Aspirasyonu – Bir Tanısal Zorluk Anahtar Kelimeler: Bronkospi, çocuklar, yabancı cisim aspirasyonu, uzamış tanı Çocuklarda yabancı cisim aspirasyonunun klinik sunumu değişkendir. Hızlı ve doğru tanı koymak için klinisyenler şüpheci olmalıdırlar. Bu makalede 54 gün boyunca anlaşılamayan bir yabancı cisim aspirasyonu olgusunu sunuyoruz. Daha önceden sağlıklı olan çocuk aniden havayolu obstrüksiyonu ile uyumlu ve tıbbi tedaviye dirençli açıklanamayan semptomlar gösterdiğinde yabancı cisim aspirasyonu düşünülmelidir.

Keywords

• Bronchoscopy, children, foreign body aspiration, prolonged diagnosis

Foreign Body Aspiration in Children-a Diagnostic Challenge

Öz

Kaynakça

1. Tan H.K.K, Brown K, McGill T, Kenna M.A, Lund D.P, Healy G.B. Airway foreign bodies (FB): a 10 year review. Int J Pediatr Otorhi- nolaryngol 2000;56:91-9. [CrossRef]
2. Gandhi R, Jain A, Agarwal R, Vajifdar H. Tracheobronchial For- eign Bodies- A seven years review. J Anesth Clin Pharmacology 2007;23:69-74.
3. Silva A.B, Muntz H.R, Clary R. Utility of conventional radiogra- phy in the diagnosis and management of pediatric airway foreign bodies. Ann Otol Rhinol Laryngol 1998;107:834-8.
4. Mul C, Sun DO, He P. Radiological diagnosis of aspirated for- eign bodies in children: review of 343 cases. J Laryngol Otol 1990;104:778-82.
5. Reilly J, Thompson J, MacArthur C, Pransky S, Beste D, Smith M, et al. Pediatric aerodigestive foreign body injuries are com- plications related to timeliness of diagnosis. Laryngoscope 1997;107:17-20. [CrossRef]
6. Darrow DH, Holinger LD. Aerodigestive tract foreign bodies in the older child and adolescent. Ann Otol Rhinol Laryngol 1996; 105:267-71.
7. Daines CL, Wood RE, Boesch RP. Foreign body aspiration: An important etiology of respiratory symptoms in children. J Allergy Clin Immunol 2008;121:1297-8. [CrossRef]
8. Deskin R, Young G, Hoffman R. Managementof pediatric airway foreign bodies. Laryngoscope 1997;107:540-3. [CrossRef]

9. Franquet T, Gimenez A, Ronson N, Torrubia S, Sabate IM, Perez C. Aspiration disease: finding, pitfalls, and differential diagnosis. RadioGraphic 2000;20:673-85.
10. Donnellyl F, Frush DP, Risset GS 3rd. The multiple presentations of foreign bodies in children. AJR Am Roentgenol 1998;170:471-7.
11. Brenner DJ, Elliston CD, Hall EJ, Berdon WE. Estimated risks of radiation-induced fatal cancer from pediatric CT. Am J Roent- genol 2001;176:289-96.
12. Shu XO, Potter JD, Linet MS, Severson RK, Han D, Kersey JH, et al. Diagnostic x-rays and ultrasound exposure and risk of child- hood acute lymphoblastic leukemia by immunophenotype. Can- cer Epidemiol Biomarkers Prev 2002;11:177-85.
13. Infante-Rivard C, Mathonnet G, Sinnett D. Risk of childhood leu- kemia associated with diagnostic irradiation and polymorphisms in DNA repair genes. Environ Health Perspect 2000;108:495-8. [CrossRef]
14. Mazrani W, McHugh K, Marsden PJ. The radiation burden of radiological investigations. Arch Dis Child 2007;92:1127-31. [CrossRef]
15. Hall E.J. Lessons we have learned from our children: cancer risks from diagnostic radiology. Pediatr Radiol 2002;32:700-6. [CrossRef]
16. Cevizci N, Dokucu AI, Baskin D, Karadağ CA, Sever N, Yalçin M, et al. Virtual bronchoscopy as a dynamic modality in the diag- nosis and treatment of suspected foreign body aspiration. Eur J Pediatr Surg 2008;18:398-401. [CrossRef]
17. Kocaoglu M, Bulakbasi N, Soylu K, Demirbag S, Tayfun C, So- muncu I. Thin-section axial multidetector computed tomography and multiplanar reformatted imaging of children with suspected foreign-body aspiration: Is virtual bronchoscopy overempha- sized? Acta Radiol 2006;47:746-51. [CrossRef]
18. Esclamado RM, Richardson MA. Laryngotracheal foreign bodies in children. A comparison with bronchial foreign bodies. Am J Dis Child 1987;141:259-62. Balkan Med J 2012; 29: 96-8 FBA in Children