The Danger Close to Home: Foreign body aspiration in the children, prevention, diagnosis and treatment evaluation
Abstract
Background and Aims: Foreign body aspiration (FBA) is frequently seen in children, and progresses with symptoms related to airway obstruction, leading to serious complications. The aim of this study was to discuss the diagnosis and treatment principles of patients who underwent bronchoscopy for suspected foreign body aspiration (FBA), and to emphasize its preventability.
Method: A retrospective review was made of the records of patients who underwent bronchoscopy for evaluation of FBA in the Pediatric Surgery Clinics of two hospitals where the authors work from January 2017 to February 2020. Age, gender, history of FBA, clinical symptoms, chest radiography findings, bronchoscopy findings, complications, and outcome were recorded for each patient. A history of FBA, physical examination findings, and radiological study results were analyzed statistically to determine the most accurate diagnostic tool to differentiate cases with and without FBA.
Results: Bronchoscopy was performed in 102 patients with suspected FBA. A foreign body was detected in 51% (52/102) of the patients. No statistically significant difference was determined in respect of age and gender (p>0.005). There was a statistically significant difference in respect of history and time of presentation, but no difference in terms of physical examination and radiological findings. Of the foreign bodies aspirated, 87% were nuts. No life-threatening complications occurred in any patient due to bronchoscopy.
Conclusion: Nuts are the most frequently aspirated foreign bodies in childhood. History, physical examination, and radiological findings may not be available for all patients. Preventive measures are important as FBA can lead to fatal consequences. Careful evaluation of the patient is necessary to reduce the negative bronchoscopy rate.
Keywords
Kaynakça
- References: 1. Ciftci AO, Bingöl-Koloğlu M, Senocak ME, Tanyel FC, Büyükpamukçu N. Bronchoscopy for evaluation of foreign body aspiration in children. J Pediatr Surg. 2003 Aug;38(8):1170-6
- 2. Şenkaya I, Sağdıç K, Gebitekin C, Yılmaz M, Özkan H, Cengiz M. Management of foreign body aspiration in infancy and childhood. Turk J Ped 1997;39:353-62.
- 3. Smitheringale A. Management of foreignbodies of the tracheobronchial tree. In: Pearson editor. Thoracic surgery. Philadelphia: Churchil Livingstone; 1995. p. 1591-9.
- 4. Zekeriya İ. Çocuklarda Trakeobronşial Yabancı Cisim Aspirasyonu. Kocaeli Tıp Dergisi 2012;2: 47-54
- 5. Hsu Wc, Sheen Ts, Lin Cd, Tan Ct, Yeh Th, Lee Sy. Clinical experiences of removing foreign bodies in the airway and esophagus with a rigid endoscope: a series of 3217 cases from 1970 to 1996. Otolaryngol Head Neck Surg. 2000 Mar;122(3):450-4
- 6. Özyüksel G, Arslan UE, Boybeyi Türer Ö, Tanyel FC, Soyer T . New scoring system to predict foreign body aspiration in children, J Pediatr Surg 55 (2020) 1663–1666
- 7. Tütüncü AÇ, Dilmen ÖK, Ozcan R, Emre Ş, Köksal G, Altıntaş F et al.. Çocuk hastalarda yabancı cisim aspirasyonu nedeniyle uygulanan rijid bronkoskopi sonuçlarımız. Turk Ped Arş 2012;47:125-9.
- 8. Sarısoy Ö, Liman ŞT, Aydoğan M, Topçu S, Burç K, Hatun Ş. Çocukluk çağı yabancı cisim aspirasyonları: klinik ve radyolojik değerlendirme. Çocuk Sağlığı ve Hastalıkları Dergisi 2007;50:96-101
- 9. Chouhan M, Sharma S. Tracheobronchial Foreign Bodies: The Importance of Timely Intervention and Appropriate Collaboration. Indian J Otolaryngol Head Neck Surg. 2019;71:972-97
- 10. Jaswal A, Jana U, Maiti PK. Tracheo-bronchial foreign bodies: a retrospective study and review of literature. Indian J Otolaryngol Head Neck Surg. 2014;66:156-60