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Central European Journal of Medicine

, Volume 9, Issue 5, pp 648–652 | Cite as

Diagnosis of paediatric airway foreign body: is it easy?

  • Beata Rybojad
  • Grażyna Niedzielska
  • Ewa Rudnicka-Drożak
Research Article
  • 102 Downloads

Abstract

Foreign-body aspiration in children results in diagnostic problems, mainly because of nonspecific signs. Therefore, in this study, we placed particular stress on false-positive and -negative predictors. Charts of 139 consecutive paediatric patients aged 6.0 months to 15.5 years who underwent bronchoscopy for a suspected foreign body aspiration were analysed retrospectively. A foreign body was found in 95 cases (68%). The anamnesis was positive in 91%. Cough was the most common clinical symptom (91%) with a sensitivity and specificity of 94% and 23%, respectively. There were no significant correlations between clinical symptoms and the locations of foreign bodies. The majority of focal hyperinflation (24%) and atelectasis (15%) were seen in chest radiographs, with a sensitivity and specificity of 33% and 89% (hyperinflation) and 15% and 82% (atelectasis), respectively. Chest X-rays were normal in 46 cases; however, an object was removed in 25. Persistent infiltrates were present in 14 X-rays, and a foreign body was extracted during bronchoscopy in 4. A highly significant correlation between the type of foreign body and radiological signs was noted (p = 0.00001). Anamnesis, clinical symptoms, and radiological findings are helpful in confirming aspiration, but can be misleading. Chronic or recurrent pneumonia should prompt further bronchoscopic diagnosis.

Keywords

Aspiration Bronchoscopy Chest radiographs Children Clinical symptoms Foreign body 

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Copyright information

© Versita Warsaw and Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Beata Rybojad
    • 1
    • 2
  • Grażyna Niedzielska
    • 3
  • Ewa Rudnicka-Drożak
    • 2
  1. 1.Department of Anaesthesiology and Intensive CareChildren’s University Hospital of LublinLublinPoland
  2. 2.Department of Expert Medical Assistance with Emergency Medicine UnitMedical University of LublinLublinPoland
  3. 3.Chair and Department of Paediatric Otorhinolaryngology, Phoniatrics and AudiologyMedical University of LublinLublinPoland

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