Diagnosis of paediatric airway foreign body: is it easy?
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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.
KeywordsAspiration Bronchoscopy Chest radiographs Children Clinical symptoms Foreign body
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- Corporate Author: Advanced Life Support Group, Advanced Paediatric Life Support: The Practical Approach, 5th ed., John Wiley & Sons, 2011Google Scholar
- Zawadzka-Głos L., Chmielik M., Gabryszewska A., Zając B., Badelek-Izdebska M., Analysis of indications for bronchoscopy In the Department of Paediatric Otolaryngology in Warsaw from 1998 to 2003, Borgis-New Medicine, 2003, 2, 4–11Google Scholar
- Kalyanappagol V.T., Kulkarni N.H., Bidri L.H., Management of tracheobronchial foreign body aspirations in paediatric age group-a 10 year retrospective analysis, Indian. J. Anaesth., 2007, 51, 20–23Google Scholar
- Lederman H.M., Airway Foreign Body Imaging. eMedicine Radiology, 2011, http://emedicine.medscape.com/article/405994-overview Google Scholar
- Kula Ö., Gürkan S., Alunöz H., Yazici Ö., Ocakli Ö., Dülger S.,U., et al. Foreign Body Aspiration in Infants and Children, Turk. Resp. J., 2003, 2, 76–78Google Scholar