Foreign Body Aspiration in Children: Clinical, Radiological and Bronchoscopy Findings

Background: Foreign body aspiration (FBA) is a serious problem that leads to partial or complete airway obstruction. Respiratory distress and pneumonia are the most common complications. The assortment of foreign bodies is very wide. The most common include candy, fish bones, peanuts and nuts, toys, food and batteries. Aim of this study was to determine how accurate the presenting symptoms and signs of foreign body aspiration are and to assess the radiologic findings, the types and sites of the foreign bodies removed. Patients and Methods: a retrospective study included101 patient from age of one month to 15 years with suspected foreign body aspiration based on history, clinical examination, Chest Xray. Rigid bronchoscopy was done for patients under general anaesthesia with muscle relaxation using neuromuscular blocking agents. For every patient gender, age, residence, interval between event and symptom onset, symptoms at admission, signs of respiratory insufficiency, pulmonary auscultation findings, Chest X-ray findings, interval between admission and bronchoscopy, the location of foreign body, type of foreign body, hospitalization days were studied and statistically analysed. A p-value of < 0.05 was considered statistically significant. Results: Seventy six (75.24%) were proved to have foreign body aspiration that was removed by rigid bronchoscopy. toddler was the common age group 43(42.6%). Male were affected more than females 1.2:1. A significantly higher percentage of patients who had a foreign body were witnessed by a family member than those who did not have a foreign body 61.8% vs 0% (p=0.001). Stridor and cough with breathlessness were the most common signs and symptoms while unilateral wheezes, crepitations and diminished air entry were less frequent while each of crepitations, unilateral wheezes and cough with breathlessness were significantly associated with foreign body aspiration (p=0.001, 0.001, 0.02 respectively). Abnormal chest X ray finding was significantly associated with FBA (p=0.02) with hyperinflation being the most frequent finding. The types of foreign bodies removed were sunflower seeds (27.6%), food particles (18.4%) and nuts (17.1%). The most common site of foreign body was the right main bronchus (52.6%) followed by left main bronchus (34.2%). There is a significant association between foreign body aspiration and the time interval between admission and bronchoscopy but no significant relation with age, interval between the event and onset of symptoms and hospitalization days. Conclusion: The history of being witnessed by a family member, the presence of stridor and cough and finding of unilateral wheezes and crepitations on examination as well as hyperinflation on chest X ray are significantly associated with FBA. The sunflower seeds and food particles are the most common types and the right main bronchus is the main site of foreign bodies removed by bronchoscopy.