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A Five-Year Review on Pediatric Foreign Body Aspiration
Introduction Foreign body aspiration is a leading cause of accidental death in children. Clinical presentation varies from non-specific respiratory symptoms to respiratory failure making diagnosis challenging.
Objective To review pediatric patients who underwent bronchoscopy due to suspicion of foreign body aspiration at a tertiary center in Malaysia.
Methods We retrospectively studied patients < 11 years old who underwent bronchoscopy from 2008 to 2018.
Results Over the 10-year period, 20 patients underwent bronchoscopy, and 16 were found to have foreign body aspiration with equal gender distribution. The most common age group was < 3 years old (75%). The most common clinical presentations were choking (82%) and stridor (31%). Foreign bodies were removed using flexible bronchoscope in 8 cases (50%), and difficulties were encountered in 6 cases (75%). Rigid ventilating bronchoscope was used in 8 cases (50%) with no difficulty. The most common object found was peanut (19%). The majority of foreign bodies were lodged in the right bronchus (43%). Eight patients (80%) received delayed treatment due to delayed diagnosis. The length of hospital stay was longer in the younger age groups.
Conclusion Clinical presentation and chest radiograph findings were comparable across all age groups. The most difficulties encountered during foreign body removal were via flexible bronchoscope, in children < 3 years old. There was no significant correlation between age and type of foreign body aspiration. The majority of patients who received delayed treatment were < 3 years old. The length of hospital stay was longer in the younger age groups.
Received: 31 May 2019
Accepted: 25 February 2020
23 June 2020 (online)
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- 1 Okonkwo OC, Simons A, Nichani J. North West ENT Research Collaborative. Paediatric airway foreign body - The human factors influencing patient safety in our hospitals. Int J Pediatr Otorhinolaryngol 2016; 91: 100-104
- 2 Brkic F, Umihanic S, Altumbabic H. et al. Death as a Consequence of Foreign Body Aspiration in Children. Med Arh 2018; 72 (03) 220-223
- 3 Adjeso T, Damah MC, Murphy JP, Anyomih TTK. Foreign Body Aspiration in Northern Ghana: A Review of Pediatric Patients. Int J Otolaryngol 2017; 2017: 1478795
- 4 Naragund AI, Mudhol RS, Harugop AS, Patil PH, Hajare PS, Metgudmath VV. Tracheo-bronchial foreign body aspiration in children: a one year descriptive study. Indian J Otolaryngol Head Neck Surg 2014; 66 (Suppl. 01) 180-185
- 5 Cassol V, Pereire AM, Zorzela LM, Becker MM, Barreto SSM. Foreign body in children's airway. J Pneumol 2003; 29 (03) 139-144
- 6 Baram A, Kakamad FH, Bakir DA. Scarf pin-related hijab syndrome: A new name for an unusual type of foreign body aspiration. J Int Med Res 2017; 45 (06) 2078-2084
- 7 Kaur K, Sonkhya N, Bapna AS. Foreign bodies in the tracheobronchial tree: A prospective study of fifty cases. Indian J Otolaryngol Head Neck Surg 2002; 54 (01) 30-34
- 8 Srivastava G. Airway Foreign Bodies in Children. Clin Pediatr Emerg Med 2010; 11 (02) 67-72
- 9 Dehghani N, Ludemann J. Aspirated foreign bodies in children: BC Children's Hospital emergency room protocol. BCMJ 2008; 50 (05) 252-256
- 10 Mitchell CA, Kreiger P, Goff C, Shah UK. Pediatric foreign body aspiration: A nidus for Aspergillus colonization. Int J Pediatr Otorhinolaryngol 2015; 79 (06) 938-940
- 11 Kitcher ED. Foreign body inhalation: a review of patients at the Korle Bu Teaching Hospital, Accra, Ghana. West Afr J Med 2009; 28 (06) 368-370
- 12 Gendeh BS, Gendeh HS, Purnima S, Comoretto RI, Gregori D, Gulati A. Inhaled Foreign Body Impaction: A Review of Literature in Malaysian Children. Indian J Pediatr 2019; 86 (Suppl. 01) 20-24
- 13 Aslan A, Topal E, Eyuboglu T, Unal Y. Which bronchoscopy procedure should be chosen for foreign body aspiration in children: Rigid, flexible or combined?. Eur Respir J 2013; 42: 1244
- 14 Asaf BB, Vijay CL, Bishnoi S, Dua N, Kumar A. Thoracoscopic foreign body removal and repair of bronchus intermedius following injury during failed bronchoscopic retrieval. Lung India 2017; 34 (02) 182-184
- 15 Yadav SPS, Singh J, Aggarwal N, Goel A. Airway foreign bodies in children: experience of 132 cases. Singapore Med J 2007; 48 (09) 850-853
- 16 Rothmann BF, Boeckman CR. Foreign bodies in the larynx and tracheobronchial tree in children. A review of 225 cases. Ann Otol Rhinol Laryngol 1980; 89 (5 Pt 1): 434-436
- 17 Swanson KL, Prakash UB, Midthun DE. et al. Flexible bronchoscopic management of airway foreign bodies in children. Chest 2002; 121 (05) 1695-1700
- 18 Tan HK, Brown K, McGill T, Kenna MA, Lund DP, Healy GB. Airway foreign bodies (FB): a 10-year review. Int J Pediatr Otorhinolaryngol 2000; 56 (02) 91-99
- 19 Senkaya I, Sağdiç K, Gebitekin C, Yilmaz M, Ozkan H, Cengiz M. Management of foreign body aspiration in infancy and childhood. A life-threatening problem. Turk J Pediatr 1997; 39 (03) 353-362
- 20 McGuirt WF, Holmes KD, Feehs R, Browne JD. Tracheobronchial foreign bodies. Laryngoscope 1988; 98 (6 Pt 1): 615-618
- 21 Mantel K, Butenandt I. Tracheobronchial foreign body aspiration in childhood. A report on 224 cases. Eur J Pediatr 1986; 145 (03) 211-216
- 22 Zur KB, Litman RS. Pediatric airway foreign body retrieval: surgical and anesthetic perspectives. Paediatr Anaesth 2009; 19 (Suppl. 01) 109-117
- 23 Yetim TD, Bayarogulları H, Arıca V, Akcora B, Arıca SG, Tutanc M. Foreign Body Aspiration in Children; Analysis of 42 Cases. J Pulm Respir Med 2012; 1 (03) 61-67
- 24 Even L, Heno N, Talmon Y, Samet E, Zonis Z, Kugelman A. Diagnostic evaluation of foreign body aspiration in children: a prospective study. J Pediatr Surg 2005; 40 (07) 1122-1127
- 25 Eren S, Balci AE, Dikici B, Doblan M, Eren MN. Foreign body aspiration in children: experience of 1160 cases. Ann Trop Paediatr 2003; 23 (01) 31-37
- 26 Merchant SN, Kirtane MV, Shah KL, Karnik PP. Foreign bodies in the bronchi (a 10 year review of 132 cases). J Postgrad Med 1984; 30 (04) 219-223
- 27 Rovin JD, Rodgers BM. Pediatric foreign body aspiration. Pediatr Rev 2000; 21 (03) 86-90
- 28 Fraga AdeM, Reis MC, Zambon MP, Toro IC, Ribeiro JD, Baracat EC. Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment. J Bras Pneumol 2008; 34 (02) 74-82
- 29 Tariq P. Foreign body aspiration in children--a persistent problem. J Pak Med Assoc 1999; 49 (02) 33-36
- 30 Janahi IA, Khan S, Chandra P. et al. A new clinical algorithm scoring for management of suspected foreign body aspiration in children. BMC Pulm Med 2017; 17 (01) 61
- 31 Midulla F, Guidi R, Barbato A. et al. Foreign body aspiration in children. Pediatr Int 2005; 47 (06) 663-668
- 32 Svedström E, Puhakka H, Kero P. How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children?. Pediatr Radiol 1989; 19 (08) 520-522
- 33 Cataneo AJ, Reibscheid SM, Ruiz Júnior RL, Ferrari GF. Foreign body in the tracheobronchial tree. Clin Pediatr (Phila) 1997; 36 (12) 701-706
- 34 Parameswaran N, Das S, Biswal N. Respiratory Morbidity Following Foreign Body Aspiration Among South Indian Children: A Descriptive Study. Cureus 2018; 10 (11) e3629 DOI: 10.7759/cureus.3629.
- 35 Sultan TA, van As AB. Review of tracheobronchial foreign body aspiration in the South African paediatric age group. J Thorac Dis 2016; 8 (12) 3787-3796
- 36 Passàli D, Lauriello M, Bellussi L, Passali GC, Passali FM, Gregori D. Foreign body inhalation in children: an update. Acta Otorhinolaryngol Ital 2010; 30 (01) 27-32
- 37 Chiu CY, Wong KS, Lai SH, Hsia SH, Wu CT. Factors predicting early diagnosis of foreign body aspiration in children. Pediatr Emerg Care 2005; 21 (03) 161-164
- 38 Kendigelen P. The anaesthetic consideration of tracheobronchial foreign body aspiration in children. J Thorac Dis 2016; 8 (12) 3803-3807