value of chest x -ray in foreign body aspiration of children

ABSTRACT

Foreign body aspiration [FBA] is a common cause of respiratory distress in children. Delay in diagnosis and treatment can cause serious complication especially chronic pneumonia. The aim of this study was evaluation of plain chest X- Ray [CXR] as the first and available imaging modality in FBA of children. A retrospective analysis was conducted on the records of pediatric patients less than 18 years of age with the discharge diagnosis of FBA from 1999 to 2003 at the Imam Reza Hospital [a large tertiary center in Khorasan province]. From 140 patients with FBA 87 [62%] were male. The mean age was 48 month. The most common clinical findings were history of chocking [77%], decreased breath sounds [42%], wheezing [38%], cough [20%], respiratory distress [15.5%] and fever. CXR was normal in 47% of patients with a sensitivity about 64%. Air trapping [Emphysema] was most common radiological findings [24.5%]. Other radiological finding were, consolidations [10.5%], atelectasis [6.5%] and opaque foreign bodies [6.5%]. In all cases except four cases, aspirated foreign bodies were food materials and watermelone seeds were the commonest one [40%]. Bronchoscopic removal of foreign body was done successfully in 133 patients [95%]. Although FBA in children diagnosed by history, physical examination and radiographic findings, but this findings may be misleading. Negative CXR should not preclude diagnosis of FBA in children with a strong history of FBA, and early bronchoscopic examination will be safe and life saving