Non opaque foreign body aspiration in children: should we be more vigilant and proactive?

ABSTRACT

To study the frequency of symptoms, composition and complications of clinically suspected non radio-opaque foreign body aspiration; which is a difficult diagnostic challenge resulting in delayed referral for bronchoscopy. This descriptive analysis of 400 cases of foreign body aspiration was done in the department of ENT and Head and Neck surgery. Lady Reading Hospital Peshawar from 2003-2006. One hundred cases were selected with presumptive diagnosis of foreign bodies in tracheobronchial tree. The inclusion criteria were not witness and non radio-opaque foreign bodies. We reviewed their hospital record to ascertain history diagnosis and treatment. Age, sex, location in tracheobronchial tree, witnessed or un-witnessed events, symptoms, radio graphic findings, anatomical abnormalities noted at endoscopy and complications were recorded. Radio opaque foreign bodies were excluded from the study. A total of hundred cases were included. Age range was from 2-5 years. Males were 70% and females were 30%. Delay in presentation was from 10 days to 4 years. Common symptoms at presentation were cough 55% and asthma 20%. Radiological findings were abnormal in 90% of cases. Upon bronchoscopy 70% were positive for foreign body and 30% were negative. Peanuts [30%] and whistles [28%] were the commonest foreign bodies. No death occurred in this study and minor complications of the procedure were only 15%. Aspiration of foreign bodies in children can lead to serious morbidity if not recognized and treated in time; hence early referral is essential