TITLE:
Airway Foreign Body in Children
AUTHORS:
Hui Sing Chew, Henry Kun Kiaang Tan
KEYWORDS:
Airway; Foreign Body; Children
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.3 No.7,
December
31,
2012
ABSTRACT:
Introduction: Foreign body aspiration is not uncommon in children. It can be
associated with significant morbidity and mortality. This study aims to
determine and analyze the characteristics of local pediatrics airway foreign
body (FB) aspiration. Methods: A retrospective study of medical records from KK hospital
(1997-2010) is done. Patient demographics, clinical/investigative findings,
duration of hospitalization and complications are analyzed. Results: The sample
consisted of 26 patients (eight months - 13 years of age), who underwent rigid
bronchoscopy for FB removal over the last 13 years. Seventy-seven percent were
three years of age or younger. Peak incidence (61.6%) was at one to two years
of age. Nineteen were males and seven were females. The top three clinical
presentations were: cough (61.5%), choking (46.2%) and wheezing (42.3%).
Decreased air entry (34.6%), tachypnea (26.9%) and no significant findings
(23.1%) were the most common features on physical examination. The most common
radiographic findings were consolidation (30.8%), presence of a foreign body
(23.1%) and no abnormality (23.1%). Aspiration was primarily into the right
main bronchus (38.5%), and 61.5% of the FB was organic in nature [principally
peanuts (38.5%)]. Mean hospitalization duration was three days. Delayed
diagnose in three cases were secondary to mis-diagnoses as croup (n = two) and
respiratory tract infection (n = one). Complications were noted in eight cases
(30.8%). There was no mortality. Conclusion: High index of suspicion is required in diagnosing airway FB. Physician’s
diagnostic acumen is vital in prompt successful treatment. Heightening public’s
awareness is the key to prevention of pediatrics FB aspiration.