The Foreign Body Aspiration in Children at Chonburi Hospital

Abstract

Background : Foreign Body Aspiration is a serious problem in children delays in diagnosis and management may result in death or physical handicap from complete upper airway obstruction. Early and accurately diagnosis is necessary for proper management to reduce these unfavorable outcomes. The aim of this study is to review clinical manifestation complications and diagnostic tool for patients who suspected foreign body aspiration.

Objective : To study 1) clinical symptoms, signs, radiologic findings, locations and types of foreign bodies in children with respiratory foreign bodies aspiration 2) complications from foreign body aspiration and complication of bronchoscopy 3) the yield of clinical symptoms, signs and x-ray in the diagnosis of foreign body aspiration score (FBA score).

Research design : Retrospective descriptive study

Methods : Collection data of Children 0-15 years old who were suspected foreign body aspiration and underwent bronchoscopy at Chonburi hospital during 1st January 2015 – 31th December 2020.

Results : The sample consisted of 20 patients, the patients had a mean age of 51.25 ± 52.84 months ,65% of whom were male. The peak incidence occurred in children aged ≤ 5 years (65%). Most common presented symptoms were sudden onset cough (100 %), choking (30%) noisy breathing (20%). Physical examination and CXR were abnormal in 80% and75 % respectively. Foreign body were identified in 14 (70%) of the total 20 children suspected foreign body aspiration. Organic foreign body were found in 40%, mainly peanut and fruit seeds (30%). The most frequent locations of foreign body were the right main bronchus (40%), and trachea (20%). The most common complication from foreign body aspiration was pneumonia (25%) which were found to be associated with length of stay (p = 0.01). Complications from bronchoscopy was acute hypoxia with respiratory failure (30%) which associated due to multiple bronchoscopies performed (p = 0.03). The yield of ≥ 3 FBA scores in diagnosis of FB were 100 % accuracy of 80 %.

Conclusion: Foreign body aspiration still common in children. Common complication from foreign body aspiration and bronchoscope treatment were pneumonia and acute respiratory failure. FBA score is the tool for early and accurately diagnosis in patients who suspected FBA.