Diagnosis and Treatment of Foreign Bodies in the Airway in Paediatrics: A Case Series
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Abstract
Background
Foreign body aspiration is an emergency in the paediatric population. Delay in diagnosis may lead to complications.
Purpose
To present our experience with the diagnosis and management of foreign body aspiration in children treated in a general hospital.
Methods
A total of 59 patients were admitted between January 2012 and May 2016 due to the ingestion or aspiration of foreign bodies. Five patients had a surgical procedure to remove the foreign body from their airway. A review was made of their medical charts in order to analyse patient characteristics, symptoms, time from aspiration to emergency visit, findings on chest x-ray, type and location of the foreign body, and treatment.
Results
Three girls and two boys between two and eight years of age had a surgical procedure for foreign body aspiration. Two patients (40%) were seen in the emergency department two hours after the event, and one of them was sent back home due to a wrong interpretation of x-ray findings. Three patients were seen in the emergency department 3-10 days after foreign body aspiration, with fever and lower respiratory symptoms, and one was treated for pneumonia for six days before the diagnosis of foreign body aspiration was made. One patient did not have an x-ray film, and the diagnosis was clinical. Three (60%) foreign bodies were metallic, one (20%) was plastic, and one (20%) was organic. All foreign bodies were found on the right side of the chest, and those located in the upper airways were extracted with rigid bronchoscopy. One patient was subjected to thoracoscopy to retrieve a needle from the lung parenchyma.
Conclusions
Delay in diagnosis and misinterpretation of chest x-ray may lead to complications and morbidity in children with foreign body aspiration. Clinicians must have a high index of suspicion and rely on patient history and symptoms to prompt a timely referral to the paediatric surgeon.
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