Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment

• Published in: Jornal brasileiro de pneumologia Vol. 34; no. 2; pp. 74 - 82
• Main Authors: Fraga, Andrea de Melo Alexandre, Reis, Marcelo Conrado Dos, Zambon, Mariana Porto, Toro, Ivan Contrera, Ribeiro, José Dirceu, Baracat, Emilio Carlos Elias
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil 01.02.2008
• Subjects: Age Distribution; Airway Obstruction - diagnosis; Airway Obstruction - etiology; Airway Obstruction - therapy; Bronchoscopy; Child; Child, Preschool; Cough - etiology; Diagnosis, Differential; Female; Foreign Bodies - complications; Foreign Bodies - diagnosis; Foreign Bodies - therapy; Humans; Infant; Inhalation; Male; Retrospective Studies; Time Factors
• ISSN: 1806-3756

To describe the clinical manifestations and bronchoscopic treatment of foreign body aspiration in children under 14 years of age, correlating the clinical aspects with the bronchoscopic findings. A retrospective, descriptive study analyzing data related to children under 14 years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005. The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age), 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%), auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%), and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts). In the follow-up period, 29% presented complications (most commonly pneumonia), which were found to be associated with longer aspiration time (p = 0.03). Mechanical ventilation was required in 7 children (10.1%), and multiple bronchoscopies were performed in 5 (7.2%). A history of sudden-onset choking and cough, plus abnormal auscultation and radiological findings, characterizes the profile of foreign body aspiration. In such cases, bronchoscopy is indicated. Longer aspiration time translates to a higher the risk of complications. The high prevalence of foreign bodies of vegetal origin underscores the relevance of prevention programs aimed at children younger than 3 years of age.