Clinico-radiological parameters predicting early diagnosis of foreign body aspiration in children.

Abstract

This study aims to investigate clinical and radiological findings to make early diagnosis of foreign body (FB) aspiration in children. This prospective study was conducted on 45 children younger than 12 years with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy between September 2010 and May 2014. The results of 37 children (22 males, 15 females; mean age 2.6 years; range 1 to 12 years) with positive for FB on bronchoscopy were analyzed. Penetration syndrome (sudden onset coughing, choking and gagging) (89.2%) and decreased breath sounds (86.5%) were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. Tachypnea, tachycardia, chest retractions, decreased chest movements and wheeze were present in 83.3%, 83.3%, 83.3%, 51.4% and 43.2% respectively. Unilateral hyperinflation (64.9%), mediastinal shift (45.9%), and collapse (21.6%) were common radiological signs on chest radiography and in 13.5% patients the chest X-rays were normal. Sites of FB lodgements were larynx, trachea, right main bronchus, left main bronchus and bilateral bronchi in 10.8%, 10.8%, 35.1%, 37.8 and 5.5% respectively. Food related FBs were present in 30 cases (peanut 54.1%) and inorganic FBs were present in seven cases. Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of FB aspiration.