Comparative analysis of computed tomography scan and flexible bronchoscopy in the evaluation of suspected foreign body aspiration in children and the role of later in its removal

Abstract

Background: Foreign body aspiration (FBA) in children is considered one of the most important diagnostic and therapeutic challenges for physicians. Often there is no history of aspiration of foreign body in this population and these children present with a wide range of nonspecific signs and symptoms. The objective of the study was to study the diagnostic utility of chest computed tomography (CT) scan in children with suspected FBA in comparison to flexible bronchoscopy (FB) and the role of later as a therapeutic tool in the removal of airway foreign bodies. Methods: This was a prospective observational study conducted from January 2015 to August 2019. Children admitted for persistent respiratory symptoms underwent CT chest and FB for confirmation of the diagnosis and retrieval of the foreign body if present. Results: A total of 101 patients of both genders were enrolled in the study. Fifty-three participants were boys and 48 were girls. FBA was diagnosed in 53 patients on chest CT. On FB, FBA was confirmed in 55 patients. The sensitivity and specificity of chest CT in our study were 85% and 87% respectively. In 25 of these patients, removal was successfully done by the FB. Conclusion: We conclude that a Chest CT scan is inferior to FB in the diagnosis of suspected trachea-bronchial foreign bodies in children. FB as a therapeutic tool has an excellent safety record in the retrieval of airway foreign bodies in this population.