Foreign body inhalation in children: clinical presentations and x-ray chest findings

Abstract

Background: Foreign body aspiration (FBA) is a medical emergency in children. Delay in diagnosis and treatment can cause complications and even deaths are reported. Objective: The aim of this study was to find out clinical features and x-ray findings in patients with FBA. Materials and Methods: A retrospective analysis was done on all patients less than 15 years of age with the discharge diagnosis of FBA from 2011 to 2014 at SMHS Hospital in Kashmir province. Results: Out of 140 patients with FBA, 87 (62%) were male. The mean age was 48 months. The most common clinical findings were history of chocking (77%), decreased breath sounds (42%), wheezing (38%), cough (20%), respiratory distress (15.5%), and fever. CXR was normal in 46% of patients. Air trapping (emphysema) was the most common radiological finding (29.5%) followed by atelectasis (14%) and consolidations (9.2%) and opaque foreign bodies (5.7%). Gram seeds (pulses) were the commonest foreign body (40%). Bronchoscopic removal of foreign body was done successfully in 133 patients (95%). Conclusion: Although FBA in children diagnosed by history, physical examination and radiographic findings, but this finding may be misleading. Negative X-ray chest should not exclude the diagnosis of FBA in children especially with a strong history of FBA. Early bronchoscopic examination will be safe and lifesaving.