Pediatric foreign body aspiration.

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1. Joshua D. Rovin, MD* 2. Bradley M. Rodgers, MD† 1. 2. *Division of Pediatric Surgery, Children’s Medical Center, University of Virginia Health Sciences Center, Charlottesville, VA. 3. 4. †Editorial Board. After completing this article, readers should be able to: 1. Delineate the signs and symptoms of foreign body aspiration. 2. Explain the process of evaluating for suspected foreign body aspiration. 3. Describe the possible radiographic manifestations of foreign body aspiration. 4. Explain the management of foreign body aspiration in children. 5. Delineate the potential late complications of foreign body aspiration. Aspiration of foreign bodies by children can lead to serious illness and sometimes even death. According to National Safety Council statistics, in 1995, mechanical suffocation accounted for 5% (167) of all unintentional deaths among children in the United States younger than 4 years of age. Most of these deaths occurred in children younger than 1 year of age (81 deaths, accounting for 10% of all unintentional deaths in children younger than 1 year of age). Fortunately, the number of deaths has decreased over the past decade, which has been attributed to better education of the public and stricter guidelines for toy manufacturers. Nevertheless, foreign body aspiration continues to account for a significant number of preventable childhood deaths. Younger children are at the highest risk for accidental foreign body aspiration. This increased incidence has been attributed to several factors among younger children, including that they: 1) have the tendency to put small objects into their mouths; 2) often cry, shout, run, and play with objects in their mouths; and 3) do not have molars to chew certain foods adequately. Most studies show that fewer than 15% of foreign body aspirations occur among children older than 5 years of age. Boys comprise more than 50% of all cases of foreign body aspiration. By far, the objects aspirated most frequently are organic or food matter. In North America, peanuts are most common (Table 1⇓ ). View this table: Table 1. Commonly Aspirated Foreign Bodies Unlike aspiration in adults, there is only a …