Abstract
OBJECTIVES: The objective of this study was to analyze the epidemiological, clinical, radiological, and endoscopic characteristics of pediatric foreign body aspiration in Algeria. METHODS: In this retrospective study, the results of 2624 children younger than 18 years admitted to our department for respiratory foreign body removal between 1989 and 2012 were reviewed. Most of them underwent ambulatory rigid bronchoscopy. RESULTS: The children (62 males [34%] and 37 [65%] females) were aged 4 months to 18 years with 66% between 1 and 3 years of age. Choking was related in 65% of the cases. The delay between aspiration and removal was 2-8 days in 65.8% and within 24 h in 9.2%. In most cases, the children arrived with cough, laryngeal or bronchial signs, and unilateral reduction of vesicular murmur. The examination was normal in 13%. The most common radiologic finding was pulmonary air trapping (40.7%). The aspirated bodies were organic in 66 (7%), dominated by peanuts, while sunflower seeds, beans, and ears of wheat were the most dangerous. In the other cases, they were metallic or plastic such as pen caps and recently scarf pins. Over the last decade, metallic foreign bodies are dominated by scarf pins in Algeria. This accident is mainly related to wearing the Islamic headscarf. Our first case presented in 2003 and since then we have compiled 169 patients. Endoscopic removal by rigid bronchoscopy was successful and complete in 97%. Cases with extraction failure (3%) limited to certain foreign bodies, all of them inorganic, were assigned to surgery. The complications related to the endoscopic procedure were 0.29% with a mortality of 0.26%. CONCLUSION: Foreign body aspiration is a real public health problem in Algeria. Its frequency is high enough to alert health authorities. The characteristics of these domestic events are those of intermediate income countries with a wide range of foreign bodies. The best way to manage this is an early diagnosis and rigid bronchoscopy removal under general anesthesia used by fully trained staff. The prevention of this domestic accident should consider the population's lifestyle and cultural habits for maximum efficacy. Language: fr
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