Aspirated foreign bodies in the respiratory tract of children: eleven years experience with 127 patients

Abstract

During 10 years, 127 children were admitted to the pediatric ward because of aspiration of foreign bodies (0.56% of all admissions). Eighty-one percent of the children were under 3 years of age. One hundred and one children (80%) had a positive history of foreign body aspiration. Vegetable substances, particularly peanuts and grains, were the commonest type of foreign body removed. Clinical signs and radiological studies were, in most children, pathognomonic, but sometimes not conclusive. Chest X-rays were normal in 18%; fluoroscopy was diagnostic in 92%. Rigid bronchoscopy and subsequent removal of the foreign body was the treatment instituted. Pneumonia (the commonest complication) developed before and after bronchoscopy in 28% of the children. Pneumomediastinum and subcutaneous emphysema were present on admission in 2 children. Cardiac arrhythmias, bronchospasm, and cardiac arrest were recorded during bronchoscopy. Bronchiectasis developed in one, and persistent intractable pneumonia, requiring lobectomy, developed in another patient. One death occurred.