Foreign body aspiration in children

Fabio Midulla, Roberto Guidi, Angelo Barbato, Paolo Capocaccia, Nicola Forenza, Gianluigi Marseglia, Massimo Pifferi, Corrado Moretti, Enea Bonci, Fernando Maria De Benedictis

Research output: Contribution to journalArticle

Abstract

Background: The aim was to investigate the role of physical and radiological findings before bronchoscopy in the diagnosis of foreign body aspiration (FBA). Methods: We retrospectively reviewed the clinical records for 82 patients (mean age 26.4 ± 21.4 months, range 9 months to 13.5 years; 49 males) with a history suggestive of foreign body aspiration. Results: The presence of a foreign body in the airways was confirmed in 70 children (85.4%) (mean age 25 ± 14.1 months, 45 boys). Of the 70 children, 63 patients (90%) were under 3 years of age, with a peak incidence during the second year. Of the 70 foreign bodies retrieved, 46 (60%) were vegetable and 35 (76%) of these were nuts. In 42% of the patients the foreign body was located in the right bronchial tree. The most frequent physical findings observed in our patients were persistent cough (75%), localized decreased breath sound (62.8%) and localized wheezing (30%). The clinical triad (concomitant cough, localized wheezing and decreased breath sound) was present in 11 patients (15.7%). All clinical findings had a high positive predictive value with poor sensitivity. In 11 patients (20%) chest X-rays were normal. Five foreign bodies (9.1%) were radiopaque. The most frequent radiological findings observed were localized air trapping (43.6%), followed by atelectasis (40%). The diagnostic sensitivity was 80% and the specificity 33% for the presence of a single positive radiological finding. Conclusions: Our study confirmed that clinical symptoms and radiological findings before bronchoscopy have a low diagnostic value in children with a history of FBA.

Original languageEnglish
Pages (from-to)663-668
Number of pages6
JournalPediatrics International
Volume47
Issue number6
DOIs
Publication statusPublished - Dec 2005

Keywords

  • Bronchoscopy
  • Children
  • Foreign body aspiration

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Midulla, F., Guidi, R., Barbato, A., Capocaccia, P., Forenza, N., Marseglia, G., Pifferi, M., Moretti, C., Bonci, E., & De Benedictis, F. M. (2005). Foreign body aspiration in children. Pediatrics International, 47(6), 663-668. https://doi.org/10.1111/j.1442-200x.2005.02136.x