Clinico-Radiological Profile and Outcome of Airway Foreign Body Aspiration in Children: A Single-Center Experience From a Tertiary Care Center in Eastern India

Abstract

BackgroundForeign body aspiration is one of the leading causes of childhood morbidity and mortality among older infants and toddler age groups. Missed and delayed diagnosis of foreign body aspiration can lead to increased incidence of complications. Early diagnosis can prevent life-threatening complications and morbidity. In this study, we aimed to evaluate the clinical and radiological details, types, localization of foreign bodies, complications, and outcomes in pediatric patients who presented to our hospital with foreign body aspiration. MethodologyWe conducted a retrospective analysis of hospital case records of children aged one month to 14 years who were admitted to the Department of Pediatrics between June 2018 and May 2020, with clinical suspicion of foreign body aspiration. ResultsA total of 22 children with a diagnosis of airway foreign body were included. The mean age of presentation was three years (SD: ±2.22), with a boy-to-girl ratio of 3.4:1. Cough (81.8%) and tachypnea (72.7%) were the most common clinical symptoms. The median duration between symptom onset and diagnosis was three (interquartile range: 6) days. Unilateral reduced breath sound (81.8%) was the most common clinical examination finding. The common site of impaction was the right main bronchus in 59.1% of cases. The foreign bodies retrieved during bronchoscopy were organic substances in 63.6% of cases, with peanuts being the most common (31.8%). Chest radiographs were normal in 36.3% of cases, and common abnormalities included hyperinflation, collapse, consolidation, and mediastinal shift. Mechanical ventilation was required in 54.5% of cases. The mean duration of hospitalization was five (SD: ±2.84) days. Complications such as pneumothorax were seen in one (4.5%) case. Mortality was seen in 4.54% of cases during the bronchoscopic procedures. ConclusionsForeign body aspiration was common in young male children, with cough being the common symptom. Normal X-rays of the chest were seen in one-third of cases. The common site of impaction was the right main bronchus, and organic substances such as peanuts were common foreign bodies retrieved. Strong clinical suspicion of foreign body aspiration should be kept in cases with acute onset of cough in young children. Prompt medical attention is needed to reduce the morbidity and mortality associated with foreign body aspiration.

Tamarind Seeds in Tracheobronchial Tree: Challenges during Rigid Bronchoscopy

“…The violent coughing bouts are followed by an asymptomatic period, after which persistent bothersome cough remains the main symptom. [ 1 ] The combination of cough and dyspnea is a late symptom associated with retained tracheobronchial foreign bodies. A meticulous history obtained from the parents and clinical suspicion is essential to diagnose foreign body aspiration.…”

“…The aspiration risk is higher in the 1–3 year age group due to their propensity for oral exploration, inadequately developed dentition and immature neuromuscular mechanisms of deglutition and airway protection. [ 1 , 2 ] Vegetative or organic foreign bodies such as ground nuts and peanuts account for about 75% of aspirated vegetable foreign bodies. [ 1 2 3 ] Tamarind seed aspiration is usually observed in kids from rural backgrounds, with easy access to tamarind fruits and their by-products.…”

“…[ 1 , 2 ] Vegetative or organic foreign bodies such as ground nuts and peanuts account for about 75% of aspirated vegetable foreign bodies. [ 1 2 3 ] Tamarind seed aspiration is usually observed in kids from rural backgrounds, with easy access to tamarind fruits and their by-products. [ 2 , 4 ] Tamarind seeds obtained from the dried, ripe, and mature fruits of Tamarindus indica have a thick, hard, glossy brown/black coat making them slippery.…”

A Research Study on Prompt Results and Physical Assessment of Mechanically Ventilated Children

“…[33] A study found the highest mortality rate of up to 58.3% [34] as opposed to the lowest only 4.5%. [35] Less than 2% of patients in PICUs who were mechanically ventilated died overall in wealthy nations 2. Groups B and C had the highest death rates (33.3%), followed by group A (28.2%), however, this difference was statistically insignificant (p=0.064).…”

Pneumothorax/pneumomediastinum as a complication of foreign body inhalation in 3 pediatric patients: A case series

“…[24] Of the 22 children studied by Sai Akhil et al, 63.6% of the foreign bodies removed during bronchoscopies were found to be composed of organic components, with peanuts being the most often (31.8%). [25] Fidkowski et al found that most aspirated foreign bodies among children were formed of organic materials in a review of the literature on Research consistently shows that peanuts and other nuts, as well as seeds like sunflower and watermelon, were the most commonly aspirated foreign bodies. [26] Pneumomediastinum as a complication of FBA is a very rare condition among pediatrics.…”