Clinical variables responsible for early and late diagnosis of foreign body aspiration in pediatrics age group
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(2020) 15:271
RESEARCH ARTICLE
Open Access
Clinical variables responsible for early and late diagnosis of foreign body aspiration in pediatrics age group Samarth Goyal1, Shubhika Jain1, Guruprasad Rai2* , Rajkamal Vishnu2, Ganesh Sevagur Kamath2, Arvind Kumar Bishnoi2, Yogesh Gaude3, Vijaya Kumara3, Harshil Joshi3 and Revanth Reddy2
Abstract Background: Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention, it can lead to collapse, consolidation and pneumonia of the affected lung. Methods: We retrospectively analyzed 37 pediatric case records who presented from January 2014–December 2018 with foreign body aspiration. Our primary aim was to assess the parameters responsible for early and late diagnosis of foreign body aspiration. We concluded with a diagnostic algorithm for management of foreign body aspiration on the basis of this outcome. Results: Around 32.5% came with a history of aspiration, 43% were referred from the primary centers with a suspicion for the same and the rest came to our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea. Furthermore, those who came in after a week had a dry cough and fever as their main complaint. Majority of ingested foreign bodies was a vegetative type (80%) as compared to the non –vegetative. Conclusion: Unlike adults, foreign body aspiration in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in the majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication. Keywords: Bronchus, Foreign body (FB), Foreign body aspiration (FBA), Rigid bronchoscopy
Background Foreign body aspiration is an egregious medical emergency [1]. Both adults and children have a tendency to inhale foreign bodies. The object enters into the trachea and usually goes further down and lodges in one of the bronchus. Children have a tendency to swallow whatever * Correspondence: [email protected] 2 Department of Cardiothoracic and vascular surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka 576 104, India Full list of author information is available at the end of the article
comes into their hands, which include a wide variety of objects like coin, parts of toys, seeds, nuts, etc. and when they cry or laugh or jump with the mouth full, the FB can enter the airway in deep inspiration. In adult’s the main cause for aspiration is trying to swallow food when they are under intoxication and common FB are unchewed food, fish bone, etc. FBA is said to be a primary cause of accidental death in children under 12 months to 3 years of age [2]. Literatures suggest sex disc
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