Occult foreign body aspirations in pediatric patients: 20-years of experience
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RESEARCH ARTICLE
Open Access
Occult foreign body aspirations in pediatric patients: 20-years of experience Bo Liu1,2* , Fengxia Ding3,2, Yong An1, Yonggang Li1, Zhengxia Pan1, Gang Wang1, Jiangtao Dai1, Hongbo Li1 and Chun Wu1
Abstract Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients. Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed. Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n = 25, 71.4%). Coughing (n = 35, 100%) and wheezing (n = 18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n = 10) and the most common inorganic foreign bodies were pen caps (n = 5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention. Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration. Keywords: Occult, Foreign body, Paediatrics Background Foreign body aspiration (FBA) is a common and serious health problem in childhood. It has a high incidence and can even be life-threatening [1]. Children under 3 years of age are most vulnerable to FBA, which is related to their narrow airways and immature protective neuromuscular mechanisms [2]. Most of them can be suspected of having a definite history of aspiration. In general, irritating *Correspondence: [email protected] 1 Department of Cardiothoracic Surgery; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan 2nd Road, Yuzhong Dis, Chongqing 400014, China Full list of author information is available at the end of the article
cough or roaring occurs immediately after inhaling a foreign body (FB). Subsequent chronic symptoms such as cough, wheezing, stridor, fever, shortness of breath, and dyspnea often trigger the guardian’s alert so that the child can be promptly diagnosed and treated. However, in very few cases, symptoms are mild or undetected after aspiration of the foreign body and the foreign body can stay in the bronchi for months or even years. The clinical symptoms and signs caused by foreign bodies are often not specific and the imaging signs are also not
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