Abstract
Foreign body aspiration affects respiration immediately. Remaining in the lung, some foreign bodies may cause devastating pulmonary damage or inflammation. In spite of widespread education to parents, foreign body aspiration is still one of the serious emergent events in infants and children.
The diagnosis process and post-operative management will be discussed to achieve a successful treatment for foreign body aspiration, based on previous reports and recent therapeutic results in our department.
Food aspiration is found in approximately 90% of patients. In this 90%, foreign body aspiration is mainly of nuts, especially peanuts. 70% of patients are less than 2 years. The majority of the patients are one year old or a bit more. The aspiration of foreign bodies often occurs in association with rapid inspiration. Physical findings are mainly respiratory sounds, such as cough and stridor, with constitute 80% of all the symptoms.
Careful interview and chest auscultation are critical to diagnose foreign body aspiration. Chest X-ray roentogenography, CT scanning and MR imaging also may helpful for diagnosis. If there is good evidence for foreign body aspiration, endoscopic examination should also be performed.
Foreign bodies are usually taken out under general anesthesia, using a ventilation bronchoscopie, rigid bronchoscope with an adapter required for anesthesia. 20% foreign bodies lodge in the trachea and 70% in the main bronchus, with no statistical difference between the right and left main bronchus. There may be more two foreign bodies in the airways, and they may lodge in different places.
The rigid bronchoscope should be operated very carefully to avoid unfavorable complications, such as injury to the tracheobronchial mucosa. Post-operative management include therapy for pneumonia caused by foreign bodies and prevention complications.
