2019 Volume 55 Issue 6 Pages 1049-1055
Purpose: Foreign body aspiration into the airway in children leads to a serious condition that requires prompt management. A definitive diagnosis cannot always be obtained from chest X-ray images, as only 10% of foreign bodies are radiopaque. Furthermore, the removal of foreign bodies using a bronchoscope is technically difficult owing to the narrow airway in children.
Methods: Fifteen cases of foreign body aspiration at our institution were collected and analyzed retrospectively.
Results: Most of the patients (66.7%) were male, and 80% were under two years of age. Only three patients were diagnosed on the basis of symptoms. One patient was asymptotic. Chest X-ray showed radiopaque bodies in four patients. The most common foreign bodies were beans (40%). Computed tomography was performed in seven patients, and foreign bodies were detected in five patients. In six patients, no foreign bodies were detected by imaging modalities. The foreign body was removed in six patients using rigid bronchoscopy. In three patients, food-based foreign bodies were removed by irrigation and suction using flexible bronchoscopy because food-based foreign bodies were dissolving.
Conclusions: Foreign body aspiration in children shows nonspecific symptoms. Chest X-ray is not sufficiently sensitive, and although computed tomography is a sensitive modality, it sometimes shows false-negative findings. Detailed discussions regarding the aspiration history and symptoms are the most important factors for achieving a definitive diagnosis. Bronchoscopy should be considered for cases suspected of involving foreign body aspiration.
