Clinico-radiological parameters predicting early diagnosis of foreign body aspiration in children.

OBJECTIVES: This study aims to investigate clinical and radiological findings to make early diagnosis of foreign body (FB) aspiration in children.

PATIENTS AND METHODS: This prospective study was conducted on 45 children younger than 12 years with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy between September 2010 and May 2014. The results of 37 children (22 males, 15 females; mean age 2.6 years; range 1 to 12 years) with positive for FB on bronchoscopy were analyzed.

RESULTS: Penetration syndrome (sudden onset coughing, choking and gagging) (89.2%) and decreased breath sounds (86.5%) were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. Tachypnea, tachycardia, chest retractions, decreased chest movements and wheeze were present in 83.3%, 83.3%, 83.3%, 51.4% and 43.2% respectively. Unilateral hyperinflation (64.9%), mediastinal shift (45.9%), and collapse (21.6%) were common radiological signs on chest radiography and in 13.5% patients the chest X-rays were normal. Sites of FB lodgements were larynx, trachea, right main bronchus, left main bronchus and bilateral bronchi in 10.8%, 10.8%, 35.1%, 37.8 and 5.5% respectively. Food related FBs were present in 30 cases (peanut 54.1%) and inorganic FBs were present in seven cases.

CONCLUSION: Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of FB aspiration.