Laryngotracheal foreign bodies in children. A comparison with bronchial foreign bodies.
Twenty cases of laryngotracheal foreign bodies were reviewed over an 11-year period to determine features that differentiate these from bronchial foreign bodies. A history of choking or aspiration was obtained in 18 patients (90%). The most common presenting symptoms were stridor, wheezing, sternal retractions, and cough. The chest roentgenogram was most often normal (58% [11/19]). Posteroanterior and lateral neck roentgenograms suggested the diagnosis in 92% (12/13) of the patients. The correct diagnosis was made within the first 24 hours of presentation in 11 patients (55%); 19 patients (95%) were correctly diagnosed within one week. The incidence of major complications was 45% (9/20); however, in patients with a delay in diagnosis of over 24 hours the complication rate was 67% (6/9). For this reason, in children with a diagnosis of croup or reactive airway disease who respond poorly or whose condition deteriorates despite appropriate medical therapy, early endoscopy should be considered.
D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology; D001980:Bronchi; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007223:Infant; D007830:Larynx; D008297:Male; D011015:Pneumonia, Aspiration / Q000209:etiology; D012189:Retrospective Studies; D014132:Trachea