title: Pediatric aerodigestive foreign body injuries are complications related to timeliness of diagnosis.
abstract: Foreign body (FB) injury from aspiration or ingestion is a common pediatric health problem. Diagnosis relies on clinical judgment plus medical history, physical examination, and radiographic evaluation. A multi-institutional review of 1269 FB events revealed that 85% were correctly diagnosed following a single physician encounter. However, 15% of the children had an elusive diagnosis (>1 week), despite previous evaluation. Delays in diagnosis were seven times more likely to occur in aspirations than in ingestions. Secondary injuries (e.g., pneumonia and atelectasis) occurred in 13% of airway FBs but in only 1.7% of esophageal FBs. Plain radiographs were used in 82% of children, and special studies (e.g., fluoroscopy) in only 7%. We conclude that diagnosis of FB injury in children is frequently achieved at the initial evaluation but that continued surveillance by follow-up visits to health care facilities from parents and other caretakers is important, to reduce pulmonary injuries.
authors.affiliation: Department of Pediatric Otolaryngology, A.I. duPont Children's Hospital, Wilmington, Del. 19899, USA.
authors.forename: J
authors.initials: J
authors.lastname: Reilly
authors.forename: J
authors.initials: J
authors.lastname: Thompson
authors.forename: C
authors.initials: C
authors.lastname: MacArthur
authors.forename: S
authors.initials: S
authors.lastname: Pransky
authors.forename: D
authors.initials: D
authors.lastname: Beste
authors.forename: M
authors.initials: M
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Gray
authors.forename: S
authors.initials: S
authors.lastname: Manning
authors.forename: M
authors.initials: M
authors.lastname: Walter
authors.forename: C
authors.initials: C
authors.lastname: Derkay
authors.forename: H
authors.initials: H
authors.lastname: Muntz
authors.forename: E
authors.initials: E
authors.lastname: Friedman
authors.forename: C M
authors.initials: CM
authors.lastname: Myer
authors.forename: R
authors.initials: R
authors.lastname: Seibert
authors.forename: K
authors.initials: K
authors.lastname: Riding
authors.forename: J
authors.initials: J
authors.lastname: Cuyler
authors.forename: W
authors.initials: W
authors.lastname: Todd
authors.forename: R
authors.initials: R
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003679:Deglutition; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D001239:Inhalation; D008297:Male; D012137:Respiratory System; D012189:Retrospective Studies