Pediatric aerodigestive foreign body injuries are complications related to timeliness of diagnosis.
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.
Reilly
J
J
Department of Pediatric Otolaryngology, A.I. duPont Children's Hospital, Wilmington, Del. 19899, USA.
Thompson
J
J
MacArthur
C
C
Pransky
S
S
Beste
D
D
Smith
M
M
Gray
S
S
Manning
S
S
Walter
M
M
Derkay
C
C
Muntz
H
H
Friedman
E
E
Myer
C M
CM
Seibert
R
R
Riding
K
K
Cuyler
J
J
Todd
W
W
Smith
R
R
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