Eight years' experience with foreign-body aspiration in children: what is really important for a timely diagnosis?
OBJECTIVE
Aspiration of foreign bodies remains a major cause of morbidity and mortality in childhood. The aim of this study was to evaluate the predictive diagnostic value of clinical signs and symptoms, the history, and the radiology to perform early diagnosis and therapy.


METHODS
From January 1990 to March 1998, 87 children were admitted to the Pediatric Surgery Department of Universita di Padova because of suspected foreign body aspiration. Sensitivity and specificity of the considered diagnostic tools were evaluated.


RESULTS
Neither clinical signs and symptoms nor radiology have sufficient diagnostic sensitivity, and especially specificity, on which to rely for the diagnosis. Only the choking crisis, when present in the history, has good sensitivity and specificity (respectively, 96% and 76% in this series).


CONCLUSIONS
A choking crisis in the child's history should alert physicians to the possibility of a foreign body aspiration. In the present series, complications always were related to the diagnostic delay.
Metrangelo
S
S
Istituto di Anestesia e Rianimazione, Università di Padova, Italy.
Monetti
C
C
Meneghini
L
L
Zadra
N
N
Giusti
F
F
D000402:Airway Obstruction / Q000209:etiology; D001980:Bronchi; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D001239:Inhalation; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013997:Time Factors; D014132:Trachea