Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment.
OBJECTIVE
To describe the clinical manifestations and bronchoscopic treatment of foreign body aspiration in children under 14 years of age, correlating the clinical aspects with the bronchoscopic findings.


METHODS
A retrospective, descriptive study analyzing data related to children under 14 years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005.


RESULTS
The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age), 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%), auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%), and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts). In the follow-up period, 29% presented complications (most commonly pneumonia), which were found to be associated with longer aspiration time (p = 0.03). Mechanical ventilation was required in 7 children (10.1%), and multiple bronchoscopies were performed in 5 (7.2%).


CONCLUSIONS
A history of sudden-onset choking and cough, plus abnormal auscultation and radiological findings, characterizes the profile of foreign body aspiration. In such cases, bronchoscopy is indicated. Longer aspiration time translates to a higher the risk of complications. The high prevalence of foreign bodies of vegetal origin underscores the relevance of prevention programs aimed at children younger than 3 years of age.
Fraga
Andrea de Melo Alexandre
Ade M
Hospital das Clínicas da Universidade Estadual de Campinas - HC-Unicamp, State University at Campinas Hospital das Clínicas - Campinas, Brazil. andreafrag@gmail.com
Reis
Marcelo Conrado Dos
MC
Zambon
Mariana Porto
MP
Toro
Ivan Contrera
IC
Ribeiro
José Dirceu
JD
Baracat
Emilio Carlos Elias
EC
D017677:Age Distribution; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D001239:Inhalation; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors