Foreign bodies in the airway: a quarter of a century's experience.
BACKGROUND
Foreign body (FB) aspiration in children is a common and potentially dangerous situation that can be associated to significant morbidity.


OBJECTIVE
To characterise the FB aspiration in children cases at the Hospital Pediátrico de Coimbra over a twenty five year period.


METHODS
This study was based on the retrospective analysis of all clinical files of children who were diagnosed with foreign body aspiration January 1982 to December 2006.


RESULTS
Foreign body aspiration was confirmed in 316 children. The incidence was higher during the first twelve years of the study (64%). Around two thirds of the children were male (206) and the sample was aged 6 months to 12 years. Most children were younger than 3 years old (83%). In 88% of cases a choking episode was noticed while an early diagnosis (<24h) was obtained in only 39%. The most frequently described signs and symptoms were unilateral diminished breath sounds and cough. In 7% of cases no symptoms were described. The most frequently recorded radiology finding was focal hyperinflation (42%) and in 22% the chest x-ray was unremarkable. Treatment was exclusively by rigid bronchoscopy. Complications related to the bronchoscopy removal were described in 22 cases. Most aspirated FB were of vegetable origin (75%). The majority of FB was lodged in the right bronchial tree. Postremoval flexible bronchoscopy was performed in 116 cases.


CONCLUSIONS
An unnoticed FB aspiration and absence of and/or non-specific initial symptoms may contribute to a late diagnosis. The significant reduction in the number of cases over the later years may be related to the implementation of preventive strategies.
Roda
Juliana
J
Paediatrics, Hospital Pediátrico de Coimbra, Centro Hospitalar de Coimbra.
Nobre
Susana
S
Pires
Jorge
J
Estêvão
M Helena
MH
Félix
Miguel
M
D015510:Clinical Medicine