Occult foreign body aspirations in pediatric patients: 20-years of experience

BMC Pulm Med. 2020 Dec 9;20(1):320. doi: 10.1186/s12890-020-01356-8.

Abstract

Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients.

Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed.

Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n = 25, 71.4%). Coughing (n = 35, 100%) and wheezing (n = 18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n = 10) and the most common inorganic foreign bodies were pen caps (n = 5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention.

Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.

Keywords: Foreign body; Occult; Paediatrics.

MeSH terms

  • Bronchi / injuries*
  • Bronchoscopy / methods*
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cough / etiology
  • Diagnosis, Differential
  • Female
  • Foreign Bodies / diagnosis*
  • Foreign Bodies / epidemiology
  • Foreign Bodies / therapy
  • Humans
  • Infant
  • Male
  • Respiratory Aspiration
  • Respiratory Sounds / etiology
  • Retrospective Studies