Foreign body aspiration in a tertiary Syrian centre: A 7-year retrospective study

Fatema Mohsen; Batoul Bakkar; Sara Melhem; Roula Altom; Bisher Sawaf; Imad Alkhija; Louei Darjazini Nahas

doi:10.1016/j.heliyon.2021.e06537

Foreign body aspiration in a tertiary Syrian centre: A 7-year retrospective study

Heliyon. 2021 Mar 17;7(3):e06537. doi: 10.1016/j.heliyon.2021.e06537. eCollection 2021 Mar.

Authors

Fatema Mohsen¹, Batoul Bakkar¹, Sara Melhem¹, Roula Altom¹, Bisher Sawaf^{2

3

4}, Imad Alkhija⁵, Louei Darjazini Nahas⁶

Affiliations

¹ Faculty of Medicine, Syrian Private University, Damascus, Syria.
² Department of Internal Medicine, Faculty of Medicine, Syrian Private University, Damascus, Syria.
³ Faculty of Medicine, American University of Beirut Medical Centre Beirut, Lebanon.
⁴ Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
⁵ Department of Otorhinolaryngology, Faculty of Medicine, Al Mouwasat University Hospital, Syria.
⁶ Department of Surgery Division of Otorhinolaryngology, Faculty of Medicine, Syrian Private University, Damascus, Syria.

Abstract

Background: Paediatric foreign body aspiration constitutes significant lethal sequela worldwide. This is the first descriptive Syrian study that aims to describe the epidemiology of foreign body aspiration in a tertiary centre in Syria.

Methods: This is a retrospective cohort study conducted at the Children's University Hospital, Damascus, from 2011 to 2018 during the Syrian crisis. The children underwent rigid bronchoscopy at Al Mouwasat University hospital, the only properly equipped hospital to perform paediatric rigid bronchoscopy in Damascus. We included all cases with complete medical records of children under the age of 13 years with positive bronchoscopy findings of foreign body aspiration. The records of patients were examined, and data extracted included physical examination, CXR reports, bronchoscopy reports, and complications. Statistical package for social sciences 25.0 program for Windows was used to report frequencies, percentages, means, medians, and standard deviations.

Results: Of 560 children diagnosed with foreign body aspiration, the peak incidence was at the age of 1-3 years 376 (67.2%). Most patients presented with an explicit history of inhalation 453 (80.9%). The most frequent clinical findings were dyspnoea 320 (57.1%), wheezing 308 (55%), and chest retraction 209 (37.35%). Hyperinflation 260 (46.4%) followed by pulmonary infiltration 197 (35.2%) were the most common abnormal radiological findings. Seeds 273 (48.8%) were the most frequent foreign body extracted by rigid bronchoscopy. The right main bronchus 255 (40.2%) was the most frequent site of foreign body lodgement. Lobar pneumonia 16 (2.8%) was the commonest complication of foreign body aspiration.

Conclusion: Foreign body aspiration is a major public health problem in Syria. The child's welfare must be our paramount concern. To prevent this accident, we should address a change in raising public health awareness with regards to appropriate food and eating habits. This would limit hazardous complications.

Keywords: Bronchoscopy; Children; Foreign body aspiration; Paediatric; Syria; War.