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Foreign Body Aspiration in Children—Retrospective Study and Management Novelties

Authors :
Dana Elena Mîndru
Gabriela Păduraru
Carmen Daniela Rusu
Elena Țarcă
Alice Nicoleta Azoicăi
Solange Tamara Roșu
Alexandrina-Ștefania Curpăn
Irina Mihaela Ciomaga Jitaru
Ioana Alexandra Pădureț
Alina Costina Luca
Source :
Medicina, Vol 59, Iss 6, p 1113 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

Foreign body aspiration (FBA) is a frequent diagnosis in children. In the absence of other lung conditions, such as asthma or chronic pulmonary infections, this manifests as a sudden onset of cough, dyspnea, and wheezing. The differential diagnosis is based on a scoring system which takes into account the clinical picture as well as the radiologic aspects. The treatment that is considered the gold-standard for FBA in children remains to be rigid fibronchoscopy, however it comes with several potentially crucial local complications such as airway edema, bleeding, and bronchospasm, along inherent issues due to general anesthesia. Material and methods: Our study is a retrospective study analyzing the medical files of the cases from our hospital over the span of 9 years. The study group consisted of 242 patients aged 0–16 years diagnosed with foreign body aspiration in the Emergency Clinical Hospital for Children “Sfânta Maria” Iași, between January 2010–January 2018. Clinical and imaging data were extracted from the patients’ observation sheets. Results: In our cohort, the distribution of children with foreign body aspiration was uneven, with the highest incidence being reported in children from rural areas (70% of cases), whereas the most affected age group was 1–3 years, amounting to 79% of all cases. The main symptoms which led to emergency admittance were coughing (33%) and dyspnea (22%). The most important factors that determined the unequal distribution were socio-economic status, which relates to a lack of adequate supervision by parents, as well as the consumption of food inappropriate for their age. Conclusions: Foreign body aspiration is a major medical emergency that may be associated with dramatic clinical manifestations. Several scoring algorithms designed to establish the need for bronchoscopy have been proposed, taking into account both the clinical and radiological results. The issue with asymptomatic or mild symptomatic cases, as well as difficulties managing cases with radiolucent foreign bodies, remains a challenge.

Details

Language :
English
ISSN :
16489144 and 1010660X
Volume :
59
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Medicina
Publication Type :
Academic Journal
Accession number :
edsdoj.73afcccb9ba9451e808679e38abf373a
Document Type :
article
Full Text :
https://doi.org/10.3390/medicina59061113