Fernández Jiménez I, Gutiérrez Segura C, Alvarez Muñoz V, Peláez Mata D
Servicio de Cirugía Pediátrica, Hospital Central de Asturias, Oviedo.
An Esp Pediatr. 2000 Oct;53(4):335-8.
Foreign body aspiration is one of the accidents with highest incidence, morbidity and mortality in childhood. It is favoured by curiosity and the immature swallowing mechanisms of this age group. To determine the most common signs and symptoms leading to the diagnosis of foreign body aspiration and to demonstrate the diagnostic value of a detailed anamnesis, we analyzed the cases of foreign body aspiration treated in our hospital between 1975 and 1997.
Retrospective study of 210 patients with suspected foreign body aspiration. In 208 patients rigid bronchoscopy was performed. Evidence of a foreign body was found in 90%.
We emphasize the clinical value of thorough anamnesis which showed high sensitivity (80%) in choking crises and persistent cough. Physical examination and respiratory auscultation showed high sensitivity (90%) but low specificity (16%). Chest X-ray showed the lowest sensitivity with 16% of false negatives. Most foreign bodies were vegetable fragments (82%), with a complication rate of 5.7%. Mortality was 0.9%, with no deaths occurring in the last 8 years.
