Lima João A B, Fischer Gilberto Bueno
Rua Henrique Scliar, 225 Porto Alegre, Brazil.
Paediatr Respir Rev. 2002 Dec;3(4):303-7. doi: 10.1016/s1526-0542(02)00265-8.
Foreign body aspiration is a common accident in children and represents an important cause of morbidity and mortality. Diagnosis of this condition demands a high degree of suspicion since physical examination and basic radiology exams have low sensitivity. It is more frequent in children younger than 3 years of age, predominantly boys. Food materials are most commonly involved, particularly peanuts, although this could change according to regional feeding habits. The right main bronchus is the site where foreign bodies are most commonly found. Radiographical findings are not diagnostic, but the presence of unilateral obstructive emphysema or atelectasis are important clues. A rigid endoscopy is indicated whenever there is a suggestive history, since delays in removing foreign bodies can lead to severe bronchial sequelae. In developing countries this type of accident may be more relevant due to the lack of resources and awareness, which can lead to late diagnosis and treatment. Routine preventive measures must be taught to caregivers in order to reduce the incidence. Health care professionals should also be made more aware of the prevalence of this condition.
异物吸入是儿童常见的意外事件,是发病和死亡的重要原因。由于体格检查和基础放射学检查的敏感性较低,对这种情况的诊断需要高度怀疑。3岁以下儿童更为常见,以男孩为主。食物材料最常涉及,尤其是花生,不过这可能因地区饮食习惯而有所不同。右主支气管是最常发现异物的部位。影像学表现不具有诊断性,但单侧阻塞性肺气肿或肺不张的存在是重要线索。只要有提示性病史,就应进行硬质内镜检查,因为异物清除延迟会导致严重的支气管后遗症。在发展中国家,由于资源匮乏和意识不足,这类意外事件可能更为严重,可能导致诊断和治疗延迟。必须向护理人员传授常规预防措施以降低发病率。医护人员也应更加了解这种情况的普遍性。