Losek J D
Department of Pediatrics, Medical College of Wisconsin, Milwaukee.
Am J Emerg Med. 1990 Jul;8(4):348-50. doi: 10.1016/0735-6757(90)90094-g.
A case of a 4-year-old child who aspirated a 22-caliber bullet is presented to illustrate the variability of signs and symptoms of foreign body aspiration. Despite the large size of the bullet, cough, dyspnea, and wheezing were absent on presentation. Chest roentgenogram confirmed the diagnosis of a radiopaque bronchial foreign body. A retrospective review of 42 additional children with foreign body aspiration showed 8 (19%) were unwitnessed, 24 (57%) were asymptomatic at presentation, 8 (19%) had normal physical examinations, and 10 (24%) had normal inspiratory/expiratory chest roentgenograms. This demonstrates the importance of considering bronchoscopy for any child who presents with a history of possible foreign body aspiration, but is asymptomatic and has normal roentgenographic findings.
本文介绍了一例4岁儿童误吸一枚22口径子弹的病例，以说明异物误吸体征和症状的多样性。尽管子弹体积较大，但患儿就诊时无咳嗽、呼吸困难及喘息症状。胸部X线片确诊为不透X线的支气管异物。对另外42例异物误吸儿童的回顾性研究显示，8例（19%）误吸情况未被目击，24例（57%）就诊时无症状，8例（19%）体格检查正常，10例（24%）吸气/呼气胸部X线片正常。这表明，对于任何有异物误吸可能病史但无症状且X线检查结果正常的儿童，考虑进行支气管镜检查具有重要意义。
