Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576 104, India.
Department of Cardiothoracic and vascular surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576 104, India.
J Cardiothorac Surg. 2020 Sep 29;15(1):271. doi: 10.1186/s13019-020-01314-9.
Incidence of foreign body aspiration has been noticed predominantly in age group ranging from 12 months-3 years. Foreign body in the trachea is a medical emergency as presentation is in respiratory distress. Obstruction of only one main or distal bronchus, leads to severe cough, choking sensation and breathlessness. Without early intervention, it can lead to collapse, consolidation and pneumonia of the affected lung.
We retrospectively analyzed 37 pediatric case records who presented from January 2014-December 2018 with foreign body aspiration. Our primary aim was to assess the parameters responsible for early and late diagnosis of foreign body aspiration. We concluded with a diagnostic algorithm for management of foreign body aspiration on the basis of this outcome.
Around 32.5% came with a history of aspiration, 43% were referred from the primary centers with a suspicion for the same and the rest came to our tertiary care hospital directly. Those who presented within a week came with complaints of wet cough, wheeze and tachypnea. Furthermore, those who came in after a week had a dry cough and fever as their main complaint. Majority of ingested foreign bodies was a vegetative type (80%) as compared to the non -vegetative.
Unlike adults, foreign body aspiration in children is most commonly diagnosed on history, suspicion and clinical findings. Chest x ray has been the primary investigation of choice but in the majority of the cases it was normal with subtle changes. Early diagnosis is the key to avoid complication.
异物吸入的发生率主要见于 12 个月至 3 岁年龄组。气管内异物是一种医疗急症，表现为呼吸窘迫。仅一个主支气管或远侧支气管阻塞，可导致严重咳嗽、窒息感和呼吸困难。如果不早期干预，可能导致受累肺塌陷、实变和肺炎。
我们回顾性分析了 2014 年 1 月至 2018 年 12 月期间 37 例因异物吸入就诊的儿科病例记录。我们的主要目的是评估导致异物吸入早期和晚期诊断的参数。在此结果的基础上，我们得出了一种用于处理异物吸入的诊断算法。
约 32.5%的患者有异物吸入史，43%的患者因有同样的怀疑而从基层医院转诊，其余的则直接来我们的三级医院就诊。那些在一周内就诊的患者有湿咳、喘息和呼吸急促的症状。此外，那些在一周后就诊的患者主要表现为干咳和发热。与非植物性异物相比，摄入的异物中大多数为植物性（80%）。
与成人不同，儿童异物吸入通常根据病史、怀疑和临床发现进行诊断。胸部 X 线检查一直是首选的主要检查方法，但在大多数情况下，它是正常的，只有细微的变化。早期诊断是避免并发症的关键。
