Bronchoscopy in childhood.

One hundred and seventeen patients underwent 183 bronchoscopies with no fatalities. Thirteen patients had complications related to their bronchoscopy and not the underlying disease state. Only the 33 patients with a diagnosis of foreign body aspiration had a high (88%) correlation of the preoperative diagnosis or condition and the postoperative findings. Fifty-one of the 117 patients had normal bronchoscopies and the number of normal bronchoscopies in patients who had wheezing, croup, hoarseness, stridor, and chronic cough was high. Assessing justification for bronchoscopies despite the negative correlation of pre- and postoperative diagnosis is difficult due to many factors, including pediatrician and parental anxiety, and the recognized consequences of missing a foreign body or other lesion in the airway of a child. Using liberal criteria for justification. fewer than 10% of the patients in this series had an unwarranted bronchoscopy, and the safety of the procedure would indicate that bronchoscopy in a pediatric medical center should be performed with minimal clinical justification.