Otolaryngologia polska = The Polish otolaryngology · 2015
Factors predicting early diagnosis of pediatric laryngotracheobronchial foreign bodies.
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Parida Pradipta, Nirmal Nirmal Shanmugasundaram, Gopalakrishnan Surianarayanan, Saxena Sunil Kumar
Аннотация
OBJECTIVE: To study the clinical and radiological findings to make early diagnosis of foreign body (FB) aspiration in children.
METHODS: This prospective study was conducted on 45 children below 12 years of age with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy from September 2008 to may 2010.
RESULTS: Bronchoscopy was positive for FB in 37 children. The results of these 37 children (15 female and 22 male) were analyzed. 81% of children were in age group of 1-3 years. Penetration syndrome (sudden onset coughing, choking and gagging when the child is having something in the mouth) (89.2%) and decreased breath sounds (86.5%) were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. Tachypnoea, tachycardia, chest retractions, decreased chest movements and wheeze were present in 83.3%, 83.3%, 83.3%, 51.4% and 43.2% respectively. Unilateral hyperinflation (64.9%), mediastinal shift (45.9%), and collapse (21.6%) were common radiological sign on chest radiograph and in 13.5% patients the chest X-rays were normal. Sites of FB lodgments were larynx, trachea, right main bronchus, left main bronchus and bilateral bronchi in 10.8%, 10.8%, 35.1%, 37.8 and 5.5% respectively. Food related FBs were present in 30 cases (peanut in 54.1%) and inorganic FBs were present in 7 cases. FBs were removed successfully by rigid bronchoscopy in all cases without any mortality.
CONCLUSIONS: Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of FB aspiration.
METHODS: This prospective study was conducted on 45 children below 12 years of age with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy from September 2008 to may 2010.
RESULTS: Bronchoscopy was positive for FB in 37 children. The results of these 37 children (15 female and 22 male) were analyzed. 81% of children were in age group of 1-3 years. Penetration syndrome (sudden onset coughing, choking and gagging when the child is having something in the mouth) (89.2%) and decreased breath sounds (86.5%) were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. Tachypnoea, tachycardia, chest retractions, decreased chest movements and wheeze were present in 83.3%, 83.3%, 83.3%, 51.4% and 43.2% respectively. Unilateral hyperinflation (64.9%), mediastinal shift (45.9%), and collapse (21.6%) were common radiological sign on chest radiograph and in 13.5% patients the chest X-rays were normal. Sites of FB lodgments were larynx, trachea, right main bronchus, left main bronchus and bilateral bronchi in 10.8%, 10.8%, 35.1%, 37.8 and 5.5% respectively. Food related FBs were present in 30 cases (peanut in 54.1%) and inorganic FBs were present in 7 cases. FBs were removed successfully by rigid bronchoscopy in all cases without any mortality.
CONCLUSIONS: Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of FB aspiration.