Bronchoscopic removal of aspirated foreign bodies in children.

Foreign body aspiration is the cause of death in over 500 children per year in the United States. Tracheobronchial inhalation of foreign bodies may result in acute respiratory distress, chronic pulmonary infections, atelectasis, or death. A review of 262 children ranging from 4 months to 13 years of age was undertaken to identify factors important in diagnosis to illustrate the effectiveness of newer endoscopic techniques and equipment, and to evaluate results and complications. Coughing, choking, and wheezing were the presenting symptoms seen in 91 percent of the patients. Inspiratory and expiratory chest radiographs were positive in 81 percent of the 224 children with foreign bodies removed. Fluoroscopy was positive in 41 patients, 88 percent of whom had foreign bodies removed. Bronchoscopy is required for treatment, and with experience, this procedure can be simple and safe. Ninety-nine percent of foreign bodies identified at bronchoscopy were removed successfully. Minor complications occurred in 8 percent of the patients, and there were no deaths.