Najmul Hasan, Ghulam Murtaza, Afroze Ramzan.
Foreign body aspiration in children.
Pak Paed J Jan ;34(1):33-8.

Objective: To know the common presentation, nature and outcome of foreign body aspiration. Design: Descriptive – case series. Place & duration of study: National Institute of Child Health- Karachi from February to May 2000. Patients & Method: Children from 6 months to 13 years, of either sex having the following features were included:- - Definite history of choking OR - Sudden onset of respiratory symptoms and signs unrelieved by medical measures OR - Chronic respiratory symptoms and signs not explainable for specific diseases. A detailed proforma was filled-in including history, examination and Investigation. Bronchoscopy was done in every case. Patients in whom foreign body was found on bronchoscopy were further studied in detail. Results: During this study period sixty three patients were enrolled fulfilling the inclusion criteria. Out of 63 cases 55 were found to have foreign body on bronchoscopy. Out of fifty five, 34 (61.8%) were male and 21 (38.1%) were female. Male to female ratio was 1.6:1. Most of the patients i.e. 25(45.0%) belonged to 1-3 year age group. Common symptoms were cough, breathlessness, choking and wheezing. Common signs were tachypnea, decreased air entry and ronchi / crepitation. In 65% of patients there were different radiological findings, unilateral hyperinflation being the most common one i.e. in 30% patients and all of them had foreign body on bronchoscopy. Twenty two patients in whom X-Ray chest were normal, 15 patients (68%) had foreign body on bronchoscopy. Out of 55 patients two most common foreign bodies were betel nuts in 26 patients (47%) and whistle or parts of it in 16 patients (29%). Ultimately all of the 63 patients who underwent bronchoscopy recovered completely. Conclusions: Children between 1-3 years of age are high risk group for foreign body aspiration. Common mode of presentations are presence of history of choking, sudden onset of respiratory distress with attacks of cough, decreased air entry or with long standing respiratory symptoms and signs not responding to medical treatment. X-Ray chest may be normal in many patients. Two most common foreign bodies were betel nuts and whistles or part of them. Foreign body aspiration is a preventable condition. Measures should be taken to prevent it.

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