Jamshed Akhtar, Farhat Mirza, Soofia Ahmed, Ali Raza Brohi, Nayma Rasool, Abdul Aziz.
Diagnostic Value Of Clinical Profile Of Patients With Foreign Body Aspiration.
J Coll Physicians Surg Pak Jan ;11(9):554-6.

Objective: Foreign body aspiration is a true emergency with significant morbidity and at times mortality. The aim of this study was to evaluate the clinical profile of the patients suspected of foreign body aspiration so as to know how reliable they were in making decision of bronchoscopy. Design : A prospective study. Place and Duration of Study: At B unit of Paediatric Surgery at National Institute of Child Health, Karachi during the year 1999. Subjects and Methods: Forty-two patients, with suspicion of foreign body aspiration, in whom bronchoscopy was performed, were included in this study. Sensitivity and specificity of historical events (history of foreign body aspiration, choking accident), clinical examination and diagnostic tool (x-ray chest) were calculated. Results: There were 26 male and 16 female patients. Ages ranged from 3 1/2 months to 12 years. The most common foreign body removed was betel nut (n-18). The sensitivity of history of foreign body aspiration was 78% with the specificity of only 16%. The specificity of choking accident was 100% but sensitivity only 55%. Clinical signs were not helpful in arriving at diagnosis. Similarly, x-ray chest was sensitive in 44% of patients only. Conclusion: A history of choking episodes should alert the physician to the possibility of foreign body aspiration. Clinical signs and radiology are not very helpful. High degree of suspicion should be exercised to decrease the morbidity associated with this condition.

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