Frequency of tracheobronchial foreign bodies in children and adolescents

OBJECTIVE: The problem of foreign body aspiration in the community has been studied and compared with other reports.

METHODS: We have retrospectively studied patients who had bronchoscopy for suspected foreign bodies in the tracheobronchial tree, attending or referred to Al-Noor Specialist Hospital, Makkah over a period of 3 years from May 1996 to May 1999.

RESULTS: The total number of patients was 94 (62 male and 32 female). Ages ranged from 4 months to 45 years(mean age 3.77 years), 85% of children being under the age of 5 years. One hundred bronchoscopies (6 repeat bronchoscopies) and one thoracotomy were carried out. Foreign bodies were removed from 60 patients (64%). Six (10%) did not have any definite history, while 15 patients (21%) with definite history of foreign body aspiration had negative bronchoscopy. An aspirated Fis-Fis (Alfalfa, Lucerne) seed accounted for more than one-third of all foreign bodies. The most frequent symptoms, signs, radiological findings and site of foreign body lodgment in the tracheobronchial tree are discussed.

CONCLUSION: We conclude that a negative history, clinical examination and chest x-ray do not necessarily exclude aspirated foreign body material. Bronchoscopy is the most effective diagnostic and therapeutic modality to prevent complications related to neglected foreign body aspiration. In addition to children, teenagers and adolescents are also not immune to this problem. We recommend early referral to an appropriate hospital on suspicion or if symptoms persist. However, preventive measures, remain the best means of protecting these children.