Management of Foreign Body Aspiration in Pediatric Patients: An Experience from a Tertiary Hospital in Ethiopia|
Tadesse, A. & Hailemariam, B.
Accidental foreign body aspiration is a relatively common occurrence in
pediatric patients and may result in asphyxiation and death, especially among those aged
less than 4 years. This study was aimed at analyzing the clinical and radiological profile,
modes of managements and outcomes of foreign body aspiration in children in a tertiary
care center and identify areas of possible interventions for proper management of such
This was a 2-year retrospective study of children who were admitted and treated
for foreign body aspiration between 1 September 2012 and 30 August 2013 at the
paediatric surgery unit of Tikur Anbesa Specialized Hospital (TAH) in Ethiopia. Case
records of patients suspected to have foreign body aspiration over the past two years were
analyzed. Clinico-radiological features, types and location of foreign bodies, modes of
management and patients outcomes were studied.
A total of 81 children underwent rigid bronchoscopic evaluation, and foreign
bodies were identified and removed in 76(93%) of the cases.The mean age of the patients
was 4.6 yrs (5 months to 11 years), 54 (71.1%) were male and 22 (28.9%) were female. A
foreign body aspiration history obtained in 58 (76.3%) of the patients, The mean duration
of illness was 1.6 +1.9 days with range of 4.5 hours and 4 months, majority of patients, 29
(38.2%) were from Oromia region; 14 (18%) reported within 24 hours of the event; plastic
tips was retrieved in 17 (22.4%) patients, seed in 15(19.7%), balloon inflator tip in
7(9.2%), metallic tips 5 (6.6%), Hijab pin 2(2.6%); 50 (73.7%) presented with cough,
shortness of breath in 38(50%), wheeze in 23(30.3%);chest x-ray common findings were
10(13.2%) lobar pneumonia, 8 (10.5%) radio opaque foreign body, 7(9.2%) hyperinflation,
and 4(5.3%) pneumonia; The site of foreign body lodgment is right main bronchus in 44
(57.9%) patients followed by left main bronchus in 20 (26.3%), trachea in 11(14.5%) and
lower stem bronchus in 1 (1.3 %);73(96%) cases had smooth course in the hospital and
discharged within 10 days after bronchoscopic procedures and individualized medical care.
1(1.3%)has passed away.
Foreign body aspiration remains a common unintentional childhood injury.
Rigid bronchoscopy is very effective procedure for the removal of aspirated foreign body
with fewer complications. Education is the best preventive measure for decreasing the
incidence of this problem. Caring physician should maintain high index of clinical suspicion
to avoid fatal outcome and long term morbidity. Bronchoscopic facility should be available
at all hospitals.
Foreign body aspiration; rigid Bronchoscopy