Foreign body aspirations in children and adults

• Published in: The American journal of surgery 2022-10, Vol.224 (4), p.1168-1173
• Main Authors: Ulas, Ali Bilal, Aydin, Yener, Eroglu, Atilla
• Format: Article
• Language: English
• Subjects: Accidental deaths; Adult; Adults; Age; Bronchoscopy; Children; Cough; Cyanosis; Dyspnea; Emergency medical care; Food; Foreign bodies; Foreign body aspiration; Hemoptysis; Human remains; Localization; Mortality; Ostomy; Patients; Pediatrics; Pneumonia; Rigid bronchoscopy; Wheezing; X-rays
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.05.032

Foreign body aspiration (FBA) can be encountered in all age groups, especially in children under 3 years of age. In this study, we aimed to evaluate our results in children and adults who underwent rigid bronchoscopy due to a history of foreign body aspiration. In a single-center study, 822 consecutive patients with suspected foreign body aspiration and undergoing rigid bronchoscopy between January 2000 and August 2021 in our clinic were retrospectively evaluated. There were 451 (54.9%) male and 371 (45.1%) female patients. The mean age was 8.1 ± 14.0 (range 1 month–84 years). 525 (63.9%) of the cases consisted of cases under 3 years old, including 3 years old. There were 726 (88.3%) pediatric patients (≤18 years old), and 96 (11.7%) adult patients. The most important symptoms were cough in 690 (83.9%) cases and wheezing in 492 (59.9%) cases. The most frequently aspirated foreign bodies in children were sunflower seeds (14.2%, n = 71), food particles (11.4%, n = 57) and needles (52%, n = 10.4). The most frequently aspirated foreign bodies in adults were needles (39.5%, n = 28), non-needle metallic objects (21.1%, n = 15) and food particles (11.3%, n = 8). No mortality was observed in any of the patients who underwent rigid bronchoscopy. FBA is higher in children and direct radiological findings are less than in adults. Current findings show that FBAs in children are more difficult to diagnose and more dangerous clinically. •FBA is a health problem seen in all age groups, especially in children.•Foreign body aspirations are life-threatening emergencies.•False negativity of chest x-ray is more prominent in pediatric patients.•Be alert to the possibility of being overlooked.•A bronchoscopic examination should be kept in mind in all suspicious cases.