Analysis of foreign body in the children's airway and follow-up study

Park, Jae Hong; Kim, Chan Yung

Abstract

The author analysed foreign body in the airway, divided into two groups vegetable foreign body group(VFBG) and non-vegetable foreign body group(N-VFBG), according to the nature, in 88 patients aged from 5 months to 15 years who were diagnosed and treated under ventilating bronchos-copy at Department of Pediatrics and Otolaryngology, Pusan National University Hospital from 1980 to 1990. Of the 88 patients analysed, 13 were followed for review, which comprised clinical assessment, chest radiography, and perfusion lung scan. The follwing results were obtained. 1) The highest incidence was seen in the age group of 1 to 3 years old especially in VFBG, bur no difference in incidence among each age group was observed in N-VFBG, The ratio of incidence between male to female was 2:1 ein total and, in N-VFBG, the incidence of male 8 times higher than female. 2) A wide variety of foreign bodies was recovered, with peanut being by far the most common (50%) and the ratio of incidence between VFBG and N-VFBG was 6 to 4. 3) The time interval of less than 24 hours between aspiration and admission was most frequently seen in 38% and of more than 3 weeks in 11%. The time interval in VFBG and the group with left bronchial lodging was longer than of N-VFBG and the group with right bronchial lodging, each respectively but no statistical difference was observed. The time interval in the group with bronchial lodging was significantly longer than of the group with laryngeal and tracheal lodging. 4) Frequent symptoms and signs were coughing, dyspnea, fever, decreased air entry, coarse breathing sound and rales. In total, clinical manifestations were more common in VFBG, especially in the incidence of fever, decreased air entry, coarse breathing sound and rhonchi. 5) The roentgenographic findings on admission were emphysema, pneumonia and atelectasis in the order of frequency. The incidence of emphysema and complex roentgenographic findings were more common in VFBG whereas in N-VFBG radioopaque foreign body normal roentgenographic findings were more common. 6) The prevalence of bronchial lodging was over 70% regardless of age group. No difference of predilection was observed between right and left bronchial lodging before 7 years old, but after 7 years old right bronchial lodging was significantly seen. 7) The longer the time lag before admission after aspiration, the longer the duration of hospitalization was in VFBG but with no statistical significance. However, no correlation between time lag and the duration o hospitalization was observed in N-VFBG. The group with bronchial lodging had significantly longer duration of hospitalization compare to that of the group with laryngeal and tracheal lodging, The group with left bronchial lodging had longer duration of hospitalization compare to that of the group with right bronchial lodging but with no statical significance. 8) Of the 13 cases reviewed, one had abnormal lung perfusion scan in spite of normal clinical assessment and chest X-ray, who was treated on 20 days days after aspiration of peanut in the right bronchus.