Tracheobronchial aspiration of foreign bodies in children: a study of 94 cases

Over the last seven years, there has been an increase in the number of children admitted to our hospital because of aspirated foreign bodies. An inhaled foreign body can become a serious matter if it results in acute respiratory distress or if it remains unrecognized for a long period in the bronchial system. Then, as a result of inflammatory tissue reactions, it can be extracted only with great difficulty. Of our 94 children with foreign body aspiration, 24% had been treated initially on the basis of a different diagnosis. In 30% of all cases, the children were admitted more than 3 days after aspiration. One third of the patients already had signs of marked inflammation on admission. Early treatment, under general anaesthesia, proved to be safe even for small babies. Bronchoscopic examinations should not last more than approximately 1 hour. All children who had complications after bronchoscopy (6%) recovered fully after treatment, except for one child who died of respiratory failure. A diminution of complications in children with inflammatory signs on admission was observed when they were treated before the operation with antibiotics and methylprednisolone.