Clinical and radiological characteristics of unrecognised foreign body aspiration into respiratory tract in children.

INTRODUCTION Diagnosing of foreign body aspiration in children is often postponed. The aim of this study was to evaluate complications, clinical signs and radiological presentation of respiratory illness arising from unrecognized foreign body aspiration in pediatric population. MATERIAL AND METHODS The study sample consisted of 33 patients aged from one to 18 years who had undergone bronchoscopy for foreign body removal over the 10 years' period (from 2000 to 2010). Neither their parents nor the pediatricians who had treated these patients before admission to hospital recognized the acute aspiration event. All the children were treated unsuccessfully for a period exceeding 10 days. The retrospective analysis included the history of foreign body aspiration, patients' age, kind of aspirated foreign body, clinical manifestations that led to hospitalization, radiographic findings and the time lapse from the first symptoms to diagnosis proven by endoscopic intervention. RESULTS The majority of the foreign bodies were organic (93.93%). Broncho-obstructive syndrome, which was the most frequent clinical presentation, was found in 18 (54.55%) patients; pneumonia was diagnosed in 10 (30.30%) patients, four children were referred to hospital due to infiltrative changes with acute broncho-obstructive syndrome and only one child (3.03%) had persistent productive cough. Radiological findings (chest X-rays) were pathological in all patients. Rigid bronchoscopy was performed in 16 (48.49%) patients 10 days after presenting the first symptoms of respiratory illness, in 6 (18.18%) patients within 10-21 days' period and in 11 (33.33%) patients 3 weeks after the first respiratory symptom. CONCLUSION Unrecognized foreign body aspiration results in various clinical manifestations and non-responsiveness to the standard therapy applied.