Foreign Body Aspiration: Utilizing Flexible Fiberoptic Bronchoscopy

Objective: To define the clinical spectrum of tracheobronchial foreign body aspiration in adults, evaluate the efficacy of bronchoscopy, and determine outcome and complications at King Hussein Medical Center. Methods: Retrospective analysis of 33 consecutive clinical series from a referral-based medical center (King Hussein Medical Center) was conducted. Case records of 33 adult patients (over 14 years of age) suspected to have foreign body aspiration over the past eight years were analyzed. All had bronchoscopic evaluation. Clinical-radiological features, types and location of foreign body were studied. About 98% of patients had their foreign bodies identified and removed using Flexible Fiberoptic Bronchoscopy while rigid bronchoscopy was needed in only three (9%) cases. Results: Of 33 consecutive patients, 25 patients (76%) were females and the majority was below 30 years of age. A total of 30 patients (91%) presented within the first 24 hours after foreign body inhalation. A radioopaque foreign body was evident in chest X-rays of 85% of the patients. Pins used to fix head scarves constituted 64% of the foreign bodies removed. The rest included a piece of bone, food particles and seeds. A total of 29 patients (88%) were discharged on the same day of the procedure. Conclusions: Ttracheobronchial foreign body aspiration in adults can occur in various settings. High clinical suspicion is necessary for diagnosis. Removal of foreign bodies can usually be accomplished with fiberoptic bronchoscopy. In our series the most commonly removed foreign bodies were metallic pins.