Clinico-Radiologic Trends inTracheobronchial Foreign Body Aspiration

Abstract

Foreign body aspiration (FBA) is a life-threatening event that is more common in children due to their habits of playing with food and  putting objects in their mouths. However, FBAcan also occur in adults. Delayed or missed diagnosis of FBAcan result in fatal airway  obstruction, chronic cough, or recurrent pneumonia episodes. The tracheobronchial tree is the most affected site. Early treatment greatly  reduces mortality and post-op pulmonary complications. However, there is a high percentage of delayed diagnosis in recorded  cases. FBAis responsible for 500-2000 deaths annually in the United States and is the 4th most common cause of accidental deaths among  preschool children globally. Aretrospective review was conducted on patients who presented to the hospital with respiratory  symptoms and were diagnosed with Tracheobronchial Foreign Bodies from January 2008 to January 2020. This study encompassed a  cohort of 30 patients, with an equal distribution of males and females and an average age of 9.34 ± 9.09 years. Our findings revealed that  Foreign Body Aspiration (FBA) was most prevalent among patients aged 4-18 years. The most reported symptoms upon presentation  were cough (93.3%), followed by dyspnea (43.3%), chest pain (16.7%), fever (10.0%), and choking (3.3%). The duration of symptoms  ranged from 4.8 hours to 1.75 years, with patients who presented with cough and chest pain exhibiting longer symptom duration compared to those with fever, dyspnea, or choking. In terms of the type of material retrieved through bronchoscopy, inorganic  substances accounted for the majority (73.3%), with groundnuts being the most frequently aspirated material (26.7%). The right main  bronchus was the most common location for the foreign body (80.0%), and carina involvement was absent in most cases (90.0%).  Groundnuts were identified as the predominant aspirated material. Notably, chest X-rays had a low identification rate, accurately  identifying foreign bodies in only 33.3% of cases. Additionally, complications related to bronchoscopy occurred in 10% of patients, as  observed in our study. Foreign body aspiration diagnosis can be challenging and requires a high level of clinical suspicion to ensure  accuracy. Prompt medical attention is critical to reduce the morbidity and mortality associated with foreign body aspiration.