NON OPAQUE FOREIGN BODY ASPIRATION IN CHILDREN: SHOULD WE BE MORE VIGILANT AND PROACTIVE

Objective: To study the frequency of symptoms, composition and complications of clinically suspected non radio-opaque foreign body aspiration; which is a difficult diagnostic challenge resulting in delayed referral for bronchoscopy. Methodology: This descriptive analysis of 400 cases offoreign body aspiration was done in the department of ENT & Head and Neck surgery, Lady Reading Hospital Peshawar from 2003-2006. One hundred cases were selected with presumptive diagnosis of foreign bodies in tracheobronchial tree. The inclusion criteria were non witness and non radio-opaque foreign bodies. We reviewed their hospital record to ascertain history diagnosis and treatment. Age, sex, location in tracheobronchial tree, witnessed or un-witnessed events, symptoms, radio graphic findings, anatomical abnormalities noted at endoscopy and complications were recorded. Radio opaque foreign bodies were excluded from the study. Results: A total of hundred cases were included. Age range was from 2-5 years. Males were 70 % and females were 30%. Delay in presentation was from 10 days to 4 years. Common symptoms at presentation were cough 55% and asthma 20%. Radiological findings were abnormal in 90% of cases. Upon bronchoscopy 70% were positive for foreign body and 30% were negative. Peanuts (30%) and whistles (28%) were the commonest foreign bodies No death occurred in this study and minor complications of the procedure were only 15%. Conclusion: Aspiration of foreign bodies in children can lead to serious morbidity if not recognized and treated in time; hence early referral is essential.