PubMed2004
In this retrospective study, the authors reviewed 31 cases of tracheobronchial foreign body in children ranging in age from one to 15 years, recruited in Ariana hospital since 1987. 74% of the patients were male, and only 26% were less than 3 years old. The foreign body is mostly revealed by a radio-clinical presentation of a feverish bronchopneumonia (32%); children were referred to the hospital within 15.4 months. Although penetration syndrome was reported in 61% of patients, it represented the reason of consultation in only 19% of cases, and children were referred within 4.5 days. The main radiographic findings were atelectasis (32%) and non specific foci of pneumonia (19%). Air trapping was noted in just 10% of cases. 55% of foreign bodies were vegetable in nature, with sunflower seeds at the head of the list (16%). They have been lodged preferentially in the right bronchial tree (58%) and 51% of them were found in the mainstem bronchus. 71% were removed by endoscopic procedures; a surgical operation was performed in 6 cases (19%): one case of pneumotomy to extract a metallic foreign body from distal respiratory tract, and five cases of parenchymal excision, including four for bronchiectasis. 77% of patients had symptoms that lasted at least 2 weeks before diagnosis; the long delay in diagnosis (average of 7.6 months) explains the high-level of bronchiectasis in our study (22%). The authors emphasize the necessity to promote preventive measures by information parents and physicians on risks of foreign body aspiration, which early diagnosis can save much trouble in children.