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May 1, 2024
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Abstract

Background: Foreign Body Aspiration (FBA) poses a substantial worldwide health issue, with the
highest incidence observed among young children, Detecting and managing FBA promptly are crucial
to prevent potential complication.
Objectives: To evaluate the significance of preoperative clinical and radiological assessment in
diagnosing FBA in comparison with results of rigid bronchoscopy(RB).
Patients and Methods: A cross-sectional study was carried out in Nineveh province, Iraq, spanning
a period of 10 months from April 2018 to February 2019. The study focused on patients of pediatric
age group who were admitted with suspicion of FBA to Al-Khansaa Teaching Hospital in Nineveh
province. The cases who were included are under the age of 14 and had confirmed FBA through rigid
bronchoscopy (RB).
Results: Out of forty-four patient, 25 (56.8 %) were males, the average patients age was 4.8 years
with a standard deviation of 3.4 years. More than half of cases (54.5%) presented within the first 24
hours after onset of suspected FBA. The most common clinical presentation is the witnessed FBA
(93%) (41/44), followed by symptoms like chocking (34%), cough (23%), shortness of breath (11%)
and cyanosis (11%). Diminished air entry was the most frequently observed findings in clinical exam
(48%), followed by rhonchi in (36%) of cases. The primary CR findings were consolidation in 25%
and normal CR in another 25%. Radiopaque FB was successfully identified in CR of seven cases
(15.9%) only. Thus, the estimated sensitivity of CR in detecting FB by using RB as gold standard test
was 15.9%. Significantly, normal CR were more frequently observed in cases of early presentation.
Among the identified FBs, 63.6% were found to be of organic type, while 36.4% were of non-organic
type. The sunflower seeds found to represent most frequently encountered FB (34 %). Regarding site
of dislodgement of FB, 40.9% of FB were found in the right main bronchus (RMB) and 36.4% were
found in he left main bronchus (LMB).
Conclusion: A chest radiograph serves as a valuable asset for pediatric FBA diagnosis. However, its
value is optimized when combined with the clinical context to enhance accuracy. Notably, the
occurrence of false-negative chest X-rays is significantly linked to early presentations

Keywords

chest radiography foreign body aspiration bronchoscopy pediatric FB aspiration

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