Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study

Document Type : Original


1 Anesthesia Research Center, Guilan University of Medical Sciences, Rasht, Iran.

2 Department of Otorhinolaryngology, Guilan University of Medical Sciences, Rasht, Iran.

3 General Physician, Guilan University of Medical Sciences, Rasht, Iran.

4 Department of Anesthesiology, Guilan University of Medical Sciences, Rasht, Iran.

5 Community Medicine, Guilan University of Medical Sciences, Rasht, Iran.


Foreign-body aspiration is still considered one of the most important diagnostic and therapeutic issues for physicians. Mortality rates and the prevalence of diseases caused by foreign bodies in the airway are higher in children because of the relatively narrow airway and immature protective mechanisms. The aim of this study was to study the pattern of foreign-body aspiration in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to the Amir-al-Momenin Hospital, Rasht during 2007–2014.
Materials and Methods:
In this cross-sectional descriptive study, the required data were collected from the medical reports of all children under the age of 14 years with suspected foreign-body aspiration who were admitted and underwent explorative rigid bronchoscopy from 2007–2014. The data recorded in the checklists were analyzed using SPSS V16.
Out of 103 children with suspected foreign-body aspiration, a foreign body was seen in 74 children (71.8%) during bronchoscopy.  Among 74 patients with a confirmed aspiration, 73% (54) were males and 27% (20) were females (P=0.68). The average age of the subjects was 34.82±33.4 months; 66.2% were aged 1–3 years. The most common complaints (symptoms) of patients were non-productive cough (48.6%), wheezing (44.3%) and respiratory distress (18.6%). The most common physical examination findings were unilateral decreased pulmonary sound (62.3%), generalized wheezing (26.1%), and crackles (17.4%). Sixty-three patients had a suspected history of foreign-body aspiration.  The most frequently aspirated foreign bodies were nuts (peanuts). In total, 52.7% of foreign bodies were lodged in the right bronchial tree. In 95.9% of cases, the foreign body was completely extracted by bronchoscope. The majority of cases were admitted more than 24 hours after the occurrence of aspiration, and pneumonia was the most common complication.
Patient history, especially initial suspicion of aspiration, coughing, wheezing and respiratory distress, can be helpful in the diagnosis of foreign-body aspiration.


Main Subjects

1. Karen L, Swanson D. Airway Foreign Bodies: What’s New? Seminars in Respiratory and  Critical Care Medicine 2004; 25(4):405–11.
2. Korlacki W, Korecka K, Dzielicki J. Foreign body aspiration in children: diagnostic and therapeutic role of bronchoscopy. Pediatr Surg Int 2011; 27:833–7.
3. Vijaykumar T, Kalyanappagol NH, Kulkarni LH. Management of Tracheobronchial Foreign body aspirations in Pediatric age group – A 10-year retrospective analysis. Indian J Anaesth 2007; 51(1):20–3.
4. Dikensoy O, Usalan C, Filiz A. Foreign body aspiration: clinical utility of flexible Bronchoscopy. Postgrad Med J 2002; 78(921):399–403.
5. Sirmali M, Türüt H, Kısacık E, Fındık G, Kaya S, Tastepe I. The Relationship between Time of Admittance and Complications in Paediatric Tracheobronchial Foreign Body Aspiration. Acta Chir Bel 2005; 105(6): 631–4.
6. Jose A, Cataneo M, Cataneo DC, Ruiz Jr RL. Management of tracheobronchial foreign body in children. Pediatr Surg Int 2008; 24(2):151–6.
7. Rina M, Quintos R. Pediatric Rigid Bronchoscopy for Foreign Body Removal. Philipp J  Otolaryngol Head Neck Surg. 2009;24(1):39–41.
8. Mallick MS, Khan AR, Al-Bassam A. Late Presentation of Tracheobronchial Foreign Body Aspiration in Children. J Trop Pediatr 2005; 51(3):145–8.
9. Abdollahi Fakhim Sh, Badbarin D, Goljanan Tabrizi A. Studying delay causes in the diagnosis of     patients with airway foreign body aspiration. J Iran University of Medical Sciences 2008;15(59):119–24.
10. Farzizadeh M, Hashemian H, AtrKarRoshan Z. Clinical and radiographic findings of foreign body aspiration in children hospitalized in 17 Shahrivar Hospital, Rasht, during 1996–2008. Feiz Journal 2013;7(5): 495–500.
11. Tomaskea M, Gerberb A, Stockera S, Weissb M. Tracheobronchial foreign body aspiration in children – diagnostic value of symptoms and signs. Swiss MED Wkly 2006; 136:533–8.  
12. Hasdiraz l, Oguzkaya F, Bilgin M. Compli- cations of bronchoscopy for foreign body removal: experience in 1035 cases. Ann Saudi Med 2006; 26(4):283–7.
13.  Ghafari J, Sahebpour A, Mosavi SA, Safar MJ. Studying condition of pulmonary foreign body aspiration in children referring to BualiSina Hospital, Sari, and its related factors during 2001–2009. Journal of Mazandaran University of Medical Sciences 2010; 20(75):17–22.
14. Orji FT, Akpeh JO. Tracheobronchial foreign body aspiration in children: how reliable are clinical and radiological signs in the diagnosis? Clinical Otolaryngology 2010(6); 35:479–85.  
15. Mansourian HR, Sadrearhami AR, Shadman Yazdi AA. Accuracy of Chest X-Ray in the Diagnosis of Tracheobronchial Foreign Bodies in Children Tanaffos 2008; 7 (1): 58–62.
16. Shaaban Gad AY, S.Hadidi M. Removal of tracheobronchial foreign bodies using flexible and rigid bronchoscopy. Egyptian Journal of Chest Diseases and Tuberculosis 2012; 61(4):501–4.