Iranian Journal of Neonatology

Iranian Journal of Neonatology

Rigid Bronchoscopy in Foreign Bodies Aspiration: Value of the Clinical and Radiological Findings

Document Type : Original Article

Authors
Arash Azadmehr 1
Behnamreza Makhsosi 1
Soleyman Mohammadi 1
Mehrasa Yousefi 2
Sara Darvishi-Shani 3
1 1. Department of General Surgery, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran 2. Famtan Research Center of Medical Sciences Co., Kermanshah, Iran
2 Department of Emergency Medicine, Hakim International Hospital, Kermanshah, Iran
3 Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
10.22038/ijn.2023.67248.2304
Abstract
Background: Foreign body aspiration (FBA) is an emergency condition in children, potentially leading to  life-threatening events. The gold standard for FBA management typically involves rigid bronchoscopy (RB). Since RB is performed under general anesthesia (GA), it exposes the child to the risk of GA and perioperative complications. Therefore, the current study aimed to examine the association of clinical and radiological signs with RB results.
Methods: This cross-sectional study was conducted at Imam Reza Hospital, affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah Province, Iran. A total of 86 children suspected of FBA were included in the study. All patients underwent RB under GA after a thorough evaluation, including a detailed medical history, physical examination, and poster anterior chest X-ray (CXR).
Results: Of 86 patients, 55 (64.0%) were male and 31 (36.0%) were female. The mean age of participants was 3.40 ± 1.41 years (1 to 7 years). The history of coughing and crepitation were the most common symptoms (100%). Among 86 patients who underwent RB, 52 (60.0%) had FBA in their airway, while 34 patients (40.0%) had negative RB results. The most frequently aspirated foreign body was sunflower seeds, observed in 25.0% of cases. The right main bronchus was identified as the most common site of the foreign bodies, accounting for 48.1%. The coughing and crepitation had a very high sensitivity of 100%, whereas hypoxemia had the highest specificity of 13.3%.
Conclusion: None of the clinical symptoms, such as coughing, demonstrated high sensitivity or specificity individually or in combination. Therefore, it is of utmost importance to educate children and parents about preventive measures to reduce the risk of FBA and to provide a comprehensive understanding of the potential consequences associated with FBA.
 
 
Keywords
Aspiration
Bronchoscopy
Chest X-ray
Iran
Symptoms
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Iranian Journal of Neonatology
Volume 14, Issue 3
Summer 2023
Pages 1-5