CHEST X-RAY FINDINGS AND TYPES OF FOREIGN BODIES IN PATIENTS PRESENTING WITH COMPLAINTS OF TRACHEOBRONCHIAL FOREIGN BODY ASPIRATION; A NINE-YEAR MULTI-CENTER PROSPECTIVE STUDY

Abstract

Objective: To analyze the x-ray findings in patients suspected of foreign body aspiration and to report different types of observed foreign bodies.

Study Design: Prospective study.

Place and Duration of Study: Combined Military Hospitals of Rawalpindi, Lahore, Malir, and Quetta following collaboration between departments of Otolaryngology, Thoracic Surgery, and Diagnostic Radiology, from Aug 2008 to May 2017.

Methodology: Patients of any age who were suspected to have foreign body aspiration into the tracheobronchial tree were consecutively included. Patients with liquid aspiration, regurgitated gastric contents’ aspiration, parasite infection, or foreign body via transcutaneous penetration were excluded. All patients underwent anteroposterior and lateral imaging of the soft tissues of the neck and chest and then went through bronchoscopy under general anesthesia. Surgery was carried out if bronchoscopy was unadvisable due to the character or location of foreign body, or the patient’s general condition.

Results: Out of 110 patients (mean age: 5.6 ± 6.9 years), the highest incidence (49.5%) was seen in patients ≤3 years of age (p<0.001). The male: female ratio was 2.3:1 (p<0.001). Chest x-rays showed a radiopaque foreign body as the commonest finding (28.2%). Twenty-six (23.6%) cases had a normal chest x-ray. The non-organic foreign bodies were more common than organic foreign bodies (60.9% vs 39.1%) (p=0.022). The commonest non-organic foreign body was whistle in 16 (14.5%) cases and the commonest organic foreign bodies were seeds and betel nuts found in 15 (13.6%) cases each.

Conclusion: Tracheobronchial foreign bodies had a peak incidence in children ≤3 years of age with.......