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  • Title: [Foreign body aspiration in children. The advantages of emergency endoscopy and foreign body removal].
    Author: Schimpl G, Weber G, Haberlik A, Höllwarth ME.
    Journal: Anaesthesist; 1991 Sep; 40(9):479-82. PubMed ID: 1952042.
    Abstract:
    In the last 15 years, 124 children with a history and clinical signs of aspiration have been managed by emergency rigid endoscopy under general anesthesia. In 115 (93%) of them a foreign body could be identified, which was successfully removed by forceps extraction in 114. Only 1 patient required a thoracotomy for removal of a distally located aspirated needle. The remaining 9 patients (7%) had a typical history and clinical signs of an aspiration, but no aspirated foreign body was found on endoscopy. Most of the children (102, or 82%) were admitted within 12 h after aspiration, while 22 (18%) had a history of foreign body aspiration between 2 days and 5 weeks before. Complications occurred in only 3% (3 children) of the 102 who underwent endoscopy within 12 h as against 50% (11 patients) of the 22 children in whom this was delayed. In all cases of foreign body aspiration and endoscopical removal within 12 h, the patients were discharged after a plain chest X-ray the following day. In children with chronic endotracheal foreign bodies, in 80% a second endoscopy after 48 h was indicated, and the mean stay in hospital was extended to 7 days. Emergency rigid tracheobronchoscopy and forceps removal of aspirated foreign bodies under general anesthesia and with meticulous perioperative monitoring is a safe and effective procedure with no mortality. Even in suspected aspiration or chronic bronchopulmonary infections, liberal use of endoscopy is recommended.
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