Objectives: To describe and compare the demographic, clinical, radiological, and bronchoscopy features and outcomes of children with foreign body aspiration in early- and late-diagnosis groups, to report the reasons for delay in diagnoses, and to determine what objects are commonly aspirated.
Design: Retrospective study.
Setting: Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong.
Patients: All children younger than the age of 18 years with foreign body aspiration admitted to the study hospital from 1 January 1993 to 31 May 2006.
Results: Sixteen (59%) of the patients were categorised into the early-diagnosis group (correctly diagnosed foreign body aspiration<7 days of symptom onset) and 11 (41%) into the late-diagnosis group (correctly diagnosed>or=7 days after symptom onset). The common clinical manifestations of foreign body aspiration were persistent cough (100%) and history of choking (74%). Most children (82%) in the late-diagnosis group and 25% in early-diagnosis group (P=0.004) were misdiagnosed as respiratory infections and asthma. Intrabronchial granulation was more common in the late-diagnosis group (13% vs 55%, P=0.033). Peanuts and watermelon seeds accounted for 85% of the aspirations; 63% of the foreign body aspirations occurred around the Chinese New Year festival.
Conclusion: Foreign body aspiration is difficult to diagnose in children. Misdiagnosis as asthma and respiratory infection can delay treatment and result in intrabronchial granuloma. We therefore suggest early bronchoscopy in suspicious cases. Parents should be cautious when giving peanuts and watermelon seeds to their children.