Foreign body aspiration: clinical utility of flexible bronchoscopy

Foreign-body aspiration mimicking congenital lobar emphysema in a forty-eight-day-old girl

Foreign-body aspiration (FBA) is a commonly encountered serious problem during childhood, accounting for 7% of lethal accidents in children aged 1-3 years. Bronchoscopy is indicated when a clear history of FBA is present, but the history may be unreliable. Clinical manifestations can be seen in various diseases, and when a history of FBA cannot be obtained, radiologic findings such as hyperaeration can suggest the presence of congenital anomalies, e.g., congenital lobar emphysema. Here, a 48-day-old girl with coconut aspiration is described, to emphasize that a clinical history may not be available and FBA should be among the possible diagnoses, even before 6 months of age.

[Inhaled foreign bodies in 50 patients in South Vietnam, mainly caused by naseberry (Sapodilla)]

Inhalation of foreign bodies is relatively frequent in children, but exceptional in adults. Various kinds of foreign bodies can be inhaled, the type generally depends on eating habits in adults. We reviewed a series of 50 consecutive cases of inhaled foreign bodies and found that naseberry fruits (Sapodilla plum) was the primary cause, followed by bone debris. This series is typical of Eastern Asia, particularly South Vietnam. Most of the foreign bodies were extracted under local anesthesia using fibroscopy with a foreign body forceps. Most of the foreign bodies were on the right side. The naseberry nut is not radio-opaque, so diagnosis was generally established late after infectious complications. The endoscopic aspect was typical and should be recognized by endoscopists working in Vietnam.

Why nut? The aspiration of hazelnuts has become a public health problem among small children in the central and eastern Black Sea regions of Turkey

Our objective was to determine the significance of hazelnuts as the causative agent in pediatric foreign body aspirations in the main hazelnut production region of the world. We conducted a 10-year retrospective review of patients admitted to the pediatric surgery department in a 900-bed university hospital. Of 135 children with foreign body aspiration, hazelnut aspiration was identified in 35 (26%). All patients were younger than 5 years of age, and 32% of the hazelnut aspirations occurred during late summer, coinciding with the hazelnut harvest. We conclude that hazelnut aspiration is a public health problem in our region in children younger than 5 years of age, particularly during harvest-time. Hazelnut aspiration can be prevented by a well-defined public education program and precautionary measures taken by government and civil organizations.