Foreign body aspiration in children: field report of a German hospital

BACKGROUND: The aspiration of foreign bodies (FB), especially by small children, is a life-threatening situation and can be fatal. The aim of this survey was to study the types of foreign bodies in the upper airways and digestive tract, and the circumstances leading to the aspiration on the basis of hospital records of the Berlin University Hospital in Germany from 1997-2002. METHODS: We performed a retrospective review of hospital records using a standardized protocol. Foreign body aspiration that occurred in children aged 0-14 were considered for inclusion in the database. During the study period, 78 patients with a diagnosis of FB were included in the database. Forty-five patients were male and 33 were female. The median age was 1. RESULTS: In 89.5% of all cases, the children were under the age of 3. Seventy-five of the 78 patients had a foreign body in the trachea/bronchial trees/lungs based on International Classification of Diseases-9 codes at the time of discharge. At the time the injury occurred, the children had either been eating (41.1%) or playing (50.0%). More than 50% of the children were being supervised by an adult at the time the injury occurred. The foreign bodies (FB) were always extracted by using an endoscopic procedure (n= 43 rigid, n= 6 flexible and n= 29 combination of both methods). Moreover, hospitalization was always required due to an institutional requirement. The most commonly found foreign bodies were seeds, nuts, berries and grains. CONCLUSION: Most of the foreign bodies were found in the bronchial tubes, trachea, and lungs. The extraction method from these areas is rigid and/or flexible bronchoscopy or gastrointestinal endoscopy, a procedure requiring anesthesia. There seems to be no association between the aspirated foreign bodies and other purchased objects or packaging material. The fact that a large fraction of the injuries occur under the supervision of the adults suggests that the number and severity of the injuries could be reduced by educating parents and children. Our experience confirms, therefore, that further research into the behavioral aspects leading to FB injuries is needed.