NON OPAQUE FOREIGN BODY ASPIRATION IN CHILDREN: SHOULD WE BE MORE VIGILANT AND PROACTIVE?

Objective: to study the frequency of symptoms, composition and complications of clinically suspected non radio-opaque foreign body aspiration; which is a difficult diagnostic challenge resulting in delayedreferral for bronchoscopy. methodology: this descriptive analysis of 400 cases of foreign body aspiration was done in the department of ent & head and neck surgery, lady reading hospital peshawar from 2003-2006. one hundred cases were selected with presumptive diagnosis of foreign bodies in tracheobronchial tree. the inclusion criteria were non witness and non radio-opaque foreign bodies. we reviewed their hospital record to ascertain history diagnosis and treatment. age, sex, location in tracheobronchial tree, witnessed or un-witnessed events, symptoms, radio graphic findings, anatomical abnormalities noted at endoscopy and complications were recorded. radio opaque foreign bodies were excluded from the study. results: a total of hundred cases were included. age range was from 2-5 years. males were 70 % and females were 30%. delay in presentation was from 10 days to 4 years. common symptoms at presentation were cough 55% and asthma 20%. radiological findings were abnormal in 90% of cases. upon bronchoscopy 70% were positive for foreign body and 30% were negative. peanuts (30%) and whistles (28%) were the commonest foreign bodies no death occurred in this study and minor complications of the procedure were only 15%. conclusion: aspiration of foreign bodies in children can lead to serious morbidity if not recognized and treated in time; hence early referral is essential