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August 1991

The Causes and Complications of Late Diagnosis of Foreign Body Aspiration in Children: Report of 210 Cases

Author Affiliations

From the Department of Otolaryngology, Third Affiliated Hospital, China Medical University, Shenyang. Dr Mu is now with the Mount Sinai Medical Center, New York, NY.

Arch Otolaryngol Head Neck Surg. 1991;117(8):876-879. doi:10.1001/archotol.1991.01870200070010

• Late diagnoses of foreign body aspiration were defined as occurring beyond 3 days between the aspiration of the foreign body, or onset of symptoms, and correct diagnosis. We reviewed a total of 210 children with late diagnosis of foreign body aspiration. The causes creating late diagnosis of foreign body aspiration in children were as follows: (1) parental negligence (106/210, 50%); (2) misdiagnosis by the fellow professionals and pediatricians (39/210, 19%); (3) the normal chest roentgenographic findings (29/210, 14%); (4) lack of typical symptoms and signs (26/210, 12%); (5) mismanagement (8/210, 4%); and (6) a negative bronchoscopic finding (2/210, 1%). The most common complications encountered were obstructive emphysema (77/186, 41%), mediastinal shift (63/186, 34%), pneumonia (43/186, 24%), and atelectasis (33/186, 18%) in 186 patients who underwent a chest roentgenographic examination. The incidence of major complications was 64% (48/75) in the children who were diagnosed within 4 to 7 days; however, the complication rate was 70% (39/56) in those with a delay in diagnosis of 15 to 30 days, and 95% (20/21) in the cases with a delay in diagnosis of over 30 days after aspirating the foreign bodies.

(Arch Otolaryngol Head Neck Surg. 1991;117:876-878)