PEDIATRIC AERODIGESTIVE FOREIGN-BODY INJURIES ARE COMPLICATIONS RELATED TO TIMELINESS OF DIAGNOSIS

Foreign body (FB) injury from aspiration or ingestion is a common pedi atric health problem. Diagnosis relies on clinical judgment plus medic al history, physical examination, and radiographic evaluation. A multi -institutional review of 1269 FB events revealed that 85% were correct ly diagnosed following a single physician encounter. However, 15% of t he children had an elusive diagnosis (>1 week), despite previous evalu ation, Delays in diagnosis were seven times more likely to occur in as pirations than in ingestions, Secondary injuries (e.g., pneumonia and atelectasis) occurred in 13% of airway FBs but in only 1.7% of esophag eal FBs. Plain radiographs were used in 82% of children, and special s tudies (e.g., fluoroscopy) in only 7%. We conclude that diagnosis of F B injury in children is frequently achieved at the initial evaluation but that continued surveillance by followup visits to health care faci lities from parents and other caretakers is important, to reduce pulmo nary injuries.