Eight years' experience with foreign-body aspiration in children: What is really important for a timely diagnosis?

Background/Purpose: Aspiration of foreign bodies remains a major cause of m orbidity and mortality in childhood. The aim of this study was to evaluate the predictive diagnostic value of clinical signs and symptoms, the history , and the radiology to perform early diagnosis and therapy. Methods: From January 1990 to March 1998, 87 children were admitted to the Pediatric Surgery Department of Universita di Padova because of suspected f oreign body aspiration. Sensitivity and specificity of the considered diagn ostic tools were evaluated. Results: Neither clinical signs and symptoms nor radiology have sufficient diagnostic sensitivity, and especially specificity, on which to rely for th e diagnosis. Only the choking crisis, when present in the history, has good sensitivity a nd specificity (respectively, 96% and 76% in this series). Conclusions: A choking crisis in the child's history should alert physician s to the possibility of a foreign body aspiration. In the present series, c omplications always were related to the diagnostic delay. Copyright (C) 199 9 by W.B. Saunders Company.