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Emergency Medicine Journal 2003;20:100-101; doi:10.1136/emj.20.1.100
© 2003 BMJ Publishing Group Ltd and the College of Emergency Medicine.

CASE REPORT

Delayed diagnosis of foreign body aspiration in children

T Hilliard1, R Sim2, M Saunders2, S Langton Hewer1, J Henderson1

1 Department of Respiratory Medicine, Royal Hospital for Children, Bristol, UK
2 Department of Ear, Nose and Throat Surgery, Royal Hospital for Children, Bristol

Correspondence to:
Correspondence to:
Dr T Hilliard, Department of Respiratory Medicine, Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK;
tom.hilliard{at}ubht.swest.nhs.uk

ABSTRACT

Foreign body aspiration in children is common and usually presents with an initial episode of choking with subsequent respiratory symptoms. There may be cough, wheeze, or stridor, with decreased or abnormal breath sounds on examination. However, it can mimic other illnesses and cause difficulty in diagnosis. Radiological investigations may help to confirm aspiration but should not be used to exclude it. Three cases are presented of foreign body aspiration with a delay in diagnosis ranging from days to weeks. It is believed that delay could have been avoided with a more careful approach to the history and more appropriate use of investigations. These cases demonstrate that children with a history of choking and subsequent symptoms should be referred for bronchoscopy.

Keywords: foreign body; aspiration; children; bronchoscopy


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