Foreign body inhalation in Tunisian children: Experience of a pediatricrespiratory diseases department

Background: The aim of the present study was to analyze the epidemiological, clinical, radiological and endoscopic characteristics of pediatric foreign body aspiration in Tunisian children. Methods: This was a retrospective study of 76 children with foreign body aspiration who were admitted to our department for flexible and/or rigid bronchoscopy between January 2002 and January 2013. Results: The median age of the children was 2.8 years (range: 1.58-6 years). Of these, 61.6% were aged between one and three years. The aspirated foreign bodies were nuts and seeds in 44.64 % of cases, with sunflower seeds representing 19.64% of these cases. Scarf pins were the most frequent metallic foreign body in 7.9% of cases. Almost half of cases were presented within 72 hours of inhalation. Diagnosis of an inhaled foreign body was delayed by more than 30 days in 23.8% of cases. In 79.6% of subjects, a typical penetration syndrome was found on interviewing the parents. Chest X-ray was normal in 18.5% of cases. All children underwent flexible bronchoscopy first, or after rigid bronchoscopy. In 73 (96%) children, the foreign body was seen during flexible bronchoscopy. Eleven foreign bodies (15.2%) were removed safely in our department, via the flexible bronchoscope under general anesthesia. Surgery for foreign body extraction, or for treatment of complications, was necessary in 21.05% of children. Conclusions: Inhalation of seeds and nuts by children is a serious problem. Education by physicians, and especially parents, is the main guarantor to significantly reduce morbidity and mortality in this pathology.