The foreign body aspiration (FBA) is a common cause of parents arriving with their children at the Paediatric Emergency Department. In the majority of cases, the problem affects children between 1‑3 years of age and it is less common in newborn babies and school children. The most important factor for diagnosis is the positive history of aspiration. Clinical symptoms, such as sudden onset of cough, wheezing and unilateral diminished breath sounds, occur uncommonly that is why imaging studies should be always taken. However, 30% of chest radiographs show normal findings. Virtual bronchoscopy (VB) may help to determine the presence and exact localization of the foreign body and may reduce the number of unnecessary rigid bronchoscopies. Rapid diagnosis can minimize dangerous respiratory complications. The authors present 3 cases. The first case is a 6‑year‑old girl with suspected FBA because of persistent inflammatory changes of the pulmonary parenchyma and with no improvement in the clinical and radiological symptoms despite intensive treatment. The second case is a 6‑month‑old infant with pneumonia and present history of aspiration. The physical examination revealed decreased breath sounds unilaterally, wheezing and abnormalities typical for FBA in the chest X‑ray. The third case is an 11‑year‑old boy with asthma exacerbation unresponsive to intensive treatment and positive medical history of FBA. In all patients CT lung images with vascular contrast were performed. No foreign body was found with VB in 2 patients (case first and second), in 1 patient there was no suspicion of foreign body (case third). " />
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The use of virtual bronchoscopy in the diagnosis of suspected foreign body aspiration in children

Bolesław Kalicki1, Agata Wawrzyniak1, Anna Żylak1, Piotr Koziński2, Sebastian Czarkowski2, Anna Jung1,
Małgorzata Placzyńska1
Affiliation and address for correspondence
Pediatr Med rodz Vol 8 Numer 1, p. 67-72
Abstract
The foreign body aspiration (FBA) is a common cause of parents arriving with their children at the Paediatric Emergency Department. In the majority of cases, the problem affects children between 1‑3 years of age and it is less common in newborn babies and school children. The most important factor for diagnosis is the positive history of aspiration. Clinical symptoms, such as sudden onset of cough, wheezing and unilateral diminished breath sounds, occur uncommonly that is why imaging studies should be always taken. However, 30% of chest radiographs show normal findings. Virtual bronchoscopy (VB) may help to determine the presence and exact localization of the foreign body and may reduce the number of unnecessary rigid bronchoscopies. Rapid diagnosis can minimize dangerous respiratory complications. The authors present 3 cases. The first case is a 6‑year‑old girl with suspected FBA because of persistent inflammatory changes of the pulmonary parenchyma and with no improvement in the clinical and radiological symptoms despite intensive treatment. The second case is a 6‑month‑old infant with pneumonia and present history of aspiration. The physical examination revealed decreased breath sounds unilaterally, wheezing and abnormalities typical for FBA in the chest X‑ray. The third case is an 11‑year‑old boy with asthma exacerbation unresponsive to intensive treatment and positive medical history of FBA. In all patients CT lung images with vascular contrast were performed. No foreign body was found with VB in 2 patients (case first and second), in 1 patient there was no suspicion of foreign body (case third).
Keywords
foreign body, aspiration, virtual bronchoscopy, chronic cough, children

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