UTILITY OF CLINICAL AND RADIOLOGICAL SIGNS IN AIRWAY FOREIGNBODIES

Abstract

Background: Foreign Body Aspiration (FBA) is a grave problem in children and delays in diagnosis and management can be devastating. The history is very often vague, with subtle physical and chest radiograph abnormalities

Aim: To assess the diagnostic accuracy of the triad: history of chocking, unilateral reduction in air entry to lungs, unilateral hyperinflation or collapse on chest X-ray.

Results: In our study sensitivity of history of chocking in detection of FB was 80.47%, specificity was 20.45%. Sensitivity of examination finding of unilateral decrease in air entry to lungs in detection of FB was 71.59%%, specificity was 4.545%.  Sensitivity and specificity of chest radiograph in detection of FB was 54.43% and 47.72% respectively. When the triad of history of chocking, decreased air entry on examination and chest radiograph finding of hyperinflation or collapse was considered in detection of FB in airway sensitivity was 59.76% while specificity was 79.54%.

Conclusion: Bronchoscopy is a gold standard in diagnosis of FBA. History, physical examination and radiologic studies have a very low specificity in detection of FBA. The triad of history of chocking, decreased air entry on examination and chest radiograph finding of hyperinflation or collapse has a better specificity in detection of FBA than individual parameters.