Avoiding Unnecessary Bronchoscopy in Children with Suspected Foreign Body Aspiration Using Computed Tomography
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In brief
In brief
Retrospective study of 133 pediatric patients demonstrates that CT imaging can reliably identify foreign body aspiration with 94.4% positive predictive value, potentially avoiding unnecessary bronchoscopies in high-risk patients with reactive airway disease. Findings support selective use of CT to reduce invasive procedures requiring general anesthesia.
Written by the GCMD Library team from the article.
Background
Bronchoscopy is the standard of care for diagnosis and treatment of foreign body aspiration (FBA). Drawbacks of this approach include its invasiveness, the potential for exacerbation of reactive airway disease, and the need for general anesthesia. Computed tomography (CT) can potentially identify patients with FBA, thereby avoiding unnecessary bronchoscopies in patients with at-risk reactive airways.
Methods
A retrospective review was performed to identify patients who underwent CT and/or bronchoscopy for suspected foreign body aspiration (FBA) from June 2012 to September 2018. Variables included clinical history, exam findings, radiographic findings, and operative findings. A telephone survey was performed for patients who had a CT without bronchoscopy. Three radiologists performed rereads of all CTs.
Results
A total of 133 patients were evaluated for FBA, and 84 were treated with bronchoscopy. For those with a CT demonstrating a foreign body, findings were confirmed on bronchoscopy in 17/18 (94.4%). For those with bronchoscopy alone, 39/64 (60.9%) were found to have a foreign body (p