Clinical, Radiological and Procedural Perspectives on Pediatric Foreign Body Aspiration: A Retrospective Analysis from Benghazi Children’s Hospital, Libya
DOI:
https://doi.org/10.54361/LJMR.19.2.48Keywords:
foreign body aspiration, pediatric airway, rigid bronchoscopy, diagnostic performance, LibyaAbstract
Background: Foreign body aspiration (FBA) is a major cause of morbidity and mortality in preschool-aged children, especially in low-resource areas where diagnosis may be delayed. This study aimed to describe the clinical, radiological, and procedural features of paediatric FBA in a single tertiary centre in Libya. Material and Methods: A retrospective review was conducted for all children aged 16 years and younger with suspected FBA at Benghazi Children’s Hospital in 2019. The data included demographics, symptoms, imaging results, and bronchoscopy findings. All of the patients in this study underwent rigid bronchoscopy under general anesthesia. Results: Sixty-six children (mean age 2.9 years; 62.1% male) were analysed. Cough (90.9%) and observed choking (86.4%) were the most prevalent symptoms. Chest X-rays were normal in 72.7% of cases. Rigid bronchoscopy revealed FBA in 69.7%, mainly vegetative material like peanuts and seeds. The right main bronchus was the most common location (50%). Fever, wheezing, and a history of previous infections were associated with a significant delay in diagnosis (P < 0.05). Operative success was greater than 95% and complications were rare. Conclusion: In pediatric FBA, normal radiographs are not predictive of non-aspiration. Diagnosis is still established through rigid bronchoscopy, and treatment is also performed through this method. A high degree of clinical suspicion is necessary, in particular in low-resource settings. This study offers critical regional data to inform practice and prevention.
Downloads
References
1. Zheng P, Zhang N, Chen Z, Jiang Z, Liu X, Ni F, et al. Global, regional, and national assessment of foreign body aspiration (1990–2021): novel insights into incidence, mortality, and disability-adjusted life years. Scand J Trauma Resusc Emerg Med. 2025;33:40.
2. Brkić F, Umihanic S, Altumbabic H, Ramas A, Salkic A, Umihanic S, et al. Death as a consequence of foreign body aspiration in children. Med Arch. 2018;72(3):220–223.
3. Khodayarfard A, Mousavi SGA, Foroughi A, et al. An investigation of the pediatric rigid bronchoscopy complication with three different anesthesia regimes. Anesth Pain Med. 2024;14(4):e150953.
4. Geller KA, Cavanaugh RM, Goodwin AT, et al. Bronchoscopy for pediatric airway foreign body: thirty-day adverse outcomes in the ACS NSQIP-P. Otolaryngol Head Neck Surg. 2019;160(2):356–362.
5. Baram A, Sherzad H, Saeed S, et al. Tracheobronchial foreign bodies in children: the role of emergency rigid bronchoscopy. Glob J Health Sci. 2017;9(12):44–50.
6. Safari M, Hashemi Manesh MR. Demographic and clinical findings in children undergoing bronchoscopy for foreign body aspiration. Ochsner J. 2016;16:120–124.
7. Moslehi MA. Failures in emergency management of pediatric airway foreign bodies by rigid bronchoscopy: we have yet to complete our learning. World J Pediatr Surg. 2022;5(2):e000321.
8. Schramm D, Skopnik H, Choroszy M, et al. Complications and risk factors in pediatric bronchoscopy in a tertiary pediatric respiratory center. Pediatr Pulmonol. 2018;53(6):722–728.
9. Wang Q, Kong X, Wang G, et al. A real-world study of foreign body aspiration in children with 4,227 cases in Western China. Sci Rep. 2024;14:15251.
10. Karišik M. Foreign body aspiration and ingestion in children. Acta Clin Croat. 2023;62(Suppl 1):105–112.
11. Martinot A, Closset M, Marquette CH, et al. Indications for flexible versus rigid bronchoscopy in children with suspected foreign-body aspiration. Am J Respir Crit Care Med. 1997;155(5):1676–1679.
12. Pozailov S, Goldbart A, Aviram M, et al. Foreign body aspiration score (FOBAS): a prospectively validated algorithm for management. Eur J Pediatr. 2024;183(2):815–825.
13. Shen Z, Wu B, Vinturache A, Cai C, Lu M, Gu H. Tracheobronchial foreign body aspiration in children: a retrospective single-center cross-sectional study. Medicine (Baltimore). 2020;99(22):e20480.
14. Anton Pacheco JL, Martín Alelú R, et al. Foreign body aspiration in children: timing and complications. Int J Pediatr Otorhinolaryngol. 2021;144:110690.
15. Lee JJW, Philteos J, Levin M, et al. Clinical prediction models for suspected pediatric foreign body aspiration: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg. 2021;147(9):787–796.
16. Shen X, Shang W, et al. Influential factors for visit time for tracheobronchial foreign bodies in pediatrics. Eur Arch Otorhinolaryngol. 2020;277:505–509.
17. Eren Ş, Balci AE, Dikici B, et al. Foreign body aspiration in children: experience of 1,160 cases. Ann Trop Paediatr. 2003;23:31–37.
18. Fidkowski CW, Zheng H, Firth PG. The anesthetic considerations of tracheobronchial foreign bodies in children: a literature review of 12,979 cases. Anesth Analg. 2010;111:1016–1025.
19. Rance A, Mittaine M, Michelet M, et al. Delayed diagnosis of foreign body aspiration in children. Arch Pediatr. 2022;29:424–428.
20. Fasseeh NA, Elagamy OA, Gaafar AH, et al. A new scoring system and clinical algorithm for the management of suspected foreign body aspiration in children: a retrospective cohort study. Ital J Pediatr. 2021;47:194.
21. Tang LF, Xu YC, Wang YS, et al. Airway foreign body removal by flexible bronchoscopy: experience with 1,027 children during 2000–2008. World J Pediatr. 2009;5:191–195.
22. Gvetadze P, Chkhaidze I, Baldas S, et al. Injuries due to foreign body aspirations in Georgia: a prevention perspective. Int J Pediatr Otorhinolaryngol. 2016;83:84–87.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Yosef Hassan Saeed, Mohammed Shultami, Rugaia Adris Alfdly, Salem Aldrsy, Mahmuod Aloriby, Yousef M Ali Hasen, Farag A Bleiblo, Moutaz F. Gebril, Tarik Ali Alghoj, Ahmed .S.Mikael, Nada. M.Heebah (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Open Access Policy
Libyan journal of medical Research (LJMR).is an open journal, therefore there are no fees required for downloading any publication from the journal website by authors, readers, and institution.
The journal applies the license of CC BY (a Creative Commons Attribution 4.0 International license). This license allows authors to keep ownership f the copyright of their papers. But this license permits any user to download , print out, extract, reuse, archive, and distribute the article, so long as appropriate credit is given to the authors and the source of the work.
The license ensures that the article will be available as widely as possible and that the article can be included in any scientific archive.
Editorial Policy
The publication of an article in a peer reviewed journal is an essential model for Libyan journal of medical Research (LJMR). It is necessary to agree upon standards of expected ethical behavior for all parties involved in the act of publishing: the author, the journal editorial, the peer reviewer and the publisher.
Any manuscript or substantial parts of it, submitted to the journal must not be under consideration by any other journal. In general, the manuscript should not have already been published in any journal or other citable form, although it may have been deposited on a preprint server. Authors are required to ensure that no material submitted as part of a manuscript infringes existing copyrights, or the rights of a third party.
Authorship Policy
The manuscript authorship should be limited to those who have made a significant contribution and intellectual input to the research submitted to the journal, including design, performance, interpretation of the reported study, and writing the manuscript. All those who have made significant contributions should be listed as co-authors.
Others who have participated in certain substantive aspects of the manuscript but without intellectual input should only be recognized in the acknowledgements section of the manuscript. Also, one of the authors should be selected as the corresponding author to communicate with the journal and approve the final version of the manuscript for publication in the LJMR.
Peer-review Policy
- All the manuscripts submitted to LJMR will be subjected to the double-blinded peer-review process;
- The manuscript will be reviewed by two suitable experts in the respective subject area.
- Reports of all the reviewers will be considered while deciding on acceptance/revision or rejection of a manuscript.
- Editor-In-Chief will make the final decision, based on the reviewer’s comments.
- Editor-In-Chief can ask one or more advisory board members for their suggestions upon a manuscript, before making the final decision.
- Associate editor and review editors provide administrative support to maintain the integrity of the peer-review process.
- In case, authors challenge the editor’s negative decision with suitable arguments, the manuscript can be sent to one more reviewer and the final decision will be made based upon his recommendations.
