ASSESSMENT AND MANAGEMENT OF FOREIGN BODY ASPIRATION IN CHILDREN - A NARRATIVE REVIEW

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.5777

Keywords:

Foreign Body Aspiration, Foreign Body, Flexible Bronchoscopy, Rigid Bronchoscopy, Tracheobronchial Foreign Body, Computed Tomography, Airway Obstruction

Abstract

Foreign body aspiration is a significant cause of morbidity and mortality in the paediatric population. It is also a relatively common presentation in children, especially those under the age of 3 years old. Prompt recognition and management are essential to prevent life-threatening airway obstruction and long-term pulmonary complications. However, the diagnosis of foreign body aspiration remains a significant clinical challenge due to non-specific presentation and high variable physical examination findings. Typically, chest radiography is a first-line radiological investigation in children presenting with suspected foreign body aspiration. However, it is associated with poor sensitivity and specificity for diagnosing foreign body inhalation. Chest computed tomography provides improved sensitivity and specificity, however, it may still fail to identify small or organic foreign bodies. Its use in clinical practice is also limited by the need for patient sedation and exposure to high doses of radiation. Flexible and rigid bronchoscopy are central to both definitive diagnosis and treatment, with rigid bronchoscopy being considered as the gold standard for foreign body retrieval. Early diagnosis and timely intervention are associated with improved outcomes and reduced complications in pediatric patients.Foreign body aspiration is a significant cause of morbidity and mortality in the paediatric population. It is also a relatively common presentation in children, especially those under the age of 3 years old. Prompt recognition and management are essential to prevent life-threatening airway obstruction and long-term pulmonary complications. However, the diagnosis of foreign body aspiration remains a significant clinical challenge due to non-specific presentation and high variable physical examination findings. Typically, chest radiography is a first-line radiological investigation in children presenting with suspected foreign body aspiration. However, it is associated with poor sensitivity and specificity for diagnosing foreign body inhalation. Chest computed tomography provides improved sensitivity and specificity, however, it may still fail to identify small or organic foreign bodies. Its use in clinical practice is also limited by the need for patient sedation and exposure to high doses of radiation. Flexible and rigid bronchoscopy are central to both definitive diagnosis and treatment, with rigid bronchoscopy being considered as the gold standard for foreign body retrieval. Early diagnosis and timely intervention are associated with improved outcomes and reduced complications in pediatric patients.

References

Wu, X., Wu, L., Chen, Z., & Zhou, Y. (2018). Fatal choking in infants and children treated in a pediatric intensive care unit: A 7-year experience. International Journal of Pediatric Otorhinolaryngology, 110, 67–69. https://doi.org/10.1016/j.ijporl.2018.04.026

Tsang, J. E., Sun, J., Ooi, G. C., & Tsang, K. W. (2017). Endobronchial foreign body presenting as exacerbation of asthma. Case Reports in Emergency Medicine, 2017, 6863083. https://doi.org/10.1155/2017/6863083

Nasir, Z. M., & Subha, S. T. (2021). A five-year review on pediatric foreign body aspiration. International Archives of Otorhinolaryngology, 25(2), e193–e199. https://doi.org/10.1055/s-0040-1709739

Centers for Disease Control and Prevention (CDC). (2002). Nonfatal choking-related episodes among children—United States, 2001. MMWR. Morbidity and Mortality Weekly Report, 51(42), 945–948.

Safari, M., & Manesh, M. R. (2016). Demographic and clinical findings in children undergoing bronchoscopy for foreign body aspiration. Ochsner Journal, 16(2), 120–124.

Kim, K., Lee, H. J., Yang, E. A., Kim, H. S., Chun, Y. H., Yoon, J. S., Kim, H. H., & Kim, J. T. (2018). Foreign body removal by flexible bronchoscopy using retrieval basket in children. Annals of Thoracic Medicine, 13(2), 82–85. https://doi.org/10.4103/atm.ATM_337_17

Ding, G., Wu, B., Vinturache, A., Cai, C., Lu, M., & Gu, H. (2020). Tracheobronchial foreign body aspiration in children: A retrospective single-center cross-sectional study. Medicine, 99(22), e20480. https://doi.org/10.1097/MD.0000000000020480

Karišik, M. (2023). Foreign body aspiration and ingestion in children. Acta Clinica Croatica, 62(Suppl. 1), 105–112. https://doi.org/10.20471/acc.2023.62.s1.13

Fidkowski, C. W., Zheng, H., & Firth, P. G. (2010). The anesthetic considerations of tracheobronchial foreign bodies in children: A literature review of 12,979 cases. Anesthesia and Analgesia, 111(4), 1016–1025. https://doi.org/10.1213/ANE.0b013e3181ef3e9c

Raviv, I., Pozailov, S., Avraham, S., Aviram, M., Goldbart, A., Dizitzer, Y., Gatt, D., Tsaregorodtsev, S., & Golan-Tripto, I. (2023). Evaluation of foreign body aspiration score (FOBAS) in children—A retrospective cohort study. European Journal of Pediatrics, 182(9), 4205–4212. https://doi.org/10.1007/s00431-023-05095-w

Genisol, I., & Uzunlu, O. (2022). Using machine learning technique to predict the most reliable diagnostic finding for foreign body aspiration in children: Symptoms, chest X-ray, or auscultation? Cureus, 14(12), e32461. https://doi.org/10.7759/cureus.32461

Mîndru, D. E., Păduraru, G., Rusu, C. D., Țarcă, E., Azoicăi, A. N., Roșu, S. T., Curpăn, A. Ș., Ciomaga Jitaru, I. M., Pădureț, I. A., & Luca, A. C. (2023). Foreign body aspiration in children—Retrospective study and management novelties. Medicina (Kaunas, Lithuania), 59(6), 1113. https://doi.org/10.3390/medicina59061113

Kaur, K., Sonkhya, N., & Bapna, A. S. (2002). Foreign bodies in the tracheobronchial tree: A prospective study of fifty cases. Indian Journal of Otolaryngology and Head and Neck Surgery, 54(1), 30–34. https://doi.org/10.1007/BF02911002

Petrová, B., Urík, M., Šíma, J., Hluchníková, M., Bartoš, M., Ťoukálková, M., Pavlovská, D., & Jabandžiev, P. (2026). Role of X-ray in managing foreign body aspiration in children. Ear, Nose, & Throat Journal, 1455613251408948. Advance online publication. https://doi.org/10.1177/01455613251408948

Sattar, A., Ahmad, I., Javed, A. M., & Anjum, S. (2011). Diagnostic accuracy of chest x-ray in tracheobronchial foreign body aspiration in paediatric patients. Journal of Ayub Medical College, Abbottabad, 23(4), 103–105.

Salih, A. M., Alfaki, M., & Alam-Elhuda, D. M. (2016). Airway foreign bodies: A critical review for a common pediatric emergency. World Journal of Emergency Medicine, 7(1), 5–12. https://doi.org/10.5847/wjem.j.1920-8642.2016.01.001

Goodarzy, B., Rahmani, E., Farrokhi, M., Tavakoli, R., Moghadam Fard, A., Ranjbaran Ghaleh, M., Ghalichebaf Yazdi, Y., Amani Beni, R., Ghadirzadeh, E., Afrazeh, F., Alipour Khabir, Y., Alipour Khabir, S., Bakhtiyari, P., Atighi, J., Mahjoubi, M., Momeni, Z., Jalayeri, H., Hosseini, M. H., Hoorshad, B., … Zare Lahijan, L. (2024). Diagnostic value of chest computed tomography scan for identification of foreign body aspiration in children: A systematic review and meta-analysis. Archives of Academic Emergency Medicine, 13(1), e3. https://doi.org/10.22037/aaem.v12i1.2431

Tuckett, P., & Cervin, A. (2015). Reducing the number of rigid bronchoscopies performed in suspected foreign body aspiration cases via the use of chest computed tomography: Is it safe? A literature review. J Laryngol Otol, 129(Suppl. 1), S1–S7. https://doi.org/10.1017/S0022215114002862

Azzi, J. L., Seo, C., McInnis, G., Urichuk, M., Rabbani, R., Rozovsky, K., & Leitao, D. J. (2023). A systematic review and meta-analysis of computed tomography in the diagnosis of pediatric foreign body aspiration. International Journal of Pediatric Otorhinolaryngology, 165, 111429. https://doi.org/10.1016/j.ijporl.2022.111429

Arlachov, Y., & Ganatra, R. H. (2012). Sedation/anaesthesia in paediatric radiology. The British Journal of Radiology, 85(1019), e1018–e1031. https://doi.org/10.1259/bjr/28871143

Mathews, J. D., Forsythe, A. V., Brady, Z., Butler, M. W., Goergen, S. K., Byrnes, G. B., Giles, G. G., Wallace, A. B., Anderson, P. R., Guiver, T. A., McGale, P., Cain, T. M., Dowty, J. G., Bickerstaffe, A. C., & Darby, S. C. (2013). Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: Data linkage study of 11 million Australians. BMJ, 346, f2360. https://doi.org/10.1136/bmj.f2360

Kim, I. A., Shapiro, N., & Bhattacharyya, N. (2015). The national cost burden of bronchial foreign body aspiration in children. The Laryngoscope, 125(5), 1221–1224. https://doi.org/10.1002/lary.25002

Schramm, D., Freitag, N., Nicolai, T., Wiemers, A., Hinrichs, B., Amrhein, P., DiDio, D., Eich, C., Landsleitner, B., Eber, E., Hammer, J., & Special Interest Group on Pediatric Bronchoscopy of the Society for Pediatric Pneumology (GPP) and invited Societies involved in pediatric airway endoscopy. (2021). Pediatric airway endoscopy: Recommendations of the Society for Pediatric Pneumology. Respiration, 100(11), 1128–1145. https://doi.org/10.1159/000517125

Chen, X., & Zhang, C. (2017). Foreign body aspiration in children: Focus on the impact of delayed treatment. International Journal of Pediatric Otorhinolaryngology, 96, 111–115. https://doi.org/10.1016/j.ijporl.2017.03.013

Iversen, R. H., & Klug, T. E. (2012). Need for more clear parental recommendations regarding foreign body aspiration in children. Danish Medical Journal, 59(9), A4498.

Ghosh, D., Mitra, R., Mondal, S., Kumar, S., & Sengupta, A. (2023). Foreign body aspiration in children and emergency rigid bronchoscopy: A retrospective observational study. Indian Journal of Otolaryngology and Head and Neck Surgery, 75(3), 1533–1541. https://doi.org/10.1007/s12070-023-03628-1

Golan-Tripto, I., Weinstein Mezan, D., Tsaregorodtsev, S., Stiler-Timor, L., Dizitzer, Y., Goldbart, A., & Aviram, M. (2021). Correction to: From rigid to flexible bronchoscopy: A tertiary center experience in removal of inhaled foreign bodies in children. European Journal of Pediatrics, 180(5), 1451. https://doi.org/10.1007/s00431-021-03960-0

Wang, Q., Kong, X., Wang, G., Dai, J., Li, Y., Wu, C., Pan, Z., He, L., & Li, H. (2024). A real-world study of foreign body aspiration in children with 4227 cases in Western China. Scientific Reports, 14(1), 15251. https://doi.org/10.1038/s41598-024-65876-7

Safia, A., Abd Elhadi, U., Bader, R., Khater, A., Karam, M., Bishara, T., Massoud, S., Merchavy, S., & Farhat, R. (2024). Flexible versus rigid bronchoscopy for tracheobronchial foreign body removal in children: A comparative systematic review and meta-analysis. Journal of Clinical Medicine, 13(18), 5652. https://doi.org/10.3390/jcm13185652

Zerella, J. T., Dimler, M., McGill, L. C., & Pippus, K. J. (1998). Foreign body aspiration in children: Value of radiography and complications of bronchoscopy. Journal of Pediatric Surgery, 33(11), 1651–1654. https://doi.org/10.1016/S0022-3468(98)90601-7

Wu, Y., Zhang, X., Lin, Z., Ding, C., Wu, Y., Chen, Y., Wang, D., Yi, X., & Chen, F. (2023). Changes in the global burden of foreign body aspiration among under-5 children from 1990 to 2019. Frontiers in Pediatrics, 11, 1235308. https://doi.org/10.3389/fped.2023.1235308

Bjerregaard, A. T., Holm, J. K., & Clausen, N. G. (2025). Time from suspected foreign body aspiration to bronchoscopy at Odense University Hospital during a 5-year period. Acta Anaesthesiologica Scandinavica, 69(6), e70053. https://doi.org/10.1111/aas.70053

Xu, Y., Ren, H. B., Jiang, L., Wang, S. F., Feng, R. L., & Li, Q. (2019). Analysis of related factors for the retention time of tracheobronchial foreign bodies in pediatrics. The Journal of Surgical Research, 233, 262–267. https://doi.org/10.1016/j.jss.2018.08.024

Huarhua Jimenez, E. A., Kruchinsky Lozada, A., Galdos Bejar, M., & Yhuri Carreazo, N. (2023). Association between pre-bronchoscopy time of illness and post-bronchoscopy discharge time in pediatric patients with foreign body aspiration: Retrospective cohort study in a Peruvian referral center, 2014–2019. Revista Peruana de Medicina Experimental y Salud Publica, 40(4), 423–431. https://doi.org/10.17843/rpmesp.2023.404.12977

Hidaka, H., Obara, T., Kuriyama, S., Kurosawa, S., Katori, Y., & Kobayashi, T. (2013). Logistic regression analysis of risk factors for prolonged pulmonary recovery in children from aspirated foreign body. International Journal of Pediatric Otorhinolaryngology, 77(10), 1677–1682. https://doi.org/10.1016/j.ijporl.2013.07.024

Downloads

Published

2026-09-10

How to Cite

Gebert, Z., Juszkiewicz, D., Zaręba, A., Dłużewska, M., Kucharska, A., Adler, K., Fetner, B. ., Ilkiv, I. ., Stankowska, P., & Kiełczewski, K. (2026). ASSESSMENT AND MANAGEMENT OF FOREIGN BODY ASPIRATION IN CHILDREN - A NARRATIVE REVIEW. International Journal of Innovative Technologies in Social Science, 3(3(51). https://doi.org/10.31435/ijitss.3(51).2026.5777

Most read articles by the same author(s)