Study of the Causes of Delayed Diagnosis in Patients with Foreign Body Aspiration

Foreign body aspiration commonly involves very young children and taking a precise history and doing a careful physical examination can lead to diagnosis. If the extraction of the object is delayed beyond 24 hours, it will lead to complications such as pneumonia, abscess, and atelectasis. Therefore, the present study tries to investigate the duration and reasons of delayed diagnosis of airway foreign body aspiration in children admitted to pediatric Hospital in Tabriz. Patients and This cross-sectional descriptive study was done over a period of 36 months, from 2001 to 2004, in the ENT Department of Children’s Hospital in Tabriz. 155 cases who had been admitted for foreign body aspiration and had undergone successful bronchoscopic removal were studied. The information such as the history of choking, the gap between initiation of symptoms and admission (duration of delayed diagnosis), outpatient visits, the first diagnosis, and the results of bronchoscopy was all recorded in the checklists. To analyze the data, descriptive statistics, and Excell 11.0 were used. The mean age of the patients was 21.58 (±12.90) months. 81.3% were under 3 years of age and 18.7% were above 3. Protracted cough lasting beyond 3 weeks was the most common symptom found in 73.5% of the cases. The average interval between aspiration and admission was 24.71 (± 8.96) days. Only 24.5% arrived in the first 24 hours. The main causes of delayed diagnosis were lack of notice on the part of parents and incorrect diagnoses made by physicians. 75.5% of the cases with foreign body aspiration were referred after 24 hours and the duration of delayed diagnosis in the present study was longer than that mentioned in the reports of other centers. Parent's unawareness and physician's insufficient training can delay the diagnosis of airway foreign body aspiration and cause serious complications. Thus, providing proper education is necessary to prevent them.