Tracheobronchial foreign bodies in children: reaching a diagnosis.

Tracheobronchial foreign body aspiration constitutes a significant cause of morbidity and mortality in the paediatric age group. Diagnosis is often delayed with symptoms and signs being attributed to other causes of respiratory distress. In this study we evaluate the importance of three criteria on which the diagnosis of foreign body aspiration may be based--a history of aspiration, physical examination and a plain chest radiograph. These parameters are correlated with findings on bronchoscopy. It is seen that a history of foreign body aspiration is notoriously unreliable in children of all age groups (p > 0.1). Similarly, presence or absence of findings on physical examination suggestive of foreign body aspiration or its sequalae are not always indicative (p > 0.1). Chest radiograph may be normal or misleading. It is therefore concluded that this is a diagnosis based on the cumulative evidence provided by all three parameters in the clinical context. The hazards of betel nut intake, the object most commonly incriminated, are emphasized.