[Foreign bodies of the respiratory tract in children. A retrospective study of 100 cases].

Foreign body inhalation is a universal problem, most common cause of death from domestic accident in children aged five years and less. Over 15 years, one hundred children aged less than six years were evaluated in Hotel Dieu de France; findings are comparable to previous data, with one avoidable death; boys are chiefly concerned (64%); mean age is 22.5 months; circumstances are often hazy (65%); vegetables are prominently responsible (90%) especially peanuts and pistachios (48%); foreign bodies are seldom radiopaque (1%); autumnal predominance is noted. Inhalation is not reported in 25% of cases; immediate risk is subglottic impaction; the child survives if the foreign body is expelled one way or another. The most frequent site is the bronchial system (87%) with a slight right predominance (49%); symptoms include: dyspnea, persistent cough, and, in case of bronchial obstruction: wheezing and asymmetry of breath sounds; 15% of children are free of symptoms. Delay before hospital care is long (21.5 days), mostly because diagnosis is misread particularly in case of bronchial foreign body; pulmonary distension is a frequent finding (45%). In case of asphyxia, first aid resuscitation is performed immediately: in fact it is rarely useful, sometimes harmful. Extraction is mandatory with the stiff bronchoscope; otherwise, bronchopulmonary infection and destruction is the usual outcome ... (25%). Management is revisited, and prevention is recalled.