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Vol. 53. Issue 4.
Pages 335-338 (1 October 2000)
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Vol. 53. Issue 4.
Pages 335-338 (1 October 2000)
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Broncoaspiración de cuerpos extraños en la infancia. Revisión de 210 casos
Foreign body aspiration in childhood. Report of 210 cases
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12797
I. Fernández Jiménez
Corresponding author
ferjinmi@yahoo.es

: Dra. I. Fernández Jiménez. Servicio de Cirugía Pediátrica. Residencia Cantabria. Cazoña, s/n. 39011 Santander
, C. Gutiérrez Segura, V. Álvarez Muñoz, D. Peláez Mata
Servicio de Cirugía Pediátrica. Hospital Central de Asturias. Oviedo
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Objetivos

La aspiración de cuerpos extraños es uno de los accidentes de mayor incidencia y morbimortalidad en la infancia, favorecido entre otros motivos por la curiosidad propia de esta edad y la inmadurez de los mecanismos de-glutorios. Con el objetivo de evaluar los signos y síntomas más comunes que conducen al diagnóstico de broncoaspi-ración, y para demostrar el valor diagnóstico de la anamnesis, analizamos los casos de aspiración de cuerpo extraño tratados en nuestro centro durante los años 1975-1997.

Pacientes y método

Se presenta un estudio retrospectivo que evalúa distintos parámetros en un total de 210 pacientes, de los cuales se realizó broncoscopia en 208 casos, hallándose evidencia de cuerpo extraño en el 90%.

Resultados y conclusiones

Destacamos el valor de una detallada historia clínica, presentando el antecedente de atragantamiento y las crisis de tos persistente una sensibilidad del 80%, respectivamente. En cuanto a la exploración clínica, la auscultación se revela como una prueba de gran sensibilidad (90%), aunque con baja especificidad (16%). Las pruebas radiológicas presentan menor sensibilidad, con un 16% de falsos negativos. Un elevado porcentaje se trataba de cuerpos extraños vegetales (82%), con una tasa de complicaciones del 5,7% y una mortalidad del 0,9%, si bien en los últimos 8 años no ha fallecido ningún niño.

Keywords:
Foreign body
Bronchoscopy
Childhood
Palabras clave:
Cuerpo extraño
Broncoscopia
Niños
Objective

Foreign body aspiration is one of the accidents with highest incidence, morbidity and mortality in childhood. It is favoured by curiosity and the immature swallowing mechanisms of this age group. To determine the most common signs and symptoms leading to the diagnosis of foreign body aspiration and to demonstrate the diagnostic value of a detailed anamnesis, we analyzed the cases of foreign body aspiration treated in our hospital between 1975 and 1997.

Patients and method

Retrospective study of 210 patients with suspected foreign body aspiration. In 208 patients rigid bronchos-copy was performed. Evidence of a foreign body was found in 90%.

Results and conclusions

We emphasize the clinical value of thorough anamnesis which showed high sensitivity (80%) in choking crises and persistent cough. Physical examination and respiratory auscultation showed high sensitivity (90%) but low specificity (16%). Chest X-ray showed the lowest sensitivity with 16% of false negatives. Most foreign bodies were vegetable fragments (82%), with a complication rate of 5.7%. Mortality was 0.9%, with no deaths occurring in the last 8 years.

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Copyright © 2002. Asociación Española de Pediatría
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