CT in Children With Suspected Residual Foreign Body in Airway After Bronchoscopy

Abstract

OBJECTIVE. The purpose of our study was to determine whether CT provides additional information for children with a suspected residual foreign body in the airway after bronchoscopy. MATERIALS AND METHODS. We reviewed the CT findings and medical records of nine patients (five girls and four boys; mean age, 17.9 months) who underwent CT between March 1999 and February 2007 for the evaluation of a clinically suspected residual foreign body in the airway after bronchoscopy. We evaluated the location and pattern of bronchial obstruction and associated parenchymal abnormalities on CT. CT findings were compared with a second bronchoscopy in five patients. The remaining four patients were followed clinically. Association between CT findings and results on second bronchoscopy was evaluated with Fisher`s exact test. RESULTS. CT after bronchoscopy (n = 9) showed bronchial obstruction in eight patients with focal complete (n = 3), diffuse (n = 3), or combined type (n = 2) bronchial obstruction. These obstructions were not seen at chest radiography. CT revealed unilateral or lobar emphysema (n = 6), atelectasis (n = 6), and consolidation (n = 1). The remaining one patient showed no abnormality on CT. A second bronchoscopy (n = 5) confirmed the focal complete bronchial obstruction at CT (n = 3) as retained foreign body fragments (n = 2) or mucus plug (n = 1) and the combined type at CT (n = 2) as retained foreign body fragments, granulation tissue, and edema of the bronchus (n = 1) or retained foreign body fragments, granulation tissue, and mucus plug (n = 1). There was a significant association between CT findings of type of bronchial obstruction and intrabronchial obstructive lesion on the second bronchoscopy (p = 0.036). CONCLUSION. CT after bronchoscopy can provide additional information regarding the presence and pattern of bronchial obstruction in children with a suspected residual foreign body.