What is the investigation of choice for suspected foreign body aspiration in children?

The investigation of choice for suspected foreign body aspiration in children is bronchoscopy. This procedure allows direct visualization of the airway and the opportunity to retrieve the foreign body if present.

Bronchoscopy is particularly effective because it can be performed both as a diagnostic tool and as a therapeutic intervention. When a child is suspected of having aspirated a foreign body, immediate bronchoscopy can provide not only confirmation by visualizing the airways but also allow for the safe removal of the object, thereby preventing potential complications such as airway obstruction or infection.

While a chest X-ray may be performed initially to assess for signs of aspiration pneumonia or obstructive atelectasis, it does not provide the ability to directly visualize or remove objects from the airway. CT scans offer detailed images and can help identify foreign bodies but are typically not the first-line choice due to the need for sedation and the radiation exposure involved, making it less ideal in pediatric cases. Laryngoscopy is usually reserved for upper airway issues and does not adequately address foreign bodies lodged deeper in the airway.

In summary, bronchoscopy is the preferred approach in suspected foreign body aspiration cases due to its dual role in diagnosis and management, making it a critical procedure in pediatric emergency settings.