Tracheobronchial pen cap and pen nib foreign body aspiration in 32 children: clinical features, CT findings, and bronchoscopic management
- 1Department of Otorhinolaryngology, Anhui Hospital of Children’s Hospital of Fudan University, Anhui Maternity and Child Health Hospital, Anhui Provincial Children’s Hospital, Hefei, Anhui Province 230022 China
Abstract
Background: Tracheobronchial foreign body aspiration is a common pediatric emergency. In recent years, aspiration of stationery-related objects such as pen caps and pen nibs has been increasingly encountered in school-aged children. These objects possess unique structural characteristics that may influence clinical presentation and management.
Methods: We conducted a retrospective analysis of 32 pediatric patients with tracheobronchial foreign body aspiration caused by pen caps or pen nibs treated between January 2017 and December 2025. Clinical features, imaging findings, foreign body characteristics, bronchoscopic management, and outcomes were analyzed. The relationship between provision of a foreign body history and disease duration was evaluated.
Results: All 32 patients were school-aged boys (mean age, 8.6 years). The most common symptoms were cough and wheezing. Chest CT was performed in 31 patients (96.9%) and identified/localized the foreign body in all examined cases; however, this retrospective study did not evaluate whether CT independently changed management or outcomes. Foreign bodies were most frequently located in the right main bronchus. All cases were successfully managed using rigid bronchoscopy, with flexible bronchoscopy used as an adjunct in one case. Patients who did not provide a clear or timely history of foreign body aspiration had a significantly longer disease course compared with those with a definite history (P < 0.001). No life-threatening complications occurred; however, clinically relevant events such as transient hemoptysis, airway edema, and pneumothorax were observed in individual cases.
Conclusions: Stationery-related tracheobronchial foreign body aspiration predominantly affects school-aged boys and presents unique diagnostic challenges. Delayed or absent reporting of aspiration history is associated with prolonged disease duration. CT may be considered as a selective adjunct for localization and procedural planning in clinically stable children, particularly when the history is unclear or presentation is atypical, while rigid bronchoscopy remains the primary diagnostic and therapeutic modality.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07395-0.
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BibTeX
@article{cheng2026tracheobronchial,
title = {{Tracheobronchial pen cap and pen nib foreign body aspiration in 32 children: clinical features, CT findings, and bronchoscopic management}},
author = {Zhao Cheng and Qi Cheng and Ying Yang and Shuhua Wu},
journal = {BMC Pediatrics},
year = {2026},
month = jul,
doi = {10.1186/s12887-026-07395-0},
url = {https://doi.org/10.1186/s12887-026-07395-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Tracheobronchial pen cap and pen nib foreign body aspiration in 32 children: clinical features, CT findings, and bronchoscopic management
AU - Zhao Cheng
AU - Qi Cheng
AU - Ying Yang
AU - Shuhua Wu
PY - 2026
DA - 2026/07/30
JO - BMC Pediatrics
DO - 10.1186/s12887-026-07395-0
UR - https://doi.org/10.1186/s12887-026-07395-0
AB - Background: Tracheobronchial foreign body aspiration is a common pediatric emergency. In recent years, aspiration of stationery-related objects such as pen caps and pen nibs has been increasingly encountered in school-aged children. These objects possess unique structural characteristics that may influence clinical presentation and management. Methods: We conducted a retrospective analysis of 32 pediatric patients with tracheobronchial foreign body aspiration caused by pen caps or pen nibs treated between January 2017 and December 2025. Clinical features, imaging findings, foreign body characteristics, bronchoscopic management, and outcomes were analyzed. The relationship between provision of a foreign body history and disease duration was evaluated. Results: All 32 patients were school-aged boys (mean age, 8.6 years). The most common symptoms were cough and wheezing. Chest CT was performed in 31 patients (96.9%) and identified/localized the foreign body in all examined cases; however, this retrospective study did not evaluate whether CT independently changed management or outcomes. Foreign bodies were most frequently located in the right main bronchus. All cases were successfully managed using rigid bronchoscopy, with flexible bronchoscopy used as an adjunct in one case. Patients who did not provide a clear or timely history of foreign body aspiration had a significantly longer disease course compared with those with a definite history (P < 0.001). No life-threatening complications occurred; however, clinically relevant events such as transient hemoptysis, airway edema, and pneumothorax were observed in individual cases. Conclusions: Stationery-related tracheobronchial foreign body aspiration predominantly affects school-aged boys and presents unique diagnostic challenges. Delayed or absent reporting of aspiration history is associated with prolonged disease duration. CT may be considered as a selective adjunct for localization and procedural planning in clinically stable children, particularly when the history is unclear or presentation is atypical, while rigid bronchoscopy remains the primary diagnostic and therapeutic modality. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07395-0.
SN - 1471-2431
ER -