Successful Management Foreign Body Aspiration Associated with Severe Respiratory Distress and Subcutaneous Emphysema: Case Report and Literature Review.

José Juan Gómez-Ramos,Oscar Gabriel Felipe-Diego,Alejandro Marín-Medina,Alexandro Azael Castillo-Cobian

doi:10.3390/medicina58030396

José Juan Gómez-Ramos, Oscar Gabriel Felipe-Diego + Show 2 more

Open Access

https://doi.org/10.3390/medicina58030396

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Abstract

The presence of a foreign body in the airway is a potentially life-threatening clinical condition that requires urgent medical attention. We present a case of a 12-year-old boy who presented in the emergency room with a history of an episode of choking after aspiration of a foreign body, followed by severe respiratory distress and subcutaneous emphysema. Chest radiography revealed hyperinflation data, pneumothorax, and subcutaneous emphysema data. The flexible bronchoscope examination showed the presence of an inorganic foreign body impacted on the carina with tracheal lesions and laryngeal edema. It was necessary to perform a tracheostomy for its definitive extraction. The gold standard in the treatment of foreign body aspiration is bronchoscopy; although, in children, the technique adopted continues to be controversial, flexible bronchoscopy can be effective and very useful.

Highlights

The presence of respiratory distress in children is one of the main reasons for consultation in the emergency room (ER), responsible for up to 10% of all consultations [1]
Montana et al [4] report an extra-hospital mortality of 36.4% related, above all, to those fatal cases where the foreign body became lodged in the larynx or trachea [5]
Bronchoscopy is the diagnostic and therapeutic method indicated when foreign body (FB) inhalation is suspected, especially in children. It is considered the gold standard in the identification and localization of foreign body in the airway (FBa) [6]

Summary

Introduction

The presence of respiratory distress in children is one of the main reasons for consultation in the emergency room (ER), responsible for up to 10% of all consultations [1]. The existing data, in relation to mortality due to the aspiration of a foreign body (FB) in pediatric age, are very few and varied, basically depending on the age group, the socioeconomic environment, and the clinical scenario studied. In this sense, Montana et al [4] report an extra-hospital mortality of 36.4% related, above all, to those fatal cases where the foreign body became lodged in the larynx or trachea [5]. Bronchoscopy is the diagnostic and therapeutic method indicated when FB inhalation is suspected, especially in children It is considered the gold standard in the identification and localization of FBa [6]. We present a case of an adolescent with an FB aspiration and review the literature regarding clinical manifestations, surgical and radiological findings, as well as the management of patients with this condition

Case Report

Findings

Discussion

Conclusions