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

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.

[1]  R. Serra,et al.  Risk Management and Recommendations for the Prevention of Fatal Foreign Body Aspiration: Four Cases Aged 1.5 to 3 Years and Mini-Review of the Literature , 2020, International journal of environmental research and public health.

[2]  D. Yıldızdaş,et al.  Evaluation of foreign body aspiration cases in our pediatric intensive care unit: Single-center experience , 2019, Turk pediatri arsivi.

[3]  H. Schroten,et al.  Management of Foreign Body Removal in Children by Flexible Bronchoscopy , 2017, Journal of bronchology & interventional pulmonology.

[4]  K. Acharya Rigid Bronchoscopy in Airway Foreign Bodies: Value of the Clinical and Radiological Signs , 2016, International Archives of Otorhinolaryngology.

[5]  Alaaddin M Salih,et al.  Airway foreign bodies: A critical review for a common pediatric emergency. , 2016, World journal of emergency medicine.

[6]  Kathryn E. Darras,et al.  Imaging Acute Airway Obstruction in Infants and Children. , 2015, Radiographics : a review publication of the Radiological Society of North America, Inc.

[7]  A. Heidarzadeh,et al.  Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study , 2015, Iranian journal of otorhinolaryngology.

[8]  M. Baghriche,et al.  Foreign body aspiration in children: experience from 2624 patients. , 2013, International journal of pediatric otorhinolaryngology.

[9]  G. Passali,et al.  Management of foreign bodies in the airway and oesophagus. , 2012, International journal of pediatric otorhinolaryngology.

[10]  G. Passali,et al.  Foreign bodies in the airways: a meta-analysis of published papers. , 2012, International journal of pediatric otorhinolaryngology.

[11]  E. Çalışkan,et al.  Foreign Body Aspiration in Children: Analysis of Diagnostic Criteria and Accurate Time for Bronchoscopy , 2011, Pediatric emergency care.

[12]  K. Narasimhan,et al.  Role of tracheostomy in the management of foreign body airway obstruction in children. , 2009, Singapore medical journal.

[13]  L. Tang,et al.  Airway foreign body removal by flexible bronchoscopy: experience with 1027 children during 2000–2008 , 2009, World journal of pediatrics : WJP.

[14]  A. Mehta,et al.  Airway Interventions in the Tracheobronchial Tree , 2008, Seminars in respiratory and critical care medicine.

[15]  A. Mehta,et al.  Subcutaneous Emphysema : An Unusual Presentation of Foreign Body Bronchus. , 2007, Medical journal, Armed Forces India.

[16]  P. Kero,et al.  How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children? , 2006, Pediatric Radiology.

[17]  M. H. Vargas,et al.  Foreign Body Removal by Flexible Fiberoptic Bronchoscopy in Infants and Children , 2005, Pediatric pulmonology.

[18]  K. Swanson Airway foreign bodies: what's new? , 2004, Seminars in respiratory and critical care medicine.

[19]  A. Filiz,et al.  Foreign body aspiration: clinical utility of flexible bronchoscopy , 2002, Postgraduate medical journal.

[20]  J. D. Hall,et al.  Tracheobronchial Foreign Body Aspiration in Children , 1996, Southern medical journal.