Surgical emphysema: a rare presentation of foreign body inhalation.
An 11-year-old girl with an almond lodging in the tracheobronchial tree is described. She presented with an uncommon symptom of subcutaneous emphysema The x-ray revealed left-sided pneumothorax and pneumomediastinum. Intercostal drain was inserted, but she developed respiratory failure and was ventilated. After initial stabilization for 60 hours, she deteriorated again and her x-ray revealed right-sided collapse. After removal of the foreign body, she was discharged but presented again with stridor necessitating tracheostomy. Tracheal stenosis was found and required end-to-end anastomosis. The authors feel that, while foreign bodies are uncommon in this age group with emphysema as a rarer manifestation, this cause should be kept in mind, even in the absence of forthcoming history. A high index of suspicion for tracheobronchial foreign body is required in atypical presentations of acute pediatric respiratory distress.
Jhamb
Urmil
U
Pediatric Intensive Care Unit, Maulana Azad Medical College & LNH, New Delhi, India.
Sethi
G R
GR
Puri
Rajeev
R
Kapoor
Seema
S
D000402:Airway Obstruction / Q000188:drug therapy / Q000209:etiology; D000714:Anastomosis, Surgical; D000900:Anti-Bacterial Agents; D001980:Bronchi; D001993:Bronchodilator Agents / Q000627:therapeutic use; D015505:Chest Tubes; D002648:Child; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D001239:Inhalation; D008478:Mediastinal Emphysema / Q000209:etiology / Q000601:surgery; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery; D027861:Prunus; D012008:Recurrence; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology; D012141:Respiratory Tract Infections / Q000175:diagnosis; D015607:Stents; D013352:Subcutaneous Emphysema / Q000209:etiology*; D014132:Trachea; D014135:Tracheal Stenosis / Q000209:etiology* / Q000601:surgery; D014139:Tracheostomy
D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents