Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Sciences Center, Memphis, Tennessee 38103, USA.
Allergy Asthma Proc. 2010 Mar-Apr;31(2):154-7. doi: 10.2500/aap.2010.30.3271.
This is a case report of a 9-year-old boy with new onset stridor 5 days after a choking event. Symptoms would last 5-45 minutes. His stridor was unresponsive to nebulized epinephrine but improved when he relaxed. Otlaryngology examination noted laryngeal irritation that was suggestive of gastroesophageal reflux (GER). Episodic stridor continued, despite treatment for GER, prompting hospitalization. On admission, barium swallow indicated hyperinflation of the left lung and bronchoscopy confirmed the aspiration of food. Within 12 hours of bronchoscopy, his stridor recurred. The recurrence of stridor after bronchoscopy resulted in further evaluation of his upper airway disorder. The true diagnosis was revealed during methacholine challenge. This case illustrates a unique presentation of a common upper respiratory disorder, the need for a high index of suspicion to make the diagnosis, and the importance of the multispecialty approach needed to treat patients with this disorder.
这是一例 9 岁男孩的病例报告，他在窒息事件发生 5 天后出现新发性喘鸣。症状持续 5-45 分钟。他的喘鸣对雾化肾上腺素无反应，但在放松时会有所改善。耳鼻喉科检查发现喉刺激，提示胃食管反流（GER）。尽管对 GER 进行了治疗，但间歇性喘鸣仍持续存在，促使他住院治疗。入院时，钡餐显示左肺过度充气，支气管镜检查证实食物吸入。支气管镜检查后 12 小时内，他再次出现喘鸣。支气管镜检查后喘鸣的复发导致进一步评估他的上呼吸道疾病。在乙酰甲胆碱激发试验中揭示了真正的诊断。该病例说明了一种常见上呼吸道疾病的独特表现，需要高度怀疑才能做出诊断，以及治疗此类疾病患者所需的多学科方法的重要性。
