Oviawe O, Abhulimhen-Iyoha B I, Obaseki D E
Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.
Niger Postgrad Med J. 2011 Jun;18(2):154-7.
Tracheobronchial foreign bodies (FBs) especially in infants and children can cause respiratory obstruction and can lead to death if intervention is delayed. Two cases of migrating FBs in the tracheobronchial (T-b) tree with fatal outcome are reported: Case 1 was an 11-year-old girl with a ten-week history of episodes of fever, cough, breathlessness and progressive weight loss. No positive history of FB aspiration. She was cachetic and febrile with short attention span, dyspnoeic, a flattened left upper hemithorax, mediastinal shift and evidence of atelectasis. Case 2, a 5-year-old girl with a three-month history of aspiration of a tiny toy. She developed fever, cough and marked weight loss, developed severe respiratory distress three days prior to presentation. She was febrile, had grade II finger clubbing, markedly dyspnoeic, left mediastinal shift, and evidence of left sided atelectasis. X-ray films in Case 1 showed evidence of FB at various locations in the T-b tree, and complete opacification and atelectasis of left hemithorax in Case 2. Planned bronchoscopy could not be done as both patients were adjudged to be too severely ill for the procedure. Both patients died after 9 days and 8 hours of hospital stay, respectively. Postmortem revealed FB in right main bronchus in both patients (tooth and toy, respectively) and evidence of tuberculosis in Case 2. Fatal outcome is attributed to inappropriate healthcare seeking behaviour, lack of medical expertise and material resources in our health facilities.
气管支气管异物（FBs），尤其是在婴幼儿和儿童中，可导致呼吸阻塞，如果干预延迟可能会导致死亡。本文报告了两例气管支气管（T-b）树中异物迁移并导致致命后果的病例：病例1是一名11岁女孩，有为期十周的发热、咳嗽、呼吸急促和体重逐渐减轻症状。无异物吸入阳性史。她消瘦、发热，注意力不集中，呼吸困难，左上半胸扁平，纵隔移位并有肺不张迹象。病例2是一名5岁女孩，有三个月前误吸一个小玩具的病史。她出现发热、咳嗽和明显体重减轻，在就诊前三天出现严重呼吸窘迫。她发热，有II级杵状指，明显呼吸困难，左纵隔移位，并有左侧肺不张迹象。病例1的X线片显示气管支气管树不同部位有异物证据，病例2显示左半胸完全致密影和肺不张。由于判定两名患者病情太重无法进行计划中的支气管镜检查。两名患者分别在住院9天和8小时后死亡。尸检发现两名患者右主支气管均有异物（分别为牙齿和玩具），病例2有结核病证据。致命后果归因于寻求医疗行为不当、我们卫生机构缺乏医学专业知识和物资资源。
