Verhees V, Ketharanathan N, Oen I M M H, Baartmans M G A, Koopman J S H A
Department of Intensive Care, Maasstad Ziekenhuis, Maasstadweg 21, 3079 DZ, Rotterdam, the Netherlands.
Department of Pediatric Intensive Care and Department of Pediatric Surgery, Erasmus MC, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
BMC Anesthesiol. 2018 Dec 22;18(1):203. doi: 10.1186/s12871-018-0665-7.
The type of scalding injury known as 'teapot syndrome', where hot liquid is grabbed by the child with the aim of ingestion and falls over a child causing burns on the face, upper thorax and arms, is known to cause peri-oral and facial oedema. Thermal epiglottitis following scalds to face, neck and thorax is rare and can occur even in absence of ingestion of a damaging agent or intraoral burns, Awareness of the possibility of thermal epiglottitis, also in scald burns, is imperative to ensure prompt airway protection.
We report the case of a child with thermal epiglottitis after a scalding burn from boiling milk resulting in mixed deep burns of the face, neck and chest, but no history of ingestion. Upon presentation there was a progressive stridor and signs of respiratory distress requiring intubation. Laryngoscopy revealed epiglottis oedema, confirming the diagnosis of thermal epiglottitis. Final extubation took place 5 days after initial burn.
Thermal epiglottitis following scalds to face, neck and thorax is rare and can occur even in absence of ingestion and intra-oral damage. Burns to the peri-oral area should raise suspicion of additional damage to oral cavity and supraglottic structures, even in absence of intra-oral injury or initial respiratory distress. Awareness of the occurrence of thermal epiglottitis in absence of intra-oral injury is important to diagnose impending upper airway obstruction requiring intubation.
有一种烫伤被称为“茶壶综合征”，即儿童为了吞咽而抓取热液体，结果热液体洒落在儿童身上，导致面部、上胸部和手臂烧伤，这种烫伤会引起口周和面部水肿。面部、颈部和胸部烫伤后发生的热源性会厌炎很罕见，即使没有摄入有害物质或口腔内烧伤也可能发生。认识到热源性会厌炎的可能性，即使在烫伤中也是至关重要的，以确保及时保护气道。
我们报告一例因烫伤导致热源性会厌炎的儿童病例，烫伤由煮沸的牛奶引起，导致面部、颈部和胸部混合深度烧伤，但无摄入史。就诊时出现进行性喘鸣和呼吸窘迫体征，需要插管。喉镜检查显示会厌水肿，确诊为热源性会厌炎。初次烧伤后5天最终拔管。
面部、颈部和胸部烫伤后发生的热源性会厌炎很罕见，即使没有摄入和口腔内损伤也可能发生。口周区域烧伤应引起对口腔和声门上结构额外损伤的怀疑，即使没有口腔内损伤或初始呼吸窘迫。认识到在没有口腔内损伤的情况下发生热源性会厌炎对于诊断即将发生的需要插管的上气道梗阻很重要。
