Hernot Sharad, Kalra Vijay, Wadhera Raman, Kaintura Madhuri
Department of Otorhinolaryngology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana 124001 India.
Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):14-17. doi: 10.1007/s12070-015-0908-6. Epub 2015 Sep 22.
Foreign body ingestion is common in infants and children, but they can pose a difficult situation and a diagnostic problem if the foreign body is embedded in the soft tissues of the pharynx. To the best of our knowledge, this is the first case reported with such an unusually shaped foreign body having three sharp ends embedded at two different locations in the hypopharynx of a kid such small in age giving rise to respiratory as well as feeding problem. Secondly, a sharp foreign body penetrating arytenoid causing its swelling and inflammation, thus compromising the glottic opening and producing stridor is a rare phenomenon. We present a case of a 9 months old male infant who presented in ENT emergency with complaints of vomiting, refusal to accept solid as well as liquid feed for 5 days and sudden onset of abnormal grunting sounds on breathing for 1 day. Chest examination revealed intercostal retractions with decreased air entry bilaterally and conducted sounds in chest on auscultation. Abdomen examination revealed no abnormalities, and routine blood and urine investigations were also within normal limits. A metallic foreign body with three sharp ends was visualized in the neck X-ray, the retrieval of which by rigid hypopharyngoscopy relieved the symptoms.
异物摄入在婴幼儿中很常见,但如果异物嵌入咽部软组织,可能会造成困难局面和诊断问题。据我们所知,这是首例报道的如此形状异常的异物,有三个尖锐末端,嵌入一名年龄如此小的儿童下咽的两个不同位置,引发了呼吸及进食问题。其次,尖锐异物穿透杓状软骨导致其肿胀和炎症,进而影响声门开口并产生喘鸣,这是一种罕见现象。我们报告一例9个月大的男婴,因呕吐、5天来拒绝接受固体及液体食物、1天来呼吸时突然出现异常呼噜声而到耳鼻喉科急诊就诊。胸部检查发现双侧肋间凹陷,呼吸音减弱,听诊时胸部有传导音。腹部检查未发现异常,常规血液及尿液检查也在正常范围内。颈部X线检查显示一个有三个尖锐末端的金属异物,通过硬质下咽镜取出该异物后症状缓解。