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青少年上气道梗阻:未自述的情况下气道异物会被漏诊吗?

Upper airway obstruction in an adolescent: Can airway foreign bodies be missed without self-reporting?

作者信息

Fukumasa Hiroshi, Tsuji Satoshi, Kawamura Kengo, Nishimura Nao

机构信息

Children's Medical Center, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.

Division of Emergency and Transport Services, National Center for Child Health and Development, Ohkura 2-10-1, Setagaya-ku, Tokyo, 157-8535, Japan.

出版信息

Respir Med Case Rep. 2020 Feb 21;29:101029. doi: 10.1016/j.rmcr.2020.101029. eCollection 2020.

Abstract

Upper airway obstruction due to foreign body aspiration is rare in adolescents. Diagnosis of the same is difficult, and incorrect, delay of treatment is common in patients with no aspiration history. Herein, we describe the case of a 15-year-old boy who presented with upper airway obstruction because of swallowing chewing gum 4 days before presentation. The patient was initially misdiagnosed and was scheduled for an emergency tracheotomy. However, this unnecessary surgical procedure was narrowly avoided because his symptoms resolved after he expelled the chewing gum from his airway. Despite being questioned several times about aspiration of any foreign bodies, he did not self-report the incident because he did not suspect that his symptoms were due to swallowing of the chewing gum.

摘要

青少年因异物误吸导致上呼吸道梗阻较为罕见。对此类情况的诊断存在困难,在无误吸史的患者中,不正确的诊断及治疗延误很常见。在此,我们描述一例15岁男孩的病例,该男孩在就诊前4天因吞咽口香糖出现上呼吸道梗阻。患者最初被误诊,并被安排进行紧急气管切开术。然而,由于他将口香糖从气道排出后症状缓解,才勉强避免了这一不必要的外科手术。尽管多次被询问是否有误吸任何异物的情况,但他并未自述该事件,因为他没有怀疑自己的症状是由吞咽口香糖所致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45a3/7063174/966b41266552/gr1.jpg

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