Noel Christopher W, Pooboni Suneel Kumar, Metwalli Metwalli Gamal, Kherani Safeena
Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
Mafraq Hospital - SEHA, Abu Dhabi, United Arab Emirates.
BMJ Case Rep. 2020 Mar 30;13(3):e234623. doi: 10.1136/bcr-2020-234623.
A 3-year-old boy had an unwitnessed fall from a highchair. The child had no loss of consciousness, vomiting, stridor or respiratory distress but within a few minutes had significant swelling in the neck, scalp and around the eyes. He was brought immediately to the emergency room where he deteriorated rapidly and was intubated with a cuffed oral endotracheal tube. A clinical diagnosis of blunt laryngeal trauma was made. Imaging showed no laryngeal disruption, but did reveal massive bilateral pneumothoraces, that were managed with chest tube. A multidisciplinary meeting with family led to a watchful waiting approach. The patient was successfully extubated at 1 week and healed with a clear voice.
一名3岁男孩从高脚椅上摔落,无人目睹。患儿没有意识丧失、呕吐、喘鸣或呼吸窘迫,但几分钟内颈部、头皮和眼部周围出现明显肿胀。他被立即送往急诊室,在那里病情迅速恶化,随后通过带气囊的口腔气管插管进行了插管。临床诊断为钝性喉外伤。影像学检查未显示喉部破裂,但确实发现双侧大量气胸,通过胸腔闭式引流管进行了处理。与家属进行的多学科会诊后采取了密切观察的方法。患者在1周时成功拔管,声音清晰,康复良好。