Abraham Zephania Saitabau, Kahinga Aveline Aloyce, Mapondella Kassim Babu, Massawe Enica Richard, Ntunaguzi Daudi
Department of Surgery, University of Dodoma, College of Health and Allied Sciences, Box 259, Dodoma, Tanzania.
Department of Otorhinolaryngology, Muhimbili University of Health and Allied Sciences, Box 65001, Dar es Salaam, Tanzania.
Int J Surg Case Rep. 2020;72:423-425. doi: 10.1016/j.ijscr.2020.05.100. Epub 2020 Jun 12.
Aspirated foreign bodies continue to pose challenges to Otorhinolaryngologists and are potentially life threatening thus an otorhinolaryngological emergency. The main stay of treatment of foreign bodies (FBs) in the tracheobronchial tree remains to be bronchoscopy while bearing in mind earlier and safer removal of such foreign bodies. Spontaneous expulsion of an Intrabronchial foreign body is a rare entity with few cases reported in the available literatures.
We are reporting a rare case of a 3-year old male child who presented to otorhinolaryngology department with a 2-days history of foreign body inhalation (sharp metallic pin) prior admission which undergone spontaneous migration and went to be excreted in feaces after passing through the gastrointestinal tract.
It is unwise, dangerous and inadvisable to wait for spontaneous expulsion in cases of intrabronchial foreign body but while preparing for endoscopy, a constant watch should be kept over the patient and every forceful bout of cough should be looked with suspicion of spontaneous expulsion and a danger of foreign body lodgment into subglottis during such rare but possible occurrence should be kept in mind.
It's always worth to rule out the possibility of foreign body inhalation in children with sudden onset of difficulty in breathing to avoid diagnostic delays.
误吸异物仍然给耳鼻喉科医生带来挑战,并且具有潜在的生命威胁,因此是耳鼻喉科的急症。气管支气管树内异物(FBs)的主要治疗方法仍然是支气管镜检查,同时要牢记尽早且安全地取出此类异物。支气管内异物自发排出是一种罕见情况,现有文献中报道的病例很少。
我们报告一例罕见病例,一名3岁男童因入院前2天有异物吸入史(尖锐金属别针)就诊于耳鼻喉科,该异物发生自发迁移,经胃肠道后随粪便排出。
对于支气管内异物,等待自发排出是不明智、危险且不可取的,但在准备内镜检查时,应持续观察患者,每次剧烈咳嗽都应怀疑有自发排出的可能,在此类罕见但可能发生的情况下,应牢记异物掉入声门下的风险。
对于突然出现呼吸困难的儿童,排除异物吸入的可能性总是值得的,以避免诊断延误。