Ravikumar Namita, Awasthi Puspraj, Nallasamy Karthi, Angurana Suresh Kumar, Jayashree Muralidharan
Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Pediatr Intensive Care. 2020 Sep;9(3):218-221. doi: 10.1055/s-0040-1701208. Epub 2020 Jan 13.
Foreign body-related injuries to aerodigestive tract and large neck vessels are rare but can be catastrophic if not identified and treated in time. We report an infant with impacted foreign body (pen cap) in the pharynx which went unnoticed until it led to the formation of a fistula with the internal jugular vein (IJV) and massive hemorrhage. His course was complicated by ventilator-associated pneumonia, air leaks, shock, acute kidney injury, prolonged mechanical ventilation, and pharyngocutaneous fistula. The surgical removal of foreign body, ligation of IJV, closure of pharyngeal defect, and supportive treatment in pediatric intensive care unit led to a favorable outcome. This is the first case of pharyngojugular and pharyngocutaneous fistula following an impacted foreign body in the pharynx.
气道消化道及颈部大血管的异物相关损伤较为罕见，但如果未能及时识别和治疗，可能会带来灾难性后果。我们报告了一名婴儿，其咽部有异物（笔帽）嵌顿，直到形成颈内静脉瘘并发生大量出血才被发现。他的病情因呼吸机相关性肺炎、气胸、休克、急性肾损伤、长时间机械通气及咽皮肤瘘而复杂化。通过手术取出异物、结扎颈内静脉、封闭咽部缺损并在儿科重症监护病房进行支持治疗，最终取得了良好的结果。这是首例因咽部异物嵌顿导致咽颈瘘和咽皮肤瘘的病例。
