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一例误诊为喉异物导致小儿反复喘息的病例报告。

A misdiagnosed laryngeal foreign body causing recurrent wheezing in a pediatric patient: Case report.

作者信息

Fraccaroli Francesca, Tosini Davide, Lerario Giorgia, Battilocchi Ludovica, D'Onghia Alessandra, Cantarella Giovanna, Pignataro Lorenzo, Neri Simona, Gaffuri Michele

机构信息

Department of Otolaryngology and Head and Neck Surgery Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy.

Department of Clinical Sciences and Community Health Università degli Studi di Milano Milan Italy.

出版信息

Clin Case Rep. 2023 Jun 28;11(7):e7476. doi: 10.1002/ccr3.7476. eCollection 2023 Jul.

DOI:10.1002/ccr3.7476
PMID:37397573
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10307997/
Abstract

KEY CLINICAL MESSAGE

The recurrence of respiratory symptoms without a clear clinical reason in children can be secondary to the presence of an unknown foreign body of the airways. In such cases, endoscopy of the airways is always necessary, regardless of the patient's age.

ABSTRACT

The management of foreign bodies of the pediatric airway can be challenging. The clinical presentation may vary and, in case of recurrent respiratory symptoms without a clear clinical cause, the presence of a foreign body of the airway should be suspected. We describe the case of a 13-month-old patient, weight 11 kg, with a misdiagnosed subglottic foreign body causing dysphonia and worsening respiratory distress, removed by means of a direct laryngotracheoscopy in tubeless general anesthesia in spontaneous breathing.

摘要

关键临床信息

儿童无明确临床原因而反复出现呼吸道症状可能继发于气道内存在不明异物。在这种情况下,无论患者年龄大小,气道内镜检查总是必要的。

摘要

小儿气道异物的处理可能具有挑战性。临床表现可能各不相同,在反复出现呼吸道症状且无明确临床病因的情况下,应怀疑气道内存在异物。我们描述了一例13个月大、体重11千克的患者,其声门下异物误诊导致声音嘶哑和呼吸窘迫加重,在无管全身麻醉下自主呼吸状态下通过直接喉镜气管镜检查取出异物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c15/10307997/5cd22b0a2bbf/CCR3-11-e7476-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c15/10307997/9c20ab8f3f42/CCR3-11-e7476-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c15/10307997/5cd22b0a2bbf/CCR3-11-e7476-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c15/10307997/9c20ab8f3f42/CCR3-11-e7476-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c15/10307997/5cd22b0a2bbf/CCR3-11-e7476-g001.jpg

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本文引用的文献

1
Foreign body aspiration in children - being safe and flexible.儿童异物吸入——确保安全与灵活应对
Curr Opin Anaesthesiol. 2023 Jun 1;36(3):334-339. doi: 10.1097/ACO.0000000000001251. Epub 2023 Jan 30.
2
Pediatric respiratory tract foreign bodies in children: A systematic review.儿童呼吸道异物:系统评价。
Auris Nasus Larynx. 2023 Aug;50(4):607-613. doi: 10.1016/j.anl.2022.10.003. Epub 2022 Oct 26.