Department of Pediatric and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Department of ENT, Aga Khan University Hospital, Karachi, Pakistan.
J Med Case Rep. 2024 Nov 30;18(1):588. doi: 10.1186/s13256-024-04915-3.
Tracheal stenosis is a known complication following intubation. However, owing to its delayed presentation and symptoms of progressive wheezing and respiratory difficulty, it is often misdiagnosed as asthma.
We present the case of a 10-year-old Asian boy who presented with cough, wheezing, and dyspnea. He was misdiagnosed with severe, uncontrolled asthma and respiratory failure, remaining unresponsive to initial asthma management. During his current admission, he had difficult intubation, necessitating an emergency tracheostomy. Further subsequent examination revealed grade III tracheal stenosis.
This case highlights the importance of considering tracheal stenosis as a differential diagnosis in children presenting with dyspnea, cough, and wheezing, particularly if there is a history of prior intubation. The airway should be secured immediately in a controlled environment by an otolaryngologist or anesthetist.
气管狭窄是插管后的已知并发症。然而，由于其表现延迟，症状为进行性喘息和呼吸困难，因此常被误诊为哮喘。
我们介绍了一个 10 岁亚洲男孩的病例，他表现为咳嗽、喘息和呼吸困难。他被误诊为严重、无法控制的哮喘和呼吸衰竭，对初始哮喘管理没有反应。在他目前的住院期间，他出现了插管困难，需要紧急进行气管切开术。进一步的后续检查显示为 3 级气管狭窄。
本病例强调了在出现呼吸困难、咳嗽和喘息的儿童中，特别是有既往插管史的儿童中，将气管狭窄作为鉴别诊断的重要性。耳鼻喉科医生或麻醉师应在受控环境中立即通过气道进行安全处理。
