Watts A M, McCallum M I
Department of Burns, Plastics and Maxillofacial Surgery, Salisbury District Hospital, UK.
Burns. 1996 Nov;22(7):570-3. doi: 10.1016/0305-4179(96)00032-0.
A 16-month-old boy received a 6 per cent hot water scald to his face and chest. The child had been suffering from an upper respiratory tract infection for 10 days prior to the injury. However, as the child rapidly developed respiratory tract obstruction, a differential diagnosis between acute infective epiglottitis and thermal injury to the hypopharynx was required. In fact, the hot water had reached the epiglottis and the aryepiglottic folds causing significant damage, whilst sparing the tongue and mouth. The child was admitted to the intensive care unit, intubated and ventilated for 4 1/2 days. The external burns eventually healed spontaneously. This case report demonstrates the rare occurrence of a minor scalding injury resulting in significant obstruction to the upper airway. Of additional interest is the presence of pre-existing symptoms of an upper respiratory tract infection and the total absence of any signs of intraoral burning. These additional factors demonstrate the necessity for absolute vigilance in the management of any scald in the region of a child's mouth. Intubation can be life saving and should be considered in any case of scalding associated with increasing respiratory distress.
一名16个月大的男孩面部和胸部被6%的热水烫伤。该儿童在受伤前已患了10天的上呼吸道感染。然而，由于患儿迅速出现呼吸道梗阻，需要对急性感染性会厌炎和下咽热损伤进行鉴别诊断。事实上，热水已到达会厌和声襞，造成了严重损伤，而舌头和口腔未受影响。患儿被收入重症监护病房，插管并机械通气4.5天。体表烧伤最终自行愈合。本病例报告显示，轻微烫伤导致上呼吸道严重梗阻的情况罕见。另外值得关注的是，患儿此前存在上呼吸道感染症状，且完全没有任何口腔内烧伤的迹象。这些额外因素表明，在处理儿童口腔部位的任何烫伤时，必须绝对警惕。插管可能挽救生命，在任何伴有呼吸窘迫加重的烫伤病例中都应考虑插管。
