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Management of an unusual presentation of foreign body aspiration

Published online by Cambridge University Press:  29 June 2007

Hassan H. Ramadan*
Affiliation:
Departments of Otolaryngology, American University of Beirut, Medical Centre and School of Medicine, Beirut, Lebanon.
Nicolas Bu-Saba
Affiliation:
Departments of Otolaryngology, American University of Beirut, Medical Centre and School of Medicine, Beirut, Lebanon.
Anis Baraka
Affiliation:
Departments of Anesthesiologyt, American University of Beirut, Medical Centre and School of Medicine, Beirut, Lebanon.
Salman Mroueh
Affiliation:
Department Pediatrics, American University of Beirut, Medical Centre and School of Medicine, Beirut, Lebanon.
*
Hassan H. Ramadan, M. D., West Virginia University, Dept. of Otolaryngology, 2222 H.S.C.S., Morgantown, WV 26506.

Abstract

Foreign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1992

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