DOZ047.96: Esophageal food impaction presenting as life-threatening airway obstruction in children with esophageal atresia

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
S Rozycki ◽  
T-N Liou ◽  
M T Brigger
Keyword(s):  
Foreign Body ◽  
Airway Obstruction ◽  
Esophageal Atresia ◽  
Rigid Bronchoscopy ◽  
Food Impaction ◽  
Esophageal Foreign Body ◽  
Acute Airway Obstruction ◽  
Respiratory Event ◽  
Esophageal Food Impaction ◽  
Life Threatening

Abstract Objective An esophageal foreign body rarely presents as an apparent life-threatening event. However, in children with esophageal atresia, strictures and dysmotility can lead to severe food impactions. Given the underlying anatomy of children with esophageal atresia, a unique risk of severe impaction with resultant airway obstruction is possible. This study reports a case of a child in respiratory distress presenting after a choking event where endoscopy revealed near total tracheal compression from esophageal food impaction. Method Case discussion and review of literature are undertaken. Result A 3-year-old boy with trisomy 21 and history of esophageal atresia who had previously undergone successful repair was transported by helicopter after a choking episode. He was witnessed to have cough followed by apnea, cyanosis, and unresponsiveness, for which he underwent the Heimlich maneuver and required chest compressions for a respiratory arrest. He was immediately taken to the operating room for endoscopy with planned foreign body removal. Rigid bronchoscopy noted near complete obstruction of the airway from posterior tracheal wall compression with no airway foreign body. The airway was secured and a combination of rigid and flexible esophagoscopy subsequently extracted a large bolus of chicken. He was observed in the intensive care unit with no further respiratory event after extubation. Conclusion Esophageal dysmotility and strictures are common in children with esophageal atresia who have undergone repair. Mild airway symptoms are common in children with an esophageal foreign body; however, in children with esophageal atresia a high index of suspicion of an esophageal foreign body is requisite in the setting of acute airway obstruction.

scholarly journals Concurrent Negative-Pressure Pulmonary Edema (NPPE) and Takotsubo Syndrome (TTS) after Upper Airway Obstruction

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Evan Harmon ◽  
Sebastian Estrada ◽  
Ryan J. Koene ◽  
Sula Mazimba ◽  
Younghoon Kwon
Keyword(s):  
Airway Obstruction ◽  
Pulmonary Edema ◽  
Negative Pressure ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Takotsubo Syndrome ◽  
Negative Pressure Pulmonary Edema ◽  
Acute Airway Obstruction ◽  
Increased Risk ◽  
Life Threatening

Upper airway obstruction is a potentially life-threatening emergency often encountered in the acute care, perioperative, and critical care settings. One important complication of acute obstruction is negative-pressure pulmonary edema (NPPE). We describe two cases of acute upper airway obstruction, both of which resulted in flash pulmonary edema complicated by acute hypoxic respiratory failure. Though NPPE was suspected, these patients were also found to have Takotsubo syndrome (TTS). Neither patient had prior cardiac disease, and both subsequently had a negative ischemic workup. Because TTS is a condition triggered by hyperadrenergic states, the acute airway obstruction alone or in combination with NPPE was the likely explanation for TTS in each case. These cases highlight the importance of also considering cardiogenic causes of pulmonary edema in the setting of upper airway obstruction, which we suspect generates a profound catecholamine surge and places patients at increased risk of TTS development.

scholarly journals Life-threatening acute airway obstruction induced by unsuspected achalasia

2019 ◽  
Vol 43 (6) ◽  
pp. e87-e89
Author(s):  
Charlotte Desprez ◽  
Marie Netchitaïlo ◽  
Marine Cheron ◽  
Guillaume Gourcerol ◽  
Chloé Melchior
Keyword(s):  
Airway Obstruction ◽  
Acute Airway Obstruction ◽  
Life Threatening

scholarly journals Application of the Virtual Bronchoscopy in Children with Suspected Aspiration of the Foreign Body - Case Report

2016 ◽  
Vol 17 (4) ◽  
pp. 361
Author(s):  
Gordana Kostic ◽  
Marina Petrovic ◽  
Slavica Markovic ◽  
Jasmina Knezevic ◽  
Zoran Igrutinovic ◽  
...  
Keyword(s):  
Foreign Body ◽  
Fiber Optic ◽  
Inhaled Corticosteroids ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Rigid Bronchoscopy ◽  
Virtual Bronchoscopy ◽  
Peripheral Airways ◽  
Life Threatening ◽  
Body Case

Abstract In diagnosing the aspiration of the foreign body (AFB) in children most important are: medical history, clinical signs and positive radiography of the lungs. Common dilemmas in the diff erential diagnosis are life-threatening asthma attacks or difficult pneumonia. Conventional rigid bronchoscopy (RB) is not recommended as a routine method. Virtual bronchoscopy (VB) can be a diagnostic tool for solving dilemmas. Fiber-optic bronchoscopy (FOB) has a therapeutic stake in severe cases. Herein, we describe a girl, at the age of 6, who was hospitalized due to rapid bronchoconstriction and based on the anamnesis, clinical symptoms and physical fi ndings the suspicion was that she aspirated the foreign body. Due to the poor general condition and possible sequel, the idea of RB was dropped out. Multidetector computed tomography of the chest and VB was performed and AFB was not found. Due to positive epidemiological situation, virus H1N1 was excluded. FOB established that the foreign body does not exist in the airways. During bronchoscopy numerous castings are aspirated from the peripheral airways which lead to faster final recovery. With additional procedures, the diagnosis of asthma was confirmed and for girl that was the first attack. Along with inhaled corticosteroids as prevention she feels well. Virtual bronchoscopy can be successfully used as a valid diagnostic procedure in suspected foreign body in the children’s lungs, but fiber-optic bronchoscopy remains most important diagnostic and therapeutic method.

Life-Threatening Acute Airway Obstruction

2005 ◽  
Vol 19 (5) ◽  
pp. 659-660 ◽  
Author(s):  
Murali Chakravarthy ◽  
Patil Thimmannagowda ◽  
Vivek Jawali
Keyword(s):  
Airway Obstruction ◽  
Acute Airway Obstruction ◽  
Life Threatening

Laryngeal manifestations of pachyonychia congenita: a clinical case and discussion on management for the otolaryngologist

2016 ◽  
Vol 131 (S2) ◽  
pp. S53-S56 ◽  
Author(s):  
A M O'Kane ◽  
C P Jackson ◽  
M Mahadevan ◽  
C Barber
Keyword(s):  
Airway Obstruction ◽  
Potassium Titanyl Phosphate ◽  
Early Evaluation ◽  
Acute Airway Obstruction ◽  
Laryngeal Disease ◽  
Pubmed Search ◽  
Life Threatening ◽  
Potassium Titanyl Phosphate Laser ◽  
Pachyonychia Congenita ◽  
Laryngeal Involvement

AbstractBackground:Pachyonychia congenita is a rare keratinising disorder, which typically presents during the first three years of life and usually affects the nails and palmoplantar surfaces. It can involve the larynx and potentially result in life-threatening airway obstruction.Methods:A case report is presented and the findings of a literature review are reported. The review involved a PubMed search using the keywords ‘pachyonychia congenita’ together with ‘larynx’, ‘laryngeal involvement’, ‘laryngeal obstruction’, ‘airway obstruction’, ‘hoarseness’ and/or ‘stridor’.Results:A five-year-old boy, with confirmed pachyonychia congenita, presented with complications of laryngeal involvement over a four-year period. He required three intubations and a tracheostomy for acute airway obstruction. Treatment with potassium titanyl phosphate laser laryngoscopy stabilised the progression of laryngeal disease.Conclusion:Patients with pachyonychia congenita and laryngeal involvement can have a varied presentation, ranging from hoarseness to acute airway obstruction. Management can be a challenge, requiring early evaluation, regular surveillance and aggressive treatment. This paper reports our experience in managing and treating the laryngeal complications of a child with pachyonychia congenita.

scholarly journals Urgent bronchoscopy for foreign body aspiration: 48 children among 1096 patients

Acta Medica ◽  
2019 ◽  
Vol 50 (3) ◽  
pp. 38-43
Author(s):  
Alper Avcı ◽  
Onder Ozden ◽  
Zehra Hatipoglu ◽  
Serdar Onat
Keyword(s):  
Foreign Body ◽  
Postoperative Complications ◽  
Oxygen Saturation ◽  
English Literature ◽  
Length Of Hospital Stay ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Peripheral Oxygen Saturation ◽  
Life Saving ◽  
Life Threatening

Objective: Foreign body aspiration (FBA) is a potentially life-threatening emergency in children. Urgent rigid bronchoscopy (URB) should be performed when presentation includes severe respiratory failure with suspicion for FBA. To the best of the knowledge, this is the first study that evaluates URB in English literature. Methods: Forty-eight patients who underwent URB were included in this study. From the medical records, the patients’ demographic characters, endotracheal intubation status, peripheral oxygen saturation, bronchoscopy results, type and location of foreign body (FB), intra- and postoperative complications and mortality, X-ray, length of hospital stay were evaluated. Results: Twenty-four of the 48 patients were non-intubated. Peripheral oxygen saturation values were 60 ± 14.40 in the preoperative period. No statistical differences were found between intubated and non-intubated patients in terms of intra- and postoperative complications. There were no statistical differences between patients with negative and positive results for bronchoscopy in terms of intra- and postoperative complications. Conclusions: Bronchoscopy is not without risk; however, it is a life-saving procedure. Despite negative FB results, urgent bronchoscopy should be performed in suspicious cases.

scholarly journals The use of a Fogarty Catheter in a Case of an Endobronchial Blood Clot in a Laryngectomy Patient

2015 ◽  
Vol 6 (3) ◽  
pp. 118-120
Author(s):  
Billy Wong
Keyword(s):  
Airway Obstruction ◽  
Blood Clot ◽  
Rigid Bronchoscopy ◽  
Clinical Settings ◽  
Fogarty Catheter ◽  
Upper Respiratory Tract ◽  
Threatening Condition ◽  
Life Threatening ◽  
Conventional Methods ◽  
Head Neck

ABSTRACT Introduction Endobronchial blood clot causing airway obstruction is a rare but potentially life-threatening condition and can occur in a variety of clinical settings. Case report A male laryngectomy, with a background of bronchogenic carcinoma was treated conservatively for tracheitis following an episode of upper respiratory tract infection. However, he later developed airway obstruction secondary to endobronchial bleeding with endobronchial clot formation. Conventional methods of suctioning and rigid bronchoscopy with forceps failed to remove the hematoma. A Fogarty embolec tomy catheter was used to remove the hematoma, relieving the airway obstruction. Discussion The Fogarty embolectomy catheter has been widely used in various vascular operations for removal of arterial and venous emboli over the last years. However, its application in nonvascular cases is not widely published. Conclusion We report a case of tracheitis, complicated by an endobronchial clot in a laryngectomy patient, and demonstrated the use of Fogarty embolectomy catheter in such case when conventional methods fail. How to cite this article Wong B. The use of a Fogarty Catheter in a Case of an Endobronchial Blood Clot in a Laryn gectomy Patient. Int J Head Neck Surg 2015;6(3):118120.

scholarly journals Life-threatening delayed arterial hemorrhage following anterior cervical spine surgery: A case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 124
Author(s):  
Giovanni Miccoli ◽  
Emanuele La Corte ◽  
Ernesto Pasquini ◽  
Giorgio Palandri
Keyword(s):  
Cervical Spine ◽  
Airway Obstruction ◽  
Operating Room ◽  
Spine Surgery ◽  
Superior Thyroid Artery ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Acute Airway Obstruction ◽  
Life Threatening ◽  
The Right

Background: One of the most serious and potentially life-threatening adverse events associated with anterior cervical spine surgery is postoperative hematoma with acute airway obstruction. The causes of unpredicted delayed bleeding are, however, not fully elucidated. Here, we report a case of delayed arterial bleeding and sudden airway obstruction following a two-level ACDF. Case Description: A 52-year-old male presented with the right paracentral disc herniations at the C4–C5 and C5–C6 levels. A two-level ACDF was performed. Notably, on the 5th postoperative day, the patient developed an acute respiratory distress due to a large right lateral retrotracheal hematoma requiring emergency evacuation at the bedside. This was followed by formal ligation of a branch of the right superior thyroid artery in the operating room. In addition, an emergency tracheotomy was performed. By postoperative day 15, the tracheotomy was removed, and the patient was neurologically intact. Conclusion: A superior thyroid artery hemorrhage should be suspected if a patient develops delayed neck swelling with or without respiratory decompensation several days to weeks following an ACDF. Notably, these hematomas should be immediately recognized and treated (i.e., decompression starting at the bedside and completed in the operating room) to prevent catastrophic morbidity or mortality.

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