Acquired tracheo-oesophageal fistula in a child with unrecognised tracheal foreign body

We report the case of a 6-month-old girl who presented with recurrent pneumonia and growth failure. After full examination, she was diagnosed with long-standing, unrecognised tracheal foreign body, which was then successfully removed. However, her chronic respiratory symptoms did not improve, and she also had feeding intolerance. The persistence of symptoms indicated a second bronchoscopy and finally an acquired tracheo-oesophageal fistula was diagnosed. This case emphasises the challenges in diagnosis of an inhaled foreign body in young children. Late diagnosis of this condition can cause significant morbidities. A high index of suspicion and careful investigation are very important to prevent long-term complications.

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Long-term presence of a denture fragment in the airway

The Journal of Laryngology & Otology ◽

10.1017/s0022215100104499 ◽

1988 ◽

Vol 102 (2) ◽

pp. 190-193 ◽

Cited By ~ 16

Author(s):

A. Poukkula ◽

E.-M. Ruotsalainen ◽

K. Jokinen ◽

A. Palva ◽

J. Nuorviita

Keyword(s):

Foreign Body ◽

Bronchial Asthma ◽

Respiratory Symptoms ◽

First Case ◽

Denture Fragment

AbstractTwo cases are reported in which a denture fragment was lodged in the bronchus for a period of six years. Bronchial asthma which did not worsen immediately after inhalation and other misleading factors made the diagnosis more difficult in the first case, whilst the respiratory symptoms in the second case appeared only 4 years after inhalation. Haemoptysis 2 years later led to a bronchoscopy and the removal of the foreign body.

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Usefulness of Nonvalved Spacers for Administration of Inhaled Steroids in Young Children with Recurrent Wheezing and Risk Factors for Asthma

Canadian Respiratory Journal ◽

10.1155/2018/3095647 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Carlos Kofman ◽

Alejandro Teper

Keyword(s):

Risk Factors ◽

Fluticasone Propionate ◽

Young Children ◽

Respiratory Symptoms ◽

Term Treatment ◽

Recurrent Wheezing ◽

Inhaled Steroids ◽

Long Term Treatment ◽

Metered Dose

Background. In vitro and scintigraphic studies have suggested that effectiveness of metered-dose inhalers (MDI) with nonvalved spacers (NVS) is similar to that of MDI with valved holding chambers (VHC). Nevertheless, there are no clinical studies that compare these techniques in long-term treatment with inhaled steroids in young children with recurrent wheezing and risk factors for asthma. Objective. To compare the efficacy of a long-term treatment with Fluticasone Propionate administered by an MDI through both type of spacers, with and without valves, in young children with recurrent wheezing and risk factors for asthma. Patients and Methods. Outpatient children (6 to 20 months old) with recurrent wheezing and risk factors for asthma were randomized to receive a 6-month treatment with metered-dose inhaler (MDI) of Fluticasone Propionate 125 mcg BID through an NVS or through a VHC. Parents recorded daily their child’s respiratory symptoms and rescue medication use. Results. 46 patients of 13.4 ± 5 months old were studied. During the study period, the NVS group (n=25) experienced 3.9 ± 2.4 obstructive exacerbations, and the VHC group (n=21) had 2.6 ± 1.6 (p=0.031). The NVS group had 17.4 ± 14% of days with respiratory symptoms, and the VHC group had 9.7 ± 7% (p=0.019). The NVS group spent 29.8 ± 22 days on albuterol while the VHC group spent 17.9 ± 11 days (p=0.022). Conclusion. Long-term treatment with inhaled steroids administered by MDI and NVS is less effective than such treatment by MDI and VHC in infants with recurrent wheezing and risk factors for asthma.

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An Unusual Case of Foreign Body Aspiration: A Case Report

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v6i2.31593 ◽

2017 ◽

Vol 6 (2) ◽

pp. 47-49

Author(s):

Kuntal Roy ◽

Syed Khairul Amin ◽

Mumtahina Setu ◽

Tarannum Khondaker ◽

Nandita Sur Chowdhury

Keyword(s):

Case Report ◽

Foreign Body ◽

Young Children ◽

Clinical Examination ◽

Respiratory Symptoms ◽

Unusual Case ◽

Foreign Body Aspiration ◽

Delay In Diagnosis ◽

Medical College ◽

Careful History

Foreign body aspiration most commonly affects young children, with respiratory symptoms such as wheeze and cough after a choking episode. A careful history and clinical examination can identify those children that need additional investigation including bronchoscopy. However foreign body aspiration can mimic other conditions. The link between choking and subsequent symptoms may not be made by parents. We present a case with a delay in diagnosis, and discuss the appropriate management of suspected foreign body aspiration.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 47-49

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Subglottic Chicken Bone in a Five Months old Baby

Journal of Nepal Medical Association ◽

10.31729/jnma.239 ◽

2009 ◽

Vol 48 (174) ◽

pp. 170-2

Author(s):

Sanjay Prakash ◽

C L Bhusal ◽

K Acharya ◽

B K Sinha

Keyword(s):

Foreign Body ◽

Young Children ◽

Respiratory Symptoms ◽

Foreign Body Aspiration ◽

Chicken Bone ◽

Air Passage

Foreign body aspiration most commonly affects young children,with respiratory symptoms such as wheeze and cough after a chokingepisode. When the foreign body is fi rst inhaled as per witnessed by the parents or caregiver there is always choking or gaging episode, followed by a coughing spell. The absence of a cough strongly rules out the possibility of foreign body having entered the air passage. Here we report a case of chicken bone inhaled as foreign body in a fi ve months old baby.Key Words: bone, chicken, subglottic

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Cough and you'll miss itCough and you'll miss it

Archives of Disease in Childhood - Education and Practice ◽

10.1136/archdischild-2019-318121 ◽

2019 ◽

pp. edpract-2019-318121 ◽

Cited By ~ 1

Author(s):

Seana Molloy ◽

Gemma Batchelor ◽

Luke McCadden ◽

Rebecca Moore ◽

Thomas Bourke ◽

...

Keyword(s):

Foreign Body ◽

Foreign Body Aspiration ◽

Diagnostic Dilemma ◽

Chewing Ability ◽

Difficulty Breathing ◽

Food Particles ◽

High Level ◽

High Index Of Suspicion ◽

Prompt Diagnosis

Foreign body aspiration is a potentially fatal occurrence, particularly in children less than 3 years of age. Predisposing factors include the tendency to put objects into the mouth, poor chewing ability, lack of posterior dentition and uninhibited inspirations when laughing or crying. Classically, the history opens with a witnessed choking episode which would raise a high level of suspicion in the clinician. Ideally, this would lead to an investigative cascade resultant in prompt diagnosis and removal of the object without significant sequelae. The clinical presentation, however, of an unwitnessed foreign body aspiration can be non-specific and subtle from acute shortness of breath and difficulty breathing to intractable cough, fever and chronic wheeze. It can masquerade as a reactive airway or primary infective pathology and delay crucial diagnosis. A high index of suspicion is therefore required when assessing a child with any of these complaints. Commonly aspirated substances include food particles, hardware and toys. Retained foreign bodies can lead to severe and dangerous long-term consequences including atelectasis, pneumothorax, pneumomediastinum or even death. The purpose of this case is to demonstrate the diagnostic dilemma when dealing with young children and the understated presentation of an unwitnessed aspiration of a foreign body.

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Late diagnosis of foreign body aspiration in children with chronic respiratory symptoms

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2006.10.006 ◽

2007 ◽

Vol 71 (2) ◽

pp. 241-246 ◽

Cited By ~ 47

Author(s):

F. Karakoc ◽

E. Cakir ◽

R. Ersu ◽

Z.S. Uyan ◽

B. Colak ◽

...

Keyword(s):

Foreign Body ◽

Respiratory Symptoms ◽

Foreign Body Aspiration ◽

Late Diagnosis

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An oesophageal spring

Journal of International Medical Research ◽

10.1177/0300060518767775 ◽

2018 ◽

Vol 46 (7) ◽

pp. 2938-2943

Author(s):

Elisabetta Calamelli ◽

Tomasso Gargano ◽

Sandra Brusa ◽

Paolo Bottau ◽

Mario Lima ◽

...

Keyword(s):

Young Children ◽

Respiratory Symptoms ◽

Foreign Bodies ◽

Clinical Course ◽

Rapid Diagnosis ◽

Diagnosis And Treatment ◽

Significant Morbidity ◽

Gastrointestinal Manifestations ◽

Delay In Diagnosis

Oesophageal foreign bodies (OFBs) are a relatively common emergency in young children. OFBs are complicated by significant morbidity and mortality because their ingestion often occurs without witnesses, leading to a delay in diagnosis and treatment. We report an occult OFB in an 11-month-old infant who initially presented without any specific respiratory symptoms, mimicking a respiratory infection. Worsening of the patient’s cough, which did not show any improvement, despite treatment, and progressive onset of gastrointestinal manifestations (dysphagia, vomiting, and drooling) led to the diagnosis of an OFB (metallic spring). The complex and long-term clinical course of the patient highlights the need of promptly recognizing the presence of an occult OFB. This is because rapid diagnosis and treatment are essential for preventing severe and sometimes irreversible complications.

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P3260 Is heart transplantation an optimal option in young children? Results of a long-term multicentric experience

European Heart Journal ◽

10.1016/s0195-668x(03)95886-6 ◽

2003 ◽

Vol 24 (5) ◽

pp. 616

Author(s):

S DIFILIPPO

Keyword(s):

Young Children ◽

Heart Transplantation

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PULMONARY TALCOSIS: A Foreign body granulomatous lung disease

Journal of Case Reports in Medicine ◽

10.25149/jcrm.v8i1.177 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Olufisayo Otusanya

Keyword(s):

Foreign Body ◽

Lung Biopsy ◽

Granulomatous Disease ◽

Mycobacterial Disease ◽

Intravascular Injection ◽

Radiological Findings ◽

Atypical Mycobacterium ◽

Mycobacterium Infection ◽

Granulomatous Lung Disease ◽

High Index Of Suspicion

Pulmonary Talcosis is a rare foreign body granulomatous disease that occurs as a result of exposure to talc either by inhalation of talc particles or via intravascular injection of talc containing medications. Pulmonary Talcosis is often misdiagnosed as pulmonary tuberculosis, atypical mycobacterium infection or sarcoidosis as many of their clinical and radiological findings overlap. We report a case of talcosis mimicking mycobacterial disease which was eventually diagnosed via lung biopsy. A detailed history and high index of suspicion is required for timely diagnosis and appropriate management.

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