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Case report
Acquired tracheo-oesophageal fistula in a child with unrecognised tracheal foreign body
  1. Kanokpan Ruangnapa,
  2. Wanaporn Anuntaseree,
  3. Kantara Saelim and
  4. Pharsai Prasertsan
  1. Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Songkhla, Thailand
  1. Correspondence to Dr Kanokpan Ruangnapa; kanoknokpan{at}gmail.com

Abstract

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.

  • paediatric intensive care
  • pneumonia (respiratory medicine)
  • primary care
  • general practice / family medicine

https://doi.org/10.1136/bcr-2020-240947

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    Footnotes

    • Twitter @pharsai103

    • Contributors KR: participated in the patient’s medical management (as main physician), family counselling, parents’ informed consent and manuscript preparation. WA: participated in the patient’s treatment (as pulmonologist consultant, bronchoscopist assistant) and manuscript editing. KS: participated in the patient’s treatment (as paediatric intensivist) and manuscript editing. PP: participated in the patient’s treatment (as paediatric intensivist) and manuscript editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.