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Subglottic concretion masquerading as foreign body in a child with β thalassemia major: an airway nightmare!
  1. Badal Parikh1,
  2. Swayam Sahu1,
  3. Devendra Kumar Gupta2 and
  4. Vikram Singh3
  1. 1Anaesthesiology & Critical Care, Army Hospital Research and Referral, New Delhi, India
  2. 2ENT-HNS, Army Hospital Research and Referral, New Delhi, India
  3. 3Pathology, Army Hospital Research and Referral, New Delhi, India
  1. Correspondence to Dr Badal Parikh; drbadalparikh{at}


Subglottic concretion is a rare and perilous condition usually presenting with existing or impending airway obstruction. Due to long-standing nature of the condition, slow progression of symptoms and rarity of occurrence, the condition is either missed or misdiagnosed. Its resemblance in presentation and symptoms to that of foreign body (FB) bronchus can lead to a diagnostic misadventure. Detailed history, chronology of symptoms and radiological imaging in conjunction with fiberoptic evaluation are keys for establishing correct diagnosis. Treatment outcomes in such cases depend on appropriate management approach with backup plan in tandem. We describe a child with β thalassemia major with subglottic concretion, which was erroneously diagnosed and managed as a case of subglottic FB due to its classical history and presentation. The aim is to highlight the circumstances leading to this diagnostic misadventure with emphasis on airway management, problems faced and lessons learnt during the same.

  • anaesthesia
  • resuscitation
  • haematology (incl blood transfusion)
  • otolaryngology / ENT

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  • Contributors BP, SS and DKG were involved in planning and active management of the case. BP and SS were involved in the reporting, conception and design of the case report. VS was involved in the histopathological aspect of the study are contributed in research and manuscript preparation. BP, SS, DKG and VS were all involved in manuscript preparation, editing, literature review and final approval of the case report.

  • 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.

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