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Case Reports: Learning from unexpected outcome (positive or negative)
Child requiring tracheostomy for removal of an airway foreign body at the tracheal bifurcation
  1. Naoki Yogo1,
  2. Sachiko Mizutari2,
  3. Kei Honda3 and
  4. Hidetoshi Asai2
  1. 1Department of Pediatrics, Division of Pediatric Emergency and Critical Care, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
  2. 2Otolaryngology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
  3. 3Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
  1. Correspondence to Dr Naoki Yogo; naoki.y0715{at}gmail.com

Abstract

Airway foreign bodies are typically removed orally using a rigid bronchoscope. We present a rare case of a foreign body at the tracheal bifurcation that required removal via tracheostomy. A child turned pale while eating nuts and was suspected to have choked on a foreign body. CT revealed a foreign body at the tracheal bifurcation. As his respiratory condition was unstable, tracheal intubation and removal were attempted using a rigid bronchoscope. Tracheal obstruction during oral removal resulted in respiratory failure and bradycardia. Following emergency tracheostomy, the foreign body was removed via the tracheal stoma after his respiratory condition stabilised. The patient was discharged 21 days later without neurological sequelae. To avoid hypoxaemia during airway foreign body removal, as in this case, assessing the size of the upper airway and foreign body is necessary. Tracheostomy and foreign body removal through the tracheal opening should be considered proactively.

  • Ear, nose and throat/otolaryngology
  • Emergency medicine
  • Paediatric intensive care
  • Accidents, injuries
  • Otolaryngology / ENT

http://dx.doi.org/10.1136/bcr-2022-250399

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    Footnotes

    • Contributors NY, SM and KH conceptualised and designed the study. NY and SM collected and analysed the data. NY wrote the majority of the original draft of the paper. HA provided technical support and conceptual advice. All authors read and approved the final manuscript.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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