Aspirative foreign body converted in ingested foreign body

Partes: 1, 2

• Summary
• Introduction

CASE REPORT

Summary:

A 9 year old boy presented in ent clinic with the diagnosis of bronchial foreign body. A bronchoscopy was performed and a foreign body was seen in the left main bronchus, during the removal procedure the foreign body went down and became imperceptible so the procedure was stoped and treatment was prescribed. A chest x ray was ordered two days later and it was normal.an abdomen x ray was ordered too and it showed the foreign body in the rectum.

Introduction

The human body is provided with number of defense mechanisms to keep the airway free and clear of extraneous matter.these include the physical actions of the epiglottis and aritenoid cartilages in blocking the airway,intense spasm of the true and false vocal cords any time objects come near the vocal cords and a highly sensitive cough reflex wich afferent impulses generated throughout the larynx, trachea and all branch points in the proximal tracheobronchial tree.however nobe of these mechanisms is perfect and foreign bodies frequently lodge in the airways of children.

Children are more prone to aspirate foreign material for several reasons.the lack of molar teeth in children decreases their ability to chew food sufficiently, leaving larger chunks of food.the propensity of children to talk,laugh and run around while chewing also increases the chance thet a sudden or large inspiration may occur with food in the mouth.children often examine even nonfood substances with their mouth.

The peak ages during which aspiration of foreign bodies are the toddler through preschool ages, although foreign bodies have been found in the airways of individuals of all ages and sizes. Even relatively immobile infants are not immune, despite not having the ability to crawl and find things or the ability to pick up objets and put them in the mouth.

Case report

A 9 year old school boy was brought to the ent clinic because a day before he was holding a piece of wire in his mouth then sddenly he started and swallowed the piece of wire a dry cough.

The ent examination was unremarkable.

Respiratory system: rr:16xmin with no retraction.breath sounds slightly decreased in the left lung.there were no stertores.

The rest of physical examination was unremarkable.

A chest x-ray was ordered and it showed a metallic foreign body in the left main bronchus.

The patient was admitted with a diagnosis of bronchial foreign body and a bronchoscopy was arranged for next morning.the bronchoscopy was performed and the foreign body was located in the left main bronchus.during the removal procedure the foreign body went down and became imperceptible.the operation was stopped. So treatment with teophiline and hydrochertizone was prescribed.the child was still asymptomatic.a new chest x-ray was ordered two days later, the result was normal.an abdominal x-ray was also ordered, it showed the metallic foreign body in the rectum.