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References
Bourrous M, Lahmini W, Nouri H, Haimeur N. Subcutaneous
emphysema and pneumomediastinum in child with asthma
revealing occult foreign body aspiration: A case report. J Med
Case Rep. 2019;13(1):13-16. doi:10.1186/s13256-019-2076-x
Afiadigwe EE, Umeh US, Ebiringa PO, Obah JU, Ukpai ND,
Nwafor I. Pattern of Foreign Body Presentation in an ENT
Outpatient Clinic in South Eastern Nigeria. Int J Innov Res Med
Sci. 2022;7(07 SE-Original Article):364-367.
doi:10.23958/ijirms/vol07-i07/1457
Afiadigwe E, Ndukwu C, Umeh U, Obidike A. Bronchial foreign
body mimicking chronic cough and recurrent
bronchopneumonia: diagnostic dilemma in a resource-poor
setting. Orient J Med. 2023;35(1-2):17.
doi:10.5281/zenodo.7263397
Davina S, Zara N, Pravin S, Faizah M, Tang S, Bee-See G.
Concealed foreign body aspiration presenting as subcutaneous
emphysema. Rawal Med J. 2016;41(4):499-501.
Melissa H, Green R, Gungor A. Pneumomediastinum and
subcutaneous emphysema from bronchial foreign body
aspiration. Am J Otolaryngol - Head Neck Med Surg.
;34(1):85-88. doi:10.1016/j.amjoto.2012.09.005
Afiadigwe EE, Chime EN, Obasikene G, Ezeanolue BC. Migratory
Bronchial Foreign Body: Role of Serial Radiographs and Review
of Literature. Int J Med Sci Clin Invent. 2020;7(11):5130-5134.
doi:10.18535/ijmsci/v7i11.011
Nimrey-Atrash N, Bentur L, Elias N. Subcutaneous emphysema
and pneumomediastinum due to foreign body aspiration in
children with asthma. Pediatr Pulmonol. 2012;47(1):88-90.
doi:10.1002/ppul.21506
Zieliński R, Piotrowska V, Zakrzewska A. Pneumomediastinum
and emphysema in a case of a soft bronchial foreign body
aspiration in a child. A case report. Otolaryngol Pol.
;65(1):59-61. doi:10.1016/S0030-6657(11)70629-1
Showkat S, Mehfooz N, Beigh Z, Shafi O, Patigaroo S, Ahmad R.
Aerodigestive tract foreign bodies: an experience at a teritiarycare
hospital. Int J Med Sci Public Heal. 2015;4(11):1551.
doi:10.5455/ijmsph.2015.07062015322
Saetti R, Derosas F, Silvestrini M, Hospital SB, Cutrone C.
Endoscopic treatment of aerodigestive tract foreign bodies in
tract foreign bodies in paediatric. 2005;(July).
Nasir ZM, Subha ST. A Five-Year Review on Pediatric Foreign
Body Aspiration. Int Arch Otorhinolaryngol. Published online
doi:10.1055/s-0040-1709739
Zerella J, Dimler M, McGill L, Pippus K. Foreign body aspiration
in children: value of radiography and complications of
bronchoscopy. J Pediatr Surg. 1998;33(11):1651-1654.
Main Article Content
A Missed Bronchial Foreign Body Presenting with Pneumomediastinum And Subcutaneous Emphysema
Abstract
Background: Pnemomediastinum with subcutaneous emphysema is a rare but potentially fatal sequalae of bronchial foreign body aspiration. An 18-month-old female presented to the Accident and Emergency (A&E) department with a 28-hour history of sudden onset choking, cough, shortness of breath and fever. At the onset of symptom, some pieces of groundnut seed were found in her immediate surroundings, but no eyewitness accounted of what transpired. Oxygen saturation was 64% on intranasal Oxygen support. The child had cardiac arrest twice and was resuscitated; first at presentation and then on the theatre table, during induction of anaesthesia. Bronchoscopy revealed edematous bronchus; secretions were suctioned, and the visible groundnut seeds lodged within the bronchial lumen retrieved. Further careful search revealed no other obvious remnant. Symptoms improved immediate postop but deteriorated about 12 hours later, with worsening dyspnoea, fever, pneumomediastinum and subcutaneous emphysema. She had a revision bronchoscopy, and another piece of ground-nut seed was identified and retrieved. All respiratory symptoms gradually resolved within the next 48hours, and she was discharged home.
Conclusion: Though an uncommon mode of presentation, foreign body aspiration should be ruled out in any child with unexplained subcutaneous emphysema around the lower neck and upper chest region in the presence of other acute lower respiratory tract symptoms. Emergency bronchoscopy remains the gold standard of treatment.
