菱木, はるか

鈴木, 宏

HISHIKI, Haruka

SUZUKI, Hiroshi

[SUMMARY] The patient was a 10-month-old boy. He put his father’s smartphone in his mouth, and immediately after it was taken away, hoarseness, wheezing, and retractive breathing developed. On admission, the patient presented with tachypnea and labored breathing. Respiratory sounds were bilaterally weak, and expiratory stridor was noted. A medical interview to the parents revealed no suspicion that foreign body aspiration occurred. Chest and neck X-ray images revealed an asymmetric radiolucent tracheal image of the lower part of the glottis, and there was no abnormality in the lung field and mediastinum. Cervical CT revealed a membrane-like structure with a length of 10 mm and a thickness of 1 mm in the same site, and the patient was transferred to an advanced hospital due to a suspected tracheal foreign body. After transferred to the hospital, labored respiration disappeared and respiratory sound improved. On the same day, removal of the tracheal foreign body was performed under general anesthesia. After induction of anesthesia, ventilation with a bag mask became difficult, causing circulatory failure. Therefore, the rapid response system was initiated, and chest compressions had to be performed for several minutes. The foreign body was incarcerated in the part of the glottis in a form that completely obstructed the airway, and once a side of the foreign body was pushed with the bronchoscope, a slight gap was formed making ventilation possible and stabilizing the condition of the patient. The removed foreign body was a fragment of the plastic case of his father's smartphone. Extubation was performed on the forth days of admission, and an inhospital family support team intervened the family during hospitalization. The patient was discharged on the 12th days of admission without any residual disability. As in the present case, pediatric airway foreign body is a potentially fatal emergency condition. Early diagnosis, treatment, and prevention are important. Unfortunately, there are still a certain number of cases of mortality annually, so continued education for healthcare providers and legal guardians is necessary.

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