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Fatal complication from a balloon-expandable tracheal stent in a child: a case report
William H Stotz1, Ivor D Berkowitz, Jeff C Hoehner
1Department of Anesthesia and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Insights
Tracheal stent placement in children, though rare, carries risks. A fatal case of tracheal erosion and severe bleeding occurred in an 18-month-old with spondylothoracic dysplasia and tracheomalacia.
Area of Science:
- Pediatric pulmonology
- Medical device complications
- Rare adverse events
Background:
- Airway stenting in pediatric patients is infrequently reported.
- Tracheomalacia management often requires innovative solutions.
- Spondylothoracic dysplasia presents unique challenges in airway management.
Observation:
- A case report details an 18-month-old child with spondylothoracic dysplasia.
- The patient underwent tracheal stent placement for severe tracheomalacia.
- The child was treated in a tertiary academic pediatric intensive care unit.
Findings:
- Despite aggressive interventions, the patient experienced a fatal outcome.
- The complication involved tracheal erosion leading to acute upper-airway hemorrhage.
- This highlights a rare but devastating risk of tracheal stents.
Implications:
- Tracheal stent use in pediatric tracheomalacia is associated with significant risks.
- Physicians must carefully weigh the benefits against potential complications like severe hemoptysis.
- Further research into safer pediatric airway interventions is warranted.
Objective:
The use of airway stents in the pediatric population is uncommon, reflected in the few patient series reported in the literature. We describe a fatal complication of tracheal stent placement in an 18-month-old child with spondylothoracic dysplasia.
Design:
Case report.
Setting:
Intensive care unit of a tertiary academic pediatric center.
Patient:
An 18-month-old child with spondylothoracic dysplasia who underwent tracheal stent placement for tracheomalacia.
Interventions:
Management of an acute upper-airway hemorrhage.
Main Results:
The patient died, despite aggressive interventions.
Conclusion:
Use of tracheal stents in pediatric patients with tracheomalacia is not without risks; tracheal erosion with severe hemoptysis is an infrequent but devastating complication of this intervention.