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[Paediatric breathlessness caused by aspiration of a foreign body in food]

Ellen Herkert1, J Alexander de Ru, Lucienne Speleman

  • 1Universitair Medisch Centrum, locatie Wilhelmina Kinderziekenhuis, Afd. KNO-heelkunde, Utrecht, the Netherlands. e.herkert@erasmusmc.nl

Nederlands Tijdschrift Voor Geneeskunde
|March 9, 2011
PubMed

Insights

Foreign body ingestion, such as fish or chicken bones, can cause severe respiratory distress in toddlers. Prompt diagnosis via airway endoscopy is crucial when initial treatments fail and a choking incident is suspected.

Area of Science:

  • Pediatrics
  • Otolaryngology
  • Emergency Medicine

Background:

  • Subglottic laryngitis and toddler's asthma are common diagnoses for pediatric respiratory distress.
  • Delayed diagnosis of airway foreign bodies can lead to prolonged illness and ineffective treatments.

Observation:

  • Two one-year-old boys presented with progressive breathlessness and inspiratory stridor.
  • Initial medical management for presumed laryngitis and asthma was unsuccessful in both cases.

Findings:

  • Laryngotracheobronchoscopy revealed a fish bone in one child and a chicken bone in the other, lodged in the larynx.
  • Retrospective questioning identified choking incidents preceding symptom onset in both patients.

Implications:

  • Active inquiry into choking episodes is vital for diagnosing airway foreign bodies.
  • Airway endoscopy is indicated for persistent or atypical respiratory symptoms, especially after a potential choking event.
  • Early identification and removal of laryngeal foreign bodies can prevent serious complications.

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