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Late recognized nail aspiration in a child: case report
Ufuk Çobanoğlu1, Muhammed Can, Ismail Birincioğlu
1Department of Chest Surgery, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey. drucobanoglu@hotmail.com
Insights
Foreign body aspiration in young children can present with vague symptoms like persistent cough. A 6 cm nail was successfully removed from a child
Area of Science:
- Pediatric Pulmonology
- Pediatric Surgery
- Emergency Medicine
Background:
- Foreign body (FB) aspiration is a frequent occurrence in children aged 0-3 years.
- Persistent cough and respiratory symptoms in children can be challenging to diagnose.
Observation:
- A 2.5-year-old girl presented with cough, fever, and sputum, initially treated for bronchitis.
- Initial esophagoscopy and chest X-ray were inconclusive for esophageal FB.
- A lateral chest X-ray revealed a nail-shaped FB lodged between the trachea and right hemithorax.
Findings:
- Rigid bronchoscopy failed to remove the 6 cm nail.
- The FB was successfully removed via thoracotomy and bronchotomy under general anesthesia.
- This case highlights a rare presentation of a sharp FB aspiration.
Implications:
- Physicians must consider FB aspiration in children with unexplained persistent cough.
- Parental neglect can contribute to delayed diagnosis of FB aspiration.
- This case underscores the importance of advanced imaging and surgical techniques for FB removal.
Abstract:
Foreign body (FB) aspiration is common in children aged 0-3 years. Our case, a 2.5-year-old girl, presented with sudden onset of cough, fever and sputum; she had been treated twice for acute bronchitis four months ago. Resisting complaints led to an esophagoscopic examination in our Chest Surgery Clinic after a chest X-ray suggested FB in the esophagus, but no FB could be detected. A lateral chest X-ray revealed a FB with its sharp end targeting the trachea and its round end to the right hemithorax. Removal of the FB with forceps was not possible during rigid bronchoscopy. The FB was removed by thoracotomy and bronchotomy under general anesthesia. The removed FB was a nail measuring 6 cm in length. This case report should serve to stress the diversity of FB aspirations in childhood, the role of parental neglect, and that physicians should be aware of the possibility of FB in children with persistent cough.
