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A Case of Airway Compromise in a 15-year-old Girl With Intellectual Disability

Courtney Haviland1, Brian M Cummings2, Josephine Lok2

  • 1Pediatrics, Massachusetts General Hospital, Boston, USA.

Cureus
|June 7, 2021
PubMed

Insights

Foreign body ingestion (FoBI) poses significant risks for children with intellectual disabilities (ID). This case highlights the challenges and complications, including repeat ingestions, necessitating careful management strategies.

Area of Science:

  • Pediatric Medicine
  • Gastroenterology
  • Neurology

Background:

  • Foreign body ingestion (FoBI) is a critical cause of pediatric morbidity and mortality.
  • Individuals with intellectual disabilities (ID) exhibit a higher predisposition to FoBI, often linked to pica behaviors.

Observation:

  • A 15-year-old female with autism spectrum disorder (ASD) and ID presented with respiratory failure due to esophageal foreign body.
  • CT scans confirmed a graphite pencil in the esophagus, causing retropharyngeal perforation.
  • The patient experienced a complicated recovery and was readmitted for a second FoBI and esophageal injury.

Findings:

  • Patients with ID undergoing surgery for FoBI face elevated complication rates and extended hospital stays.
  • Repeat FoBI incidents underscore the complexities in managing this population.

Implications:

  • Effective prevention strategies for FoBI in patients with ID are crucial for clinical care.
  • Balancing patient safety with autonomy is essential when managing individuals with ID and FoBI risk.

Keywords:
autism spectrum disorder (asd)esophageal foreign bodygeneral pediatric surgeryintellectual and developmental disabilitiespediatric emergency departmentpediatric entpediatric intensive care unit(picu)pica

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