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Published on: November 30, 2010
Idiopathic subglottic stenosis with an inguinal hernia in children: A case report
Sai Liang1, Ji Wang1, Kai Song2
1Department of Clinical Medicine, Guizhou Medical University, Guiyang City, Guizhou Province, China.
Rationale:
Idiopathic subglottic stenosis is a fibrotic condition of unknown origin that results in blockage of the central airway in the subglottic region. It is widely acknowledged that subglottic stenosis is a relatively uncommon structural anomaly that is difficult to operate on and cure due to its anatomical location. Inguinal hernias are well-established to be prevalent in infants and youngsters. We present a case of subglottic stenosis in a child complicated with an inguinal hernia (IH).
Patient Concerns:
A 7-year-old female was admitted to our hospital with a 1-month history of progressive bulging in the left lower quadrant of the abdomen. She complained of no stomach discomfort, distension, or dyspnea, but her family reports that the patient usually wheezes during moderate exertion and has no family history of asthma or lung illness. However, for unclear reasons, the infant experienced shortness of breath following training. A chest CT scan was unremarkable. Below the glottis, a membranous stenosis was discovered. The stenosis beneath the glottis was discovered using dynamic laryngoscopy.
Diagnoses:
Idiopathic subglottic stenosis with an IH.
Interventions:
An otorhinolaryngologist employed a carbon dioxide laser to eliminate the subglottic stenosis. Following successful intubation by the anesthesiologist, pediatric surgeons performed laparoscopic high ligation of the hernial sac.
Outcomes:
After 1 month, a repeat laryngoscopy revealed significant expansion of the subglottic stenosis, accounting for the improvement in respiratory symptoms.
Lessons:
The present case raises awareness that surgeons should be more vigilant about respiratory complications in patients with an IH. Early diagnosis and treatment of respiratory illnesses are critical for patients undergoing endotracheal intubation.
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