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Colombian Journal of Anestesiology
Print version ISSN 0120-3347On-line version ISSN 2256-2087
Abstract
MORAIS, Inês et al. Diagnostic challenges in paediatric foreign body aspiration: a case report. Rev. colomb. anestesiol. [online]. 2021, vol.49, n.2, e500. Epub May 30, 2021. ISSN 0120-3347. https://doi.org/10.5554/22562087.e919.
Introduction
Foreign body aspiration (FBA) is a potentially fatal paediatric emergency. Our objective was to highlight the importance of a multidisciplinary approach to difficult/doubtful diagnosis.
Case report
34-month-old girl referred for urgent rigid bronchoscopy after suspected metallic blade ingestion (found chewing on it). She had a previous recurrent history of wheezing. The physical examination revealed face/lip wounds, traces of powder on her teeth but no breathing difficulty. The plain X-Ray revealed radiopaque images of the upper pulmonary field and gastric chamber. In the absence of FBA clinical signs but considering a previous history of bronchial hyperresponsiveness, a direct digital radiographic study was performed. There were no images compatible with foreign bodies: the results were interpreted as artefacts and no bronchoscopy was performed.
Conclusions
A careful pre-anaesthetic evaluation, a high level of suspicion and excellent multidisciplinary communication led to the recognition of false radiologic findings. A conservative approach was followed and invasive procedures in a remote location, with high anaesthetic risk for the paediatric population were avoided.
Keywords : Foreign body; aspiration; paediatrics; bronchology; radiology.