Medical Lasers

Korean Society for Laser Medicine and Surgery (대한의학레이저학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Bilateral Tension Pneumothorax after the Successful CO2 Laser-assisted Removal of a Bronchial Foreign Body in a Child

  • Mun, In Kwon (Department of Otolaryngology-Head and Neck surgery, Dankook University College of Medicine) ;
  • Ju, Yeo Rim (Department of Otolaryngology-Head and Neck surgery, Dankook University College of Medicine) ;
  • Lee, Sang Joon (Department of Otolaryngology-Head and Neck surgery, Dankook University College of Medicine) ;
  • Woo, Seung Hoon (Department of Otolaryngology-Head and Neck surgery, Dankook University College of Medicine)
  • Received : 2020.04.26
  • Accepted : 2020.05.07
  • Published : 2020.06.30
⟨ Previous Next ⟩

Abstract

Bronchial foreign body aspiration (BFA) is a common but emergent condition in infants and children. Furthermore, it can result in various complications such as atelectasis, pneumonia, bronchiectasis, and pneumothorax. Among these, pneumothorax is a very rare complication. However, it can be fatal without the swift implementation of appropriate treatment. We experienced a case of 16-month-old girl with an aspirated peanut. The foreign body was fixed in her left main bronchus. A CO2 laser was used to safely cut and break the foreign body. Removal was successful after breaking it. But after the process, inflammatory tissue of the tracheal mucosa was ruptured. Bilateral tension pneumothorax followed after the rupture. The patient was treated with bilateral chest tube insertion. Here we present this BFA case with a rare and unexpected complication. We also review the appropriate literature.

Keywords

References

  1. Mantor PC, Tuggle DW, Tunell WP. An appropriate negative bronchoscopy rate in suspected foreign body aspiration. Am J Surg 1989;158:622-4. https://doi.org/10.1016/0002-9610(89)90208-0
  2. Steen KH, Zimmermann T. Tracheobronchial aspiration of foreign bodies in children: a study of 94 cases. Laryngoscope 1990;100:525-30.
  3. Zhijun C, Fugao Z, Niankai Z, Jingjing C. Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body. J Pediatr Surg 2008;43:718-21. https://doi.org/10.1016/j.jpedsurg.2007.10.010
  4. Van Looij MA, Rood PP, Hoeve LJ, Borgstein JA. Aspirated foreign bodies in children: why are they more commonly found on the left? Clin Otolaryngol Allied Sci 2003;28:364-7. https://doi.org/10.1046/j.1365-2273.2003.00725.x
  5. Altuntas B, Aydin Y, Eroglu A. Complications of tracheobronchial foreign bodies. Turk J Med Sci 2016;46:795-800. https://doi.org/10.3906/sag-1504-86
  6. Woo SH, Park JJ, Kwon M, Ryu JS, Kim JP. Tracheobronchial foreign body removal in infants who had very small airways: a prospective clinical trial. Clin Respir J 2018;12:738-45. https://doi.org/10.1111/crj.12586
  7. Altkorn R, Chen X, Milkovich S, Stool D, Rider G, Bailey CM, et al. Fatal and non-fatal food injuries among children (aged 0-14 years). Int J Pediatr Otorhinolaryngol 2008;72:1041-6. https://doi.org/10.1016/j.ijporl.2008.03.010
  8. Grover S, Bansal A, Singhi SC. Airway foreign body aspiration. Indian J Pediatr 2011;78:1401-3. https://doi.org/10.1007/s12098-011-0488-8
  9. Woo SH, Kim KH. Proposal for methods of diagnosis of fish bone foreign body in the esophagus. Laryngoscope 2015;125:2472-5. https://doi.org/10.1002/lary.25340
  10. Yang C, Hua R, Xu K, Hua X, Ma P, Zheng JN, et al. The role of 3D computed tomography (CT) imaging in the diagnosis of foreign body aspiration in children. Eur Rev Med Pharmacol Sci 2015;19:265-73.
  11. Na AS, Lim SC, Cho JS, Kim JH, Shin MS. Usefulness of flexible bronchoscopy in the diagnosis of tracheobronchial foreign bodies in children. Korean J Otorhinolaryngol-Head Neck Surg 2001;44:1103-6.
  12. Jang JY, Park JO, Ryu J, Jeong HS. Real-time video-assisted retrieval of airway foreign body in very young pediatric patients. Clin Exp Otorhinolaryngol 2014;7:329-33. https://doi.org/10.3342/ceo.2014.7.4.329
  13. Wood RE, Gauderer MW. Flexible fiberoptic bronchoscopy in the management of tracheobronchial foreign bodies in children: the value of a combined approach with open tube bronchoscopy. J Pediatr Surg 1984;19:693-8. https://doi.org/10.1016/S0022-3468(84)80354-1
  14. Kim YD, Min MK, Chun JY, Song KW. A case of tracheal foreign body: removed by partial resection of trachea & permanent tracheostomy. Korean J Otorhinolaryngol-Head Neck Surg 1995;38:1481-4.
  15. Lim JH, Lee SY, Ryu YJ, Hah JH. A case of tracheal foreign body removed by endoscopic approach with tracheotomy. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:723-6. https://doi.org/10.3342/kjorl-hns.2014.57.10.723
  16. Chung EJ, Rho YS, Jung KY, Kim JW, Lee SW. The role of transnasal esophagoscopy in ENT office: a prospective, multicenter study in Korea. Clin Exp Otorhinolaryngol 2014;7:123-5. https://doi.org/10.3342/ceo.2014.7.2.123
  17. Kim JP, Kwon OJ, Shim HS, Kim RB, Kim JH, Woo SH. Analysis of clinical feature and management of fish bone ingestion of upper gastrointestinal tract. Clin Exp Otorhinolaryngol 2015;8:261-7. https://doi.org/10.3342/ceo.2015.8.3.261
  18. Lee YW, Cho JH, Koo MB, Yeo CK. Accurate diagnosis with chest CT for bronchial foreign body removal in young patient: report of three cases and review of the literature. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:850-3. https://doi.org/10.3342/kjorl-hns.2014.57.12.850
  19. Seo JW, Lee DK, Hong JC, Park HS. Two cases of pneumothorax and subcutaneous emphysema associated with removal of neglected tracheal foreign body. Korean J Otorhinolaryngol-Head Neck Surg 2015;58:44-7. https://doi.org/10.3342/kjorl-hns.2015.58.1.44
  20. Kwon OJ, Park JJ, Kim JP, Woo SH. Vocal cord paralysis caused by stingray. Eur Arch Otorhinolaryngol 2013;270:3191-4. https://doi.org/10.1007/s00405-013-2692-9
  21. Cho DY, Aaron GP, Shepard KG. Spontaneous retropharyngeal and mediastinal emphysema. Clin Exp Otorhinolaryngol 2016;9:178-81. https://doi.org/10.21053/ceo.2014.01543
  22. Sehgal A, Singh V, Chandra J, Mathur NN. Foreign body aspiration. Indian Pediatr 2002;39:1006-10.
  23. Chu H, Kim DY. Use of lasers in the treatment of alopecia areata. Med Lasers 2016;5:71-6. https://doi.org/10.25289/ml.2016.5.2.71
  24. Kim S, Park E, Nam S. Synergy effect of combination of fractional CO2 and fractional Q-switched ruby laser treatment for skin rejuvenation. Med Lasers 2015;4:25-8. https://doi.org/10.25289/ml.2015.4.1.25
  25. Cho SE, Kim JY, Nam SM, Park ES. Spot CO2 laser revision of facial atrophic linear scars in Korea. Med Lasers 2014;3:22-6. https://doi.org/10.25289/ML.2014.3.1.22
  26. Kim YK, Park ES, Cho SB. Double-eyelid blepharoplasty-induced scar treated with a 10,600-nm carbon dioxide fractional laser. Med Lasers 2013;2:82-4. https://doi.org/10.25289/ML.2013.2.2.82
  27. Ahn KJ, Kang JS, Cho SB. Treatment of xanthelasma palpebrarum by the pinhole method using a 10,600-nm carbon dioxide laser. Med Lasers 2013;2:70-2. https://doi.org/10.25289/ml.2013.2.2.70
  28. Park S, Jung KY, Park MW, Hwang J, Lee SY, Baek SK. A single-arm, prospective study of laser-assisted marsupialization for epiglottic cysts in adults. Med Lasers 2013;2:64-6. https://doi.org/10.25289/ML.2013.2.2.64