Telescopic Removal of a Subglottic Foreign Body in a Child: A Case Report

Abstract

The foreign body ranges from metallic to non-metallic household materials of different shapes and sizes. Foreign body aspiration in the airway is not an uncommon problem and is one of the causes of morbidity and mortality affecting children which requires prompt diagnosis and management. A child presenting in severe respiratory distress with upper airway obstruction may require urgent relief of the upper airway obstruction. A 6 years old male child presented to the Children Emergency Ward (CHEW) on account of aspiration of trunking nail of one hour duration prior to presentation while playing with it in his mouth. There was associated noisy breathing, respiratory distress and cough. At presentation, he was restless and stridulous. The respiratory rate was 60 cycles per minute, Peripheral oxygen saturation (SPO2) was 85%, reduced air entry in both lung fields and no crepitation on chest examination. A diagnosis of foreign body (trunking nail) in the larynx was made. Patient was worked up for emergency tracheostomy. Intraoperative finding showed a metallic trunking nail, with plastic component. The foreign body was grasped with the attached forceps of the telescope with the tip facing upwards and carefully extracted without injury to the surrounding structures .No intraoperative complication was noted, patient was admitted into the ward, given medications and observed for a few days. He was later weaned off the tracheostomy tube and discharged home in a stable clinical condition.