On December 27, Children’s Hospital 1 (Ho Chi Minh City) informed that the hospital’s Ear, Nose and Throat Department had just had the airway removed by endoscopy. foreign object 1.2 cm long for pediatric patients (15 years old, residing in Phu Yen province).
The patient came to see the doctor because of a persistent cough that was not cured after many treatments.
The family said that 7 years ago, while the patient was blowing a toy trumpet, a friend patted his back, causing the patient to choke due to swallowing the trumpet, but did not have difficulty breathing or turn blue. Family members heard the child breathing loudly and took him to the local hospital for examination.
The doctor took an X-ray to check and thought that the foreign object would follow its way out, so he did not intervene.
For the past 7 years, the child has been breathing normally, without difficulty breathing or pneumonia. Sometimes he has a cough and buys medicine to take it, and the cough does not last long.
More than a month ago, the child suddenly coughed more and more. Family members took her to a hospital in Ho Chi Minh City for examination. The doctor suspected pulmonary tuberculosis, so she transferred her to another hospital for tuberculosis treatment. Here, children are treated with a tuberculosis regimen and have follow-up visits every 10 days.
At the third follow-up visit, the condition still did not improve, the child still coughed a lot. Chest X-ray showed no improvement, lung CT-scan suspected foreign body, so medication was given and re-examination after 10 days.
After four follow-up examinations but the child’s condition did not improve, the child was taken back to his hometown for examination at Binh Dinh Tuberculosis and Lung Disease Hospital. A CT-scan of the lungs suspected a foreign object in the airway, so the family asked to be transferred to Children’s Hospital 1, Ho Chi Minh City for airway endoscopy.
The foreign object is a 1.2 cm long hard plastic trumpet that stayed in the child’s lungs for 7 years, causing a prolonged cough. Photo: BVCC
Dr. Phu Quoc Viet, Deputy Head of the Department of Otolaryngology (Children’s Hospital 1), commented that this is a difficult and rare foreign body case because foreign body in the lungs too long, deep in the right lung subsegment bronchus.
When endoscopically entering the airway to determine the location of a foreign object, the surgeon has difficulty accessing the foreign object because the endoscopic instrument is not long enough to penetrate deeply. At the same time, granulation tissue grows a lot, forming a block that covers the foreign body.
In addition, when the endoscope is inserted, a lot of blood flows into the airway, making it difficult for the surgeon and anesthesia team to observe. The surgical team spent more than 90 minutes, both stopping the bleeding, stabilizing anesthesia, and ensuring the patient’s airway many times to continue finding a way to approach the foreign object through endoscopy.
After many efforts at scanning, the surgical team was able to see the foreign object, but the foreign object’s location was a challenge for the surgeon. Doctors use the 4 hands technique, which means two doctors will work together to examine and pick up at the same time.
After failing the first time, the doctors succeeded the second time, get the foreign object is a 1.2 cm long hard plastic trumpet that sticks out of the pediatric patient’s airway.
Up to now, the patient can eat and live normally.