Successful removal of distal persistent foreign body airway with CO2 cryotherapy in a child

Roser Ayats-Vidal; Amalui Vásquez-Pérez; Miguel Gallego-Díaz; Antoni Rosell; Laura Valdesoiro-Navarrete; Rachid Tazi-Mezalek

doi:10.1016/j.rmcr.2022.101594

Successful removal of distal persistent foreign body airway with CO2 cryotherapy in a child

Respir Med Case Rep. 2022 Feb 1:36:101594. doi: 10.1016/j.rmcr.2022.101594. eCollection 2022.

Authors

Roser Ayats-Vidal¹, Amalui Vásquez-Pérez², Miguel Gallego-Díaz³, Antoni Rosell⁴, Laura Valdesoiro-Navarrete¹, Rachid Tazi-Mezalek⁵

Affiliations

¹ Paediatric Pulmonology and Allergology Department. Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
² Paediatric Pulmonology Department, Hospital Universitari Joan XXIII, Universitat Rovira i Virgili, Institut d'Investigació Sanitaria Pere Virgili, Spain.
³ Department of Respiratory Medicine. Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
⁴ Centro de Investigación Biomédia en Red- Instituto Carlos III (isciii-CIBERES), Institut de Recerca Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Thorax Insitute, Pulmonolgy Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
⁵ Head of the Interventional Pulmonology Program, Bronchoscopy and Pleural disease Unit, Respiratory Department, Thorax Clinic Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

Abstract

We report a case of a nine-year-old boy with clinical evidence of foreign body (FB) aspiration with 3 months of delay in diagnosis. The bronchoscopy found soft tissue FB with surrounding inflamed granulation tissue at the entrance to the lateral segmental bronchus. Repeated attempts to remove the FB with flexible forceps were unsuccessful due to friable FB and granulation tissue. Ablation of the granulation tissue using nitrous oxide cryotherapy was then successfully performed and the distal and organic FB was extracted. Early diagnosis is important for minimizing granulation tissue development which complicates FB removal. Cryotherapy with a flexible bronchoscope is an option if organic FB cannot be removed using conventional bronchoscopic instrumentation.

Keywords: Case report; Child; Cryotherapy; FB, foreign body; FBA, foreign body aspiration; Flexible bronchoscopy; Foreign body aspiration; Granulation tissue.

Publication types

Case Reports