Pneumothorax/pneumomediastinum as a complication of foreign body inhalation in 3 pediatric patients: A case series

Medicine (Baltimore). 2022 Oct 14;101(41):e31073. doi: 10.1097/MD.0000000000031073.

Abstract

Introduction: Foreign body inhalation (FBI) is a serious and common emergency in children. Such children present in the emergency room (ER) with cough, shortness of breath, choking, or wheezing but rarely present with pneumomediastinum.

Patient concerns: Three children aged 2 to 5 years (2 girls and 1 boy) were seen in our ER complaining of FBI. Emergency bronchoscopy removal of the inhaled foreign body was performed; however, all 3 patients developed pneumomediastinum.

Diagnosis: A foreign body inhalation complicated by Pneumomediastinum/pneumothorax.

Intervention and outcomes: All the patients underwent emergency bronchoscopy and foreign body removal. After the ER intervention, 2 children were placed in the pediatric intensive care unit, and the pneumomediastinum resolved without intervention. The third patient required an operation for chest tube placement, which was then observed in the pediatric intensive care unit, and had several chest radiography follow-ups. After 5 days, the patient exhibited clinical improvement, and the chest tube was removed.

Conclusion: In this case series, we present 3 cases of children aged 2 to 5 years seen in our ER with a history of different types of organic FBI complicated by pneumomediastinum/pneumothorax. Pneumomediastinum/pneumothorax is a rare complication of FBI in pediatric patients. However, such complications require multidisciplinary collaboration for early diagnosis and intervention.

MeSH terms

  • Bronchi / diagnostic imaging
  • Bronchoscopy / adverse effects
  • Child
  • Female
  • Foreign Bodies* / surgery
  • Humans
  • Inhalation
  • Male
  • Mediastinal Emphysema* / diagnostic imaging
  • Mediastinal Emphysema* / etiology
  • Pneumothorax* / diagnostic imaging
  • Pneumothorax* / etiology
  • Pneumothorax* / therapy