Save the life of a child who choked a pig bone into the airway causing severe respiratory failure

At noon on October 15, 2021, the Emergency Department – City Children’s Hospital received a case of Tr. NL, 20 months old, male, living in Duc Hue, Long An in a state of restlessness, wheezing, shortness of breath, cyanosis, a lot of mucus in the mouth. Taking the medical history recorded for 9 days, I coughed, wheezed, and breathed tired, treated by a private doctor for 2 days, and did not get better, so I was admitted to a local hospital to diagnose severe bronchial asthma, receive oxygen therapy, nebulize bronchodilators , intravenous antibiotics and antibiotics, the condition did not improve, so the City Children’s Hospital was transferred. Here, the child exhibits wheezing, difficulty breathing, chest indrawing, nodding neck breathing, lots of viscous sputum, irritability, and cyanosis, so they are intubated, helped with breathing, given bronchodilators, and sprayed when using dilators. bronchi through a ventilator, as well as using antibiotics to treat pneumonia. The child’s condition still did not improve, so a CT scan of the lungs showed a foreign body image of 0.5x1cm in size right at the split of the trachea into the right and left main bronchus, slightly lying on the left side, so consultation with Respiratory, ENT, and emergency airway endoscopy after having a negative COVID-19 rapid test. The doctors wore personal protective equipment to ensure COVID-19 safety, performed airway endoscopy, and removed a 0.5x1cm triangular piece of pig bone with a sharp edge inserted into the lateral main bronchial wall. On the left side, slight abrasion was noted, and a little bleeding of the bronchial mucosa was noted. The child was continued to be treated at the outpatient intensive care unit.

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In this case, we would like to remind parents that while preparing food, it is necessary to remove all bones, it is best to remove all bones for children to eat meat to avoid unfortunate bone loss. In this case, parents said that they used bone broth to cook meat porridge for children to eat, but accidentally left bone fragments, leading to an accident that could endanger the child’s life if not thought of and emergency intervention. timely.

The chest CT scan image shows the foreign body fragment at the tracheal division at the left main bronchus, the risk of bronchial perforation, pneumomediastinum, the doctors performed emergency endoscopy.

A triangular piece of pork bone with a sharp edge inserted into the left main bronchus, was skillfully removed by doctors using specialized endoscopic tools without causing perforation of the bronchus.

A 20-month-old child, choking on a pig bone in the airway causing severe respiratory failure, underwent emergency endoscopic removal of foreign bodies and continued treatment at the Outpatient Resuscitation Department.

Doctor 2 Nguyen Minh Tien
City Children’s Hospital

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