Recently, the City Children’s Hospital, received a case of Tr. PA 7, male, living in Soc Trang with shortness of breath, cyanosis, was transferred from a frontline hospital. Previously, the child was studying math homework, thinking about solving the exercise while biting the pencil eraser, accidentally the eraser tip and metal ring fell out, the child swallowed a foreign object into the airway, coughed and turned purple. , coughed up blood, was taken to a local hospital for first aid and transferred to the City Children’s Hospital. Here, the doctors provided respiratory support for the child, took chest x-ray, and CT scan of the airway to identify the foreign body located in the right medial bronchus, so they consulted the airway endoscopy team to use a flexible bronchoscope to pass through. Right nostril fall, nasal slit is cloudy, dry, has little bleeding, larynx and glottis are open, 2 vocal cords open and close well, move the flexible bronchoscope down to record the trachea to the carina clear, stagnant There is little white sputum near the carina, right main bronchus, right upper lobe is open, white sputum is completely occluded right medial bronchus. Remove the sputum, record the white, translucent foreign body, blue light completely blocking the medial bronchus, insert the crocodile forceps to grasp the foreign body, turn and pull the foreign body up slowly out of the airway. Use Magill alkali to pick up the foreign body at the bottom of the tongue, the foreign body is the aluminum cap surrounding the pencil eraser
Endoscopic examination and irrigation of the right lower lobe bronchus are free of foreign bodies, the left bronchus and its segments are open and free of foreign bodies. After removing the foreign body, the child was awake and was still being treated for pneumonia. It is known that the child is an uncle who has been adopted by the temple since he was born, grew up studying very hard, but often forgets to bite his head to write – a fairly common habit among students, so parents should note.
CT scan of the lungs showing a foreign body obstructing the right medial bronchus
After removing the foreign body, the child was awake and continued to be treated for pneumonia
Doctor 2 Nguyen Minh Tien
City Children’s Hospital
