Foreign Body Inhalation in Child With Mediastinal and Subcutaneous Emphysema

A 2-year-old boy was brought to the emergency department
with dyspnea and subcutaneous emphysema over the chest, back, and face. On
talking to the parents, they gave a history suggestive of foreign body
inhalation consisting mostly of chickpeas. Examination revealed the presence of
subcutaneous emphysema and decreased air entry on the right side. A chest x-ray
(Figure 1) and computed tomography scan of the chest (Figure 2) revealed
hyperinflation of the right lung, subcutaneous emphysema, and pneumomediastinum.
Rigid bronchoscopy revealed inhaled pieces of chickpeas in right main bronchus.
The foreign body was extracted using forceps and suction (Figure 3). A postextraction chest x-ray showed
improvement of the right lung hyperinflation (Figure 4).Figure 1: Pre-extraction chest x-ray.Figure 2: Pre-extraction computed tomography scans.Figure 3: Foreign body pieces following extraction.Figure 4: Postextraction chest x-ray.

一名两岁男童因呼吸困难及胸部、背部、面部皮下气肿被紧急送往急诊科。经与家长沟通，了解到其主要症状为吸入异物，主要为鹰嘴豆。体检发现皮下气肿及右侧呼吸音减弱。胸部X光片（图1）和胸部CT扫描（图2）显示右侧肺过度膨胀、皮下气肿和纵隔气肿。硬质支气管镜检查发现右侧主支气管内有吸入的鹰嘴豆碎片。异物经钳夹和吸引器取出（图3）。取出异物后的胸部X光片显示右侧肺过度膨胀有所改善（图4）。图1：取出异物前的胸部X光片。图2：取出异物前的胸部CT扫描。图3：取出异物后的异物碎片。图4：取出异物后的胸部X光片。