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A transglottic foreign body in the airway of an infant

A transglottic foreign body in the airway of an infant A 10‐month‐old infant was brought to the emergency department with respiratory distress. Clinical examination revealed biphasic stridor, bilateral crepitations and wheezing. Her peripheral pulse oximetry oxygen saturation was 90%. A chest radiograph demonstrated widening at the level of the glottis. As there was a suspicion of an inhaled foreign body, we decided to proceed with a gaseous induction of anaesthesia using sevoflurane. Spontaneous ventilation was maintained throughout. A supraglottic airway device (SAD) (size 1.5 i‐gel, Intersurgical, Wokingham, UK) was inserted and we attempted to advance a flexible bronchoscope into the trachea. We were unable to visualise the glottic opening due to the presence of a large transglottic foreign body aligned to longitudinal axis (Video 1). The SAD was removed and the surgeon was able to retrieve the foreign body with direct laryngoscopy and biopsy forceps. The foreign body was found to be a 2 × 1 cm triangular section of aluminium foil packaging from a tablet multipack which was left unattended by the parents after use (Fig. ).The transglottic foreign body was found to be a triangular piece of a torn edge of a tablet pack. The Video URL is: https://youtu.be/I_YM-ZnBIXsThe reported incidence of a foreign body in the glottis is 2–11% . http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Anaesthesia Reports Wiley

A transglottic foreign body in the airway of an infant

Sharma, R.; Singh, R.
Anaesthesia Reports , Volume 8 (1) – Jan 1, 2020
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References (6)

Publisher
Wiley
Copyright
2020 © Association of Anaesthetists
eISSN
2637-3726
DOI
10.1002/anr3.12029
Publisher site
See Article on Publisher Site

Abstract

A 10‐month‐old infant was brought to the emergency department with respiratory distress. Clinical examination revealed biphasic stridor, bilateral crepitations and wheezing. Her peripheral pulse oximetry oxygen saturation was 90%. A chest radiograph demonstrated widening at the level of the glottis. As there was a suspicion of an inhaled foreign body, we decided to proceed with a gaseous induction of anaesthesia using sevoflurane. Spontaneous ventilation was maintained throughout. A supraglottic airway device (SAD) (size 1.5 i‐gel, Intersurgical, Wokingham, UK) was inserted and we attempted to advance a flexible bronchoscope into the trachea. We were unable to visualise the glottic opening due to the presence of a large transglottic foreign body aligned to longitudinal axis (Video 1). The SAD was removed and the surgeon was able to retrieve the foreign body with direct laryngoscopy and biopsy forceps. The foreign body was found to be a 2 × 1 cm triangular section of aluminium foil packaging from a tablet multipack which was left unattended by the parents after use (Fig. ).The transglottic foreign body was found to be a triangular piece of a torn edge of a tablet pack. The Video URL is: https://youtu.be/I_YM-ZnBIXsThe reported incidence of a foreign body in the glottis is 2–11% .

Journal

Anaesthesia Reports – Wiley

Published: Jan 1, 2020

Keywords: foreign body; infant; transglottic

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