Tension Pneumothorax with Cardiac Arrest Complicating Bronchoscopy in a Nut - Aspirated Child
Keywords:Bronchoscopy, tension pneumothorax, Foreign body
Tension pneumothorax is one of the most disastrous complications of rigid bronchoscopy. Despite being rare, it can be fatal. We present a case of a one-year-old child who aspirated a hazelnut and underwent rigid bronchoscopy for removal. Intraoperatively, he developed tension pneumothorax resulting in cardiac arrest. The procedure was discontinued however completed safely the day after. Subsequently, he developed severe hypoxic brain injury post cardiac arrest, aspiration pneumonia, kidney failure, and requiring high ventilatory and inotropic support. The child succumbed to death seven days later due to multiorgan failure.
Rovin JD, Rodgers BM. Paediatric foreign body aspiration. Paediatric Review. 2000;21(3):86-90.
Sandhofer MJ, Salzer H, Kulnig J. Foreign body aspiration – Sometimes a tough nut to crack. Respiratory Medicine Case Reports. 2015;15:18-9.
Hasdiraz L, Oguzkaya F, Bilgin M, Bicer C. Complications of bronchoscopy for foreign body removal: experience in 1035 cases. Annals of Saudi Medicine. 2006;26(4):283-7.
Han KA, Kim HJ, Byon HJ, Kim JT, Kim HS, Kim CS, Kim SD. Cardiac arrest induced by tension pneumothorax during ventilating bronchoscopy - a case report. Korean Journal of Anesthesiology. 2010;59(2):123.
Behera G, Tripathy N, Maru YK, Mundra RK, Gupta Y, Lodha M. Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree. The Journal of Laryngology and Otology. 2014;128(12):1078.
Norii T, Igarashi Y, Sung-Ho K, et al. Protocol for a nationwide prospective, observational cohort study of foreign-body airway obstruction in Japan: the MOCHI registry. BMJ Open. 2020;10:e039689.
Franzese CB, Schweinfurth JM. Delayed diagnosis of a paediatric airway foreign body: case report and review of the literature. Ear, Nose and Throat Journal. 2002;81(9):655-6.
Black RE, Johnson DG, Matlak ME. Bronchoscopic removal of aspirated foreign bodies in children. Journal of Paediatric Surgery. 1994;29(5):682-4.
Abdulmajid OA, Ebeid AM, Motaweh MM, Kleibo IS. Aspirated foreign bodies in the tracheobronchial tree: report of 250 cases. Thorax. 1976;31(6):635-40.
Tan HK, Brown K, McGill T, Kenna MA, Lund DP, Healy GB. Airway foreign bodies (FB): a 10-year review. International Journal of Pediatric Otorhinolaryngology. 2000;56(2):91-9.
Dias RJ, Dave NM, Chaskar VP, Garasia MB. Late onset pneumothorax following bronchoscopic foreign body removal. Journal of Anaesthesiology, Clinical Pharmacology. 2017;33(2):280.
Gallagher MJ, Muller BJ. Tension pneumothorax during paediatric bronchoscopy. Anaesthesiology. 1981;55(6):685-6.
Rothmann BF, Boeckman CR. Foreign bodies in the larynx and tracheobronchial tree in children: a review of 225 cases. Annals of Otology, Rhinology and Laryngology. 1980;89(5):434-6.
Tan HK, Tan SS. Inhaled foreign bodies in children-anaesthetic considerations. Singapore Medical Journal. 2000;41(10):506-10.
Baumann MH, Sahn SA. Tension pneumothorax: diagnostic and therapeutic pitfalls. Critical Care Medicine. 1993;21(2):177-8.
Ibrahim AE, Stanwood PL, Freund PR. Pneumothorax and systemic air embolism during positive-pressure ventilation. The Journal of the American Society of Anaesthesiologists. 1999;90(5):1479-81.
Shivnani D, Raman EV, Gaur S. Tension pneumothorax - challenge of foreign body removal during rigid bronchoscopy in children. IP Journal of Otorhinolaryngology Allied Science. 2020;3(2):63-6.
Steen KH, Zimmermann TH. Tracheobronchial aspiration of foreign bodies in children: a study of 94 cases. The Laryngoscope. 1990;100(5):525-30.
How to Cite
Copyright (c) 2022 Malaysian Journal of Paediatrics and Child Health
This work is licensed under a Creative Commons Attribution 4.0 International License.