Subcutaneous emphysema due to bronchial foreign body demonstrated by multidetector-row computed tomography

Abstract

Foreign body aspiration is an important cause of emergency hospital admissions in young children less than 3 years of age. It may manifest with acute respiratory difficulty, choking and wheeze acutely or may be asymptomatic. Surgical emphysema is an unusual presentation of bronchial foreign body aspiration in young children. We describe an infant with bronchial foreign body aspiration that manifested with subcutaneous emphysema and pneumomediastinum. Multidetector-row CT with virtual bronchoscopy helped in the diagnosis by detecting and localizing the intraluminal foreign body in the right main bronchus that was removed with rigid bronchoscopy.

Tracheobronchial Foreign Bodies in Children: Experience From 1,328 Patients in China

“…The most common CT finding of tracheobronchial FBs was local obstruction or tracheobronchial narrowing (99.17%), which is similar to the previous studies ( 1 , 22 ). The second most common CT finding was obstructive emphysema of lung (74.55%).…”

Suitability of òhe modality virtual bronchoscopy with aspiration of a foreign body

“…It is known that if the foreign body falls into the larynx area, the body reacts immediately to the effects of asphyxiation, but if the foreign body penetrates down into the bronchial lumen, the sensation can be even without symptoms, making it difficult to diagnose without bronchoscopy. X-rays are often considered as unreliable in the aspiration of X-rays negative foreign bodies, as opposed to MDCT VB, allowing objective assessment of lung, bronchi and mediastinum by non-invasive diagnosis and final intervention planning (21). The multimodal approach to diagnosis has always been considered useful (22, etc.).…”

“…The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and chest Xray accuracy obtained by them are: 66.6%, 50%, 89.6%, 18.7% 4%. Wani et al (21) indicated that the aspiration of a foreign body in children under the age of 3 might manifest acute respiratory difficulties, suffocation and sharp wheezing, or might be asymptomatic. Sensitivity to the foreign body was due to the small caliber of the airways, incomplete laryngeal closure, and inadequate swallowing reflexes at this age.…”

“…The positive VB, according to Cevizci et al (25), helps to reduce the operative time by providing information on the localization and the size of the foreign body. The low-dose MDCT with VB, according to Wani et al (21), enhances detection and helps in localizing the intraluminal foreign body and thus speeds up proper management. Removal of the foreign body is performed with a rigid bronchoscopy.…”

Air leak syndrome and respiratory distress after green chilli aspiration in a child

“…Fascial planes arrangement in the neck subsequently allows air migration to pneumothorax and then subcutaneous emphysema. [ 3 4 ] Air leak syndrome, however, is a very rare occurrence. Only 1%–2% of children show all the features described.…”