Muhammad Rashid, Inamul Haq, Syed Nadeem Uddin Naqvi, Azhar Niwaz.
A rare case of airway foreign body (cement & sand)
Pak Armed Forces Med J Dec 2005;55(4):355-7.
PAF Hospital, Sargodha

An eighteen months old girl was brought in respiratory distress for the last two days. There was no history of eating or swallowing any item. She was pale, fatigued and in a state of obvious respiratory distress, there was tracheal tug, recession of the intercostals margin and spaces on the right side, while the left side of the chest was not moving with respiration and no breath sounds were audible on the left side. Her X-ray chest revealed that the left lung was completely collapsed with mediastinal shift. Bronchoscopy was done under general anesthesia by apneic technique. The child was maintaining his oxygen saturation at 85 to 90% even with 100% oxygen ventilation. When ever child`s saturation started falling down below 70%, the bronchoscopy was stopped and oxygen saturation was maintained at maximum level with positive pressure ventilation through mask before again restarting the procedure. Negus type of bronchoscope, size 25 cm length with 4.5 mm diameter at the front end was used. There was whitish to green discharge filing the left main bronchus. On aspiration there were cement and gravel particles filling the main lumen of the left main bronchus. The main pieces of cement particle were removed with chevalier Jackson forceps while the remaining sand was removed by applying strong suction through small pediatric nasogastric tube. The child started maintaining oxygen saturation at 100 % with assisted ventilation. His X- ray chest was done on the next day which showed fully aerated lungs bilaterally.

Category: Case Reports
Keywords: Foreign Bodies. Bronchoscopy. Lung Collapse.

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