Multidisciplinary Management of Foreign Body Aspiration in Pediatrics: A Case Complicated by Bilateral Pneumothorax and Respiratory Failure

TL;DR

This paper discusses the management of a severe case of foreign body aspiration in a 2-year-old child complicated by lung collapse and respiratory failure.

Contribution

The paper presents a rare case highlighting the challenges and multidisciplinary approach in managing complex pediatric FBA.

Findings

FBA can lead to severe complications like bilateral pneumothorax and respiratory acidosis in young children.

High-frequency oscillatory ventilation and rigid bronchoscopy were essential in treating the patient.

Advanced therapies like ECMO may be necessary for critically ill pediatric FBA cases.

Abstract

Foreign body aspiration (FBA) is a significant cause of morbidity and mortality in the pediatric population, particularly in children under three years of age. This condition often presents with nonspecific respiratory symptoms, leading to delays in diagnosis and an increased risk of severe complications such as pneumothorax and respiratory failure. Here, we present a case of a 2-year-old child with FBA complicated by bilateral pneumothorax, severe respiratory acidosis, and left lung collapse. Diagnostic imaging, including computed tomography (CT), identified an obstruction in the left main bronchus. High-frequency oscillatory ventilation (HFOV) and multidisciplinary planning were critical in stabilizing the patient before definitive management with rigid bronchoscopy under high-risk conditions. The case highlights the diagnostic and therapeutic challenges associated with severe FBA and underscores the importance of advanced therapeutic modalities, such as extracorporeal membrane oxygenation (ECMO), in managing critically ill pediatric patients.

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