Foreign Body Migration from Subglottis to Bronchus in a Tracheostomised Child: A Case Report

TL;DR

A child with a foreign body in the airway required tracheostomy, and the object migrated during treatment, highlighting the need for careful intervention.

Contribution

Reports a rare case of foreign body migration during bronchoscopy in a tracheostomized child.

Findings

Foreign body migrated from subglottis to bronchus during first bronchoscopy attempt.

Successful removal of a 2.5*2 cm bone chip via second bronchoscopy using forceps.

Tracheostomy was critical for airway stabilization during the procedure.

Abstract

Foreign body (FB) aspiration is a critical paediatric emergency, often requiring timely diagnosis and intervention to prevent complications. We report the case of a three-year-old female presenting with persistent cough and breathing difficulty, initially managed as croup. Imaging revealed a subglottic FB, necessitating tracheostomy for airway stabilization. During the first rigid bronchoscopy attempt, the FB migrated into the left main bronchus, likely due to manipulation and the use of an uncuffed tracheostomy tube. A second bronchoscopy successfully removed the FB, a 2.5*2 cm bone chip, using telescope-mounted forceps. This case highlights the rare phenomenon of FB migration during intervention and emphasizes the importance of tracheostomy in maintaining airway. Awareness of migration risks and tailored interventions are critical for successful outcomes.

Figures