Supraglottic Foreign Body Aspiration: Delayed Diagnosis and Lesson Learnt

Abstract

Foreign body aspiration is a clinical emergency requiring prompt action to ensure speedy recovery and minimise complications. Foreign body aspiration is common among children below 3 years old but sometimes there is significant delay until the diagnosis is made. Clinical diagnosis requires a high degree of suspicion in the medical history, especially when the choking event is unclear in the history as physical examination and radiological findings have a low sensitivity. Herein, we present a case of 8-month-old baby boy who presented with dysphonia in which the diagnosis of foreign body aspiration was missed during the first consultation. (Hong Kong j.emerg.med. 2015;22:57-59)

The Mysterious Whistling Breath: Foreign Body Aspiration

“…Foreign body aspiration can be potentially fatal and requires a multi-disciplinary team approach from emergency, pediatric, anesthesiology, and otorhinolaryngology departments for early diagnosis, optimization, and successful foreign body retrieval. The common clinical presentations include wheezing, dysphonia and stridor [1]. However, these symptoms are also seen in asthma, exacerbation of asthma, croup and pneumonia, which may lead to misinterpretation of the impression and lead to delayed diagnosis [1].…”

“…The common clinical presentations include wheezing, dysphonia and stridor [1]. However, these symptoms are also seen in asthma, exacerbation of asthma, croup and pneumonia, which may lead to misinterpretation of the impression and lead to delayed diagnosis [1]. Foreign body aspiration has been the commonest cause of accidental death in children, typically within 1 to 3 years of age [2].…”