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Case Reports
. 2021 Oct 20;15(1):533.
doi: 10.1186/s13256-021-03015-w.

Pneumonectomy in a child due to belated diagnosis of foreign body aspiration: a case report

Narindra N M Razafimanjato  1 , Rindra A Ralaivao  2 , Tsiry D N Ravelomihary  3 , Francis A Hunald  4 , Jean Louis H Rakotovao  3
Affiliations
Case Reports

Pneumonectomy in a child due to belated diagnosis of foreign body aspiration: a case report

Narindra N M Razafimanjato et al. J Med Case Rep. .

Abstract

Introduction: With early diagnosis, fiberoptic or rigid bronchoscopy methods are the gold standard in the management of tracheobronchial foreign body. Otherwise, nonrecognized bronchial foreign bodies cause irreversible damage to the airways and lungs. The deficiency of the health system noted in many developing countries such as Madagascar, combined with the fundamental problem relating to children's conditions, which are determined by social and educational factors, makes it almost impossible to provide early and appropriate management of the penetration syndrome.

Case presentation: An 11-year-old Malagasy female patient was referred to our hospital for an investigation of the etiology of the patient's hemoptysis. The investigations revealed a localized bronchiectasis and atelectasis due to a foreign body obstructing the left main bronchus. Based on the hemoptysis and left lung almost destroyed by an occlusive lesion within, we decided to proceed with left pneumonectomy. A retrospective interrogation revealed a choking episode 4 years prior in elementary school after the child sucked on a pen cap and involuntarily aspirated it. Two years after the pneumonectomy, our patient was doing well and was asymptomatic.

Conclusion: In this case report, we describe a rare case of a late presentation of foreign body aspiration that resulted in a left pneumonectomy in a child. Despite our favorable results, pneumonectomy must be the preferred last option. Preventive actions remain the optimal approach.

Keywords: Aspiration; Children; Foreign bodies; Morbidity; Mortality; Pneumonectomy; Pneumonia.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
A Chest computed tomographic scan showing cavitary lesions in the left lung, as well as right lung herniates into the left chest. B, C Image of foreign body on thoracic computed tomography. The circle denotes a foreign body on thoracic computed tomography
Fig. 2
Fig. 2
Definitive pathology result revealed, on sectioning the specimen. A Image of the left pneumonectomy material and B showing a red pen blind cap obstructing the left main bronchus, with distal bronchiectasis
See this image and copyright information in PMC

References

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