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January, 2017

Pediatric Foreign Body Ingestion Surgery & Treatment

Docs extricate LED bulb from toddler

Infants and babies have their own new ways of exploring everything in the small world around them. Everything is new to them and so is to the new parents. Especially in case of first time parents, everything that the child encounters and experiences for the first time, the parents have their own moments of learning, with lots of surprises, both good and bad. In this whole process of exploring and learning, the dangers that children are prone to are sometimes completely unimaginable for parents. Therefore, it is very essential to understand the potential risks that your child might be exposed to, while doing simple activities like playing, crawling, walking, and even eating.

Foreign body ingestion is one such risk that the parents need to consider at all points of time. Especially for children above the age of 6 months, i.e when they start sitting and crawling and have the ability to move around and  the tendency to approach or pick up almost any object in their reach. Almost every child has the risk of foreign body ingestion in the form of objects like – coins, pins, screws, buttons, batteries, and any kind of toy and toy parts. Although children may also sometimes aspirate food particles but the risks are comparatively lower, unless it is hard food particles like nuts that a baby is unable to chew. The foreign body can enter into the food passage or into the breathing passage, the latter resulting in serious breathing problems.

Recently a 15 month old baby was admitted to the ED of Sakra World hospital when the child accidentally ingested a small LED light, which was actually a part of one of his toys. Certainly the child must have broken that part of the toy while playing and would have put it into his mouth out of curiosity. Now the likelihood of such a thing is purely out of a new parents’ imagination but it seems parents need to become extra cautious nowadays. The incident happened outside Bangalore and the parents had to rush the child driving 3 hours to Bangalore.

The child was admitted immediately to the emergency and an X- Ray was done to identify the foreign body and its location in the breathing passage. A team of doctors including – pediatric surgeons (Dr.Ramachandra.C and Dr.Anilkumar P.L), Anesthesiologist (Dr.Hirachand Mutagi) at Sakra World Hospital got together and discussed the case to decide upon an appropriate line of treatment keeping in mind the best interest of the baby. It is very essential to take the right decision at the right time in such situations and since it is a complicated procedure considering the type of foreign body and its location. Every step needs to be performed carefully to avoid damage to the vocal cords (voice box) and trachea (main breathing passage) further leading to possible blockage of the breathing passage and temporary/permanent disabilities in speaking.

A carefully coordinated challenging anesthesia was induced for completing a successful bronchoscopy to safely retrieve the foreign body from the breathing passage ensuring it did not slip further into lungs nor caused any damage to the breathing passage.  A healthy playful child was discharged and the parents were well informed about future precautions and for ensuring a safe environment for the child to play and explore his surroundings.

Dr. Anil Kumar, Consultant – Pediatric Surgery, Sakra World Hospital – “Foreign body ingestion is a very common and a life threatening condition that infants and babies are highly prone to. The line of treatment and surgeries in such situations are also very complicated as the child often has to be put under general anesthesia and the surgery itself is complicated. Also such surgeries are considered very technique sensitive as the anesthesia is given through the trachea which is also the main site for surgery - Bronchoscopy.   I advise all parents to be very careful especially when they feed the baby with nuts / fruits with seeds. It is always preferable to feed these things under vision and also supervise the child while playing. Parents should seek immediate medical attention whenever child chokes or has continuous cough post feeding.”

Mr. Hari Kirishna Naidu – father of the baby said – “The whole situation came as a complete shock and was like living a nightmare for me and my family.  And I believe that the prompt decisions like taking an X-ray as the first step and deciding on an appropriate line of treatment taken by Dr. Anil Kumar and his team at Sakra World Hospital have played a big role in saving our child. I would also like to advise all parents to be extra careful and never to leave your kids unattended and also make sure that you buy only age appropriate toys for your kids.”

*representative image only and does not represent the actual patient

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