20 March 2012
Eight–month–old Chandrakant (name changed) was brought to a city hospital with severe respiratory distress and was on the verge of total collapse, a fortnight ago.
A bronchoscopy, the technique of visualising the inside of the airways, showed that peanut pieces were lodged in the child’s windpipe.
“The peanut pieces were embedded in the main branch supplying air to the left lung. They were deeply impacted and soft, suggesting that the actual ingestion must have taken place at least a week earlier,” said paediatric surgeon Dasmit Singh, who carried out the bronchoscopy.
Removing the pieces was another challenge, given the critical condition of the child. “The windpipe was tiny and the left lung had collapsed and the infant was on ventilator. We had to ‘nibble away’ at the peanut pieces–– erode it with instruments and free the airway,” he added.
“Thin and long forceps were inserted through the bronchoscope, and the pieces were taken out in bits. Multiple pieces of a whole peanut were stuck inside,” Singh added.
Chandrakant was brought to Jehangir hospital from Perne Phata, Koregaon Bhima, some 30 km from Pune, where he lives with his family, in the middle of the night. He had suddenly ‘coughed, puked and become breathless’, his father, a crane operator, said.
The company’s doctor, who told the parents to rush to Pune, called the hospital staff and informed them. “When they arrived, the infant was unconscious, gasping desperately for breath. His oxygen saturation and blood pressure were critically low. Every second was precious and he was shifted to the Paediatric Intensive Care Unit (PICU) for ventilation,” Sanjay Bafna, head of paediatrics department at Jehangir Hospital, said.
For the next three days, Chandrakant battled for life. “Initial investigations showed that the left lung had collapsed and was less than half the normal size. There was severe infection in the lungs which had spread to the entire body causing sepsis,” Bafna said.
The procedure was successfully accomplished and subsequent medication and ventilation took care of the severe inflammation and infection. After 48 hours, the infant was able to breathe without artificial support. He was discharged on March 14.
Such cases are rare and parents must keep small items out of toddlers’ reach. Working parents must take additional care to make their homes child–safe, experts said.
“When there is a sudden and serious breathing problem, people around must realize that a foreign body could be trapped in the windpipe. The patient must be immediately rushed to a facility capable of extracting and ventilating the patient,” said Bafna.