Rigid bronchoscopy for foreign body removal in a tracheostomized patient with mitochondrial myopathy, encephalopathy, and stroke-like episodes (MELAS) syndrome: A case report

Elsevier

Available online 15 April 2023, 101255

Trends in Anaesthesia and Critical CareAuthor links open overlay panel, , , Abstract

Accidental tracheobronchial foreign body aspiration is a life-threatening event occurring most commonly in children, however, neurological diseases affecting swallowing function and airway reflexes can be risk factors for aspiration in older children and adults. We are presenting a case of a 7-year-old child with MELAS syndrome who presented to the emergency room in distress after a tracheobronchial aspiration of the tracheostomy tube. The poor haemodynamics and oxygenation of the child warranted a novel approach with a smaller rigid bronchoscope (4) being passed alongside a smaller tracheostomy tube (4.5mm ID) with the cuff being in a deflated state, and ventilation was continued via the tracheostomy tube. The broken tracheostomy tube lodged at the carina was retrieved. A comprehensive team effort along with precise titration of drugs, proactive monitoring, and efforts to prevent metabolic shifts helped in the successful recovery of the child.

Keywords

MELAS

Foreign body

Tracheostomy

Bronchoscopy

Anaesthesia

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© 2023 Published by Elsevier Ltd.

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