Publication

Abstract : We report a child who died after an attempt to remove a 4.5 cm metallic angled nail from the bronchus of an 18-month-old child. This case highlights a number of problems which can complicate foreign body extraction in small children: •Delayed diagnosis: often misdiagnosed as asthma. •Sudden deterioration: no time to plan approach. •Minimal stridor may be present with low airflow. •Intubation: this risks distal dislodgement of foreign body. •Laryngeal lumen in children under 18 months will often not accept optical forceps. •Edema from manipulation worsens an already precarious situation. The sudden deterioration requiring intubation was the critical point in this case. If at all possible intubation should be avoided.