A case of bronchial dental foreign body complicated by mediastinal emphysema

Abstract

Tracheal and bronchial foreign bodies are important in the field of otorhinolaryngology. Most foreign bodies are food. The most common complications are pneumonia and atelectasis. We describe a 9-year-old boy who accidentally ingested a tooth, which was complicated by subcutaneous emphysema and mediastinal emphysema. Since the patient did not report accidental ingestion, an initial diagnosis of pneumonia was made; however, subcutaneous emphysema increased, leading to the diagnosis of a bronchial foreign body. Extraction of the tooth was difficult, but after removal, the subcutaneous and mediastinal emphysema resolved quickly, and the patient was discharged from the hospital.

A witness to accidental ingestion makes the diagnosis of tracheal and bronchial foreign bodies straightforward; however, if there is no witness, the diagnosis is more difficult. It is important to suspect accidental ingestion of a foreign body, especially for patients presenting with pneumonia and atelectasis. There have also been reports of death due to hemorrhage during removal of bronchial dental foreign bodies; thus, attention should be paid to potential adverse events.