International Journal of Pediatric Otorhinolaryngology Extra
Case ReportPenetrating laryngotracheal injury in a child: An unusual case of firework fragment
Introduction
Penetrating laryngotracheal injury caused by fireworks or explosives is rare, and can be associated with a wide range of injuries varying from trivial to life-threatening [1]. Penetrating laryngotracheal injuries are more common in warfare and extremely uncommon in civilian life. The depth of penetration and tissue damage depends mainly on the explosive velocity. It is hard to predict the extent of the damage based on the wound entry. The foreign body can travel through the soft tissues ending in unsuspectable sites which may lead to diagnostic confusion and dilemmas in treatment [1]. The main concern in these injuries is control of the airway. Endotracheal intubation is the mainstream option for managing the airway of trauma patients but it becomes a challenge in cases in which the airway is already injured. There are several options of managing the airway, depending the severity of the injury, the equipment available, the experience of the medical staff and the urgency. We present those options in the discussion [2].
Section snippets
Case report
An 11 year old child suffered from a penetrating neck injury by a fragment from the explosion of a flash bottle in his hands. He was brought to the emergency room fully conscious, complaining of hoarseness and mild dyspnea. Physical examination revealed a small penetrating wound in the level of the laryngeal cartilages and subcutaneous emphysema (Fig. 1). Vital signs were stable except for a mild dyspnea. During his stay in the emergency room the child became sleepy and stridorous. The medical
Discussion
Penetrating neck injuries are uncommon especially in the pediatric age group. They usually occur due to gun-shot or knife injuries. Penetrating injury caused by fireworks or explosives can be associated with a variety of injuries: from trivial to life-threatening. Sometimes, apparently small entry wound can hide extensive tissue damage. A penetrating foreign body can travel through the soft tissues of the neck ending in unsusceptible sites which can lead to diagnostic confusion and dilemma in
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