Pneumomediastinum and Pneumoretroperitoneum Induced by Foreign Body in Bronchus

ABSTRACT

A 5-year-old boy was on medication after diagnosed with infantile spasm, and had regular diet with bedridden state. The patient had intermittent fever and cough lasting 1 week before admission. Symptom was worsened from the night before the first day of admission, and chest swelled up on the day of admission. Chest computed tomography (CT) was performed and showed extensive subcutaneous emphysema in neck, thorax, and abdomen. Pneumomediastinum, pneumoretroperitoneum, and right lung atelectasis was accompanied. An emergency bronchoscopy was performed because of the suspicion of complete obstruction of left main bronchus. The distal part of left main bronchus was completely obstructed by multiple polypoid masses. The mass was removed with a laser incision, and a foreign body surrounded by mucus was found. It was removed with a forceps. At 2 days after the removal, the subcutaneous emphysema was improved, and the chest CT taken 14 days later showed stenosis but no obstruction.