文献一覧: 久木田一朗 (著者)

1 0 0 0 OA イカ釣り針による乳児の咽頭異物の1例

著者: 佐藤俊秀岡元和文久木田一朗菊田浩一濱口正道生田義浩中野幸治
出版者: Japanese Association for Acute Medicine
雑誌: 日本救急医学会雑誌 (ISSN:0915924X)
巻号頁・発行日: vol.8, no.8, pp.347-350, 1997-08-15 (Released:2009-03-27)
参考文献数: 5

We present a case of pharyngeal foreign body in an infant. A 6-month-old girl whose oropharyngeal space was occupied by a cuttlefish hook, was sent to our intensive care unit. The double-banked, radial needles were stuck in the base of the tongue as well as the middle pharynx and were seen on a roentgenogram. Neither a laryngoscope nor even a small bronchofiberscope could be inserted into the oral space occupied by the foreign body. Prior to transoral removal of the foreign body, tracheostomy was performed. Intravenous anesthesia using ketamine and diazepam combined with the local anesthesia was chosen for the tracheostomy. A small dose of atropine was effective in reducing secretions and maintaining the patency of the upper airway. Induction of anesthesia was followed by isoflurane, nitrous oxide, and oxygen after tracheostomy, then surgery was performed successfully within 90 minutes. Tracheostomy is indicated for a patient in whom endotracheal intubation is difficult to perform. Upper airway management during tracheostomy is the main issue in such a case, especially in an infant with a large pharyngeal foreign body.