Case Report

A Case of Black Magic

Authors: Gwyn Samuel Williams, MBBS, MRCS, BSc, Chetan Modi, MBBS, MRCS, Talvinder Singh, MBBS, MRCS, Moninder Bhabra, MBBS, FRCS

Abstract

The authors present the case of a 64-year-old woman who presented with massive subcutaneous emphysema 2 weeks after unknowingly inhaling a Brazil nut. Foreign body inhalation should be a differential diagnosis in all such patients, with computed tomography scanning of the chest being the most appropriate investigation.


Key Points


* Subcutaneous and mediastinal emphysema is a known complication of delayed diagnosis of foreign body aspiration.


* Patients presenting with subcutaneous emphysema of unknown cause should be investigated for foreign body aspiration.


* A computed tomography followed by bronchoscopic examination if indicated is the investigation pathway of choice in suspected foreign body aspiration.

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References

1. Sadan N, Raz A, Wolach B. Impact of community educational programmes on foreign body aspiration in Israel. Eur J Paediatr 1995;154:859–862.
 
2. Hughes CA, Baroody FM, Marsh BR. Pediatric tracheobronchial foreign bodies: historical review from the Johns Hopkins Hospital. Ann Otol Rhinol Laryngol 1996;105:555–561.
 
3. Jhamb U, Sethi GR, Puri R, et al. Surgical emphysema: a rare presentation of foreign body inhalation. Pediatr Emerg Care 2004;20:311–313.
 
4. Findlay CA, Morrissey S, Paton JY. Subcutaneous emphysema secondary to foreign-body aspiration. Pediatr Pulmonol 2003;36:81–82.
 
5. Pinto A, Scaglione M, Pinto F, et al. Tracheobronchial aspiration of foreign bodies: current indications for emergency plain chest radiography. Radiol Med (Torino) 2006;111:497–506.