Despite the case's complexity, the baby recovered well and was discharged in just 36 hours. Today, the baby has recovered fully and has returned to his cheerful self.
Nine-month-old baby Aarav, a cheerful toddler, was sitting in a corner of the hall, playing with his toys, when he suddenly began coughing and sputtering. After a few hard pats on his back from his father, baby Aarav fortunately seemed to calm down within 2-3 minutes.
However, given the child’s age, his parents refused to take a chance. Within just two hours, they took him to the emergency room at Manipal Hospital Varthur. At that time, baby Aarav appeared active and playful, showing no abnormal symptoms. If anything, doctors assumed that a piece of the toy may have slipped down his food pipe. After consulting a gastroenterologist, it was confirmed that the baby’s food pipe was clear, and he was soon deemed safe for discharge.
Despite this, his father remained suspicious as he began noticing subtle, yet noticeable symptoms such as a slight cough, a mild runny nose and noises while breathing. These symptoms were initially brushed off as a common cold, until baby Aarav unexpectedly began developing a fever that gradually rose to 99 degrees. He was once again brought into the hospital, where doctors, at this point, suspected a high chance of foreign body aspiration, and decided to perform an X-ray. Reports revealed a complete collapse of the right middle lobe and right lower lobe of the lung.
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The fact that two lobes had collapsed in a short span of 2-3 days in the absence of high-grade fever was highly unusual. Without further delay, baby Aarav was wheeled into the operation theatre, where Dr. Tejaswi Chandra, Consultant – Pediatric Interventional Pulmonology & Sleep Medicine along with support from Dr. Anupam Prakash, Consultant – Interventional Pulmonology at Manipal Hospital Varthur, performed flexible bronchoscopy, which revealed the presence of a small inorganic foreign object which loosely resembled the eye of a doll.
About the case
What made this case challenging was the incredibly small size of the object lodged deep into the deep airway in the lower section of the right lung. A multidisciplinary team comprising Dr. Anupam Prakash, Consultant – Interventional Pulmonology, Dr. Ravi Shankar Swamy, Consultant – Neonatology & Pediatrics, Dr. Subhasmita Mohanty, Consultant - Anesthesiology and PICU and Dr. Shreya ----- at Manipal Hospital Varthur Road, persisted to carry out the procedure despite its complexity, avoiding the need for an open surgery.
“While these procedures generally take 15-30 minutes, baby Aarav’s case took nearly 2 hours due to the challenging anatomical location as well as other factors such as age, size of the airway, and availability of suitable equipment,” said Dr. Tejaswi. “Instead of a rigid telescope, a 2mm flexible scope was repurposed as a telescope, and the foreign body was successfully removed using a HYBRID Bronchoscopy technique.” Baby Aarav’s parents breathed a sigh of relief when their beloved son was finally wheeled out of the operating room.
Despite the case's complexity, the baby recovered well and was discharged in just 36 hours. Today, the baby has recovered full and has returned to his cheerful self. The case highlights the importance of parental vigilance and the potential for seemingly mild symptoms to mask serious conditions in infants.
