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Year : 2022  |  Volume : 2  |  Issue : 1  |  Page : 57

Inspiratory whistling in a child – An unusual occurrence

Department of ENT and HNS, Government Medical College, Srinagar, Jammu and Kashmir, India

Date of Submission30-Dec-2021
Date of Decision23-Jan-2022
Date of Acceptance24-Jan-2022
Date of Web Publication25-Feb-2022

Correspondence Address:
Dr. Suhail Amin Patigaroo
Department of ENT and HNS, Government Medical College, Srinagar
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ipcares.ipcares_380_21

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How to cite this article:
Patigaroo SA, Showkat SA. Inspiratory whistling in a child – An unusual occurrence. Indian Pediatr Case Rep 2022;2:57

How to cite this URL:
Patigaroo SA, Showkat SA. Inspiratory whistling in a child – An unusual occurrence. Indian Pediatr Case Rep [serial online] 2022 [cited 2022 May 27];2:57. Available from: http://www.ipcares.org/text.asp?2022/2/1/57/338494

A 4-year-old boy presented with a history of accidental inhalation of a small toy whistle while blowing it, 6 h earlier. This was followed by coughing, choking, and gagging. There was no history of bluish discoloration, loss of consciousness, or seizures. Subsequently, the child was producing a whistling sound while breathing. An otorhinolaryngology consultation was sought. The child was hemodynamically stable, without respiratory distress. Saturation was maintained in room air. Paroxysmal bouts of coughing were observed and a whistling sound was audible that increased in intensity on deep inspiration [Video 1][Additional file 1]. Throat inspection was unremarkable. Air entry was bilaterally normal and equal. An expiratory chest X-ray was normal. Keeping a diagnosis of foreign body aspiration (FBA), we performed rigid bronchoscopy. A whistle was retrieved from the right lower lobe bronchus [Figure 1].
Figure 1: Toy whistle caught in an alligator forcep

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FBA is common in children, mostly preschoolers, due to their tendency to mouth objects, and incomplete chewing while eating (due to noneruption of the third molars). Sudden posterior propulsion of an object in the oral cavity may result in reflex inhalation. There are a few reports of accidental aspiration of small whistles in older children that have lodged in the tracheobronchial tree. FBA is a potentially life-threatening condition requiring prompt recognition and early management.[1] The usual triad is coughing/wheezing, respiratory distress, and decreased air entry.[2] The diagnosis may get delayed in young children when the acute event has not been witnessed, and the child is later asymptomatic. When the child is old enough to give definite history, diagnosis is easier. The standard modality of treatment is rigid bronchoscopy, which has a high success rate.[2]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images/video and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Passàli D, Lauriello M, Bellussi L, et al. Foreign body inhalation in children: An update. Acta Otorhinolaryngol Ital 2010;30:27-32.  Back to cited text no. 1
Suhail AP, Nazia M, Omar MS, et al. Pediatric airway foreign bodies and their management by rigid bronchoscopy: How I Experienced. Indian J Otolaryngol Head Neck Surg 2020. https://doi.org/10.1007/s12070-020-01868-z.  Back to cited text no. 2


  [Figure 1]


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