Follow up on child with peanut aspiration

The peanut/groundnut mentioned in the previous blog was successfully removed from the infant boy improving his breathing and stopping his cough. However, a repeat chest x-ray still shows a collapsed left lung and bronchoscopy may again be necessary to remove a blocking blood clot or thickened exudate. The peanut was friable, separating as it was being removed and copious exudate and bleeding obscured visibility.

Visiting plastic surgeons released a woman’s contracted, flexed neck by excising her scar tissue and inserting a full thickness skin graft and reconstructed a boy’s mouth damaged from an accidental gunshot wound. Both procedures were beyond my skill and I greatly appreciate their help with my patients. I was also taught better suturing techniques and learned new operations. Medical knowledge and skill is freely and gladly exchanged and I am proud of our health care professionals.

Delayed Treatment

We currently have an eighteen month old male patient who aspirated a groundnut (peanut) four months ago. The mother was roasting the groundnuts when the child picked one up, swallowed it and began coughing. Subsequently, he was brought to their local hospital where he was treated with antibiotics for three weeks, but he did not improve. When he presented to Tamale Teaching Hospital, there were diminished breath sounds in his left lung, and on x-ray the left lung was collapsed. Bronchoscopy will be done to remove the peanut, but after four months, the cartilaginous walls of the bronchus may be destroyed and the left lung may eventually have to be partially or totally removed.

There is also a visiting volunteer team of plastic surgeons, anesthesiologists and nurses who are here to do plastic surgery. Seventy-five patients came to be evaluated, but some require too extensive a surgery to be done at this facility with the equipment and expertise available. Many of our patients present with advanced disease due to their tribal customs and the lack of available care in the areas in which they live.