Adnkronos (Adnkronos) –
She had been suffering from a hazelnut in her bronchi for two weeks. Then, doctors, with a "complex and extremely delicate" operation, managed to save her. The protagonist of the incident, reported by the ULSS 2 Marca Trevigiana, is a 20-month-old girl. Her case "draws attention to a risk that can be underestimated in young children," experts emphasize. "Small foods and objects can be accidentally inhaled and cause very serious consequences."
The little Albanian girl, resident in South Tyrol, arrived at Ca' Foncello Hospital in Treviso after choking while on vacation in Albania with her parents. She had eaten a hazelnut when she suddenly began coughing and breathing with difficulty, according to a statement. After a few minutes, she seemed to have recovered, but in the following days, her parents noticed something was wrong: the child was making constant wheezing sounds while breathing.
Tests performed in Albania revealed mild right-sided pulmonary emphysema. The suspicion was that a hazelnut fragment had been inhaled.
The parents therefore decided to urgently return to Italy and contact Ca' Foncello directly, where the little girl arrived late on the evening of August 21, about two weeks after the episode.
The next day, during checks, the suspicion became true, and the little girl was immediately transferred to the operating room. Massimo Sonego, head of the Endoscopic Surgery Unit of the ENT (Otorhinolaryngology) District at Ca' Foncello Hospital, intervened with a team composed of colleagues Carlo Cattelan, anesthesiologist Nicoletta Toppan, scrub nurse Egidio Berto, anesthesia nurse Paola Romano, and operating room nurse Federico Mattarollo. The support of Mario Ferro, a pediatric surgeon, was also crucial, as he provided specific guidance and equipment for the operation on such a young patient.
"These situations," Sonego explains, "can be underestimated, but they are actually very serious and dangerous. The persistence of a foreign body in the bronchus can cause serious complications, and its removal is essential." The surgery lasted over an hour and a half. The foreign body, which had remained in the lung for approximately two weeks, had by then fragmented into six pieces. The inflammation had also further narrowed the bronchus and increased the risk of bleeding, making visualization and extraction even more difficult.
In a girl weighing approximately 10 kilograms, the rigid bronchoscope used to access the bronchi provided the surgeon with a working "lumen" of just 3,5 millimeters. Through that space, the foreign body had to be identified and removed, while the anesthesiologist simultaneously ensured the young patient's ventilation. The complex procedure was successfully completed. All the fragments of the hazelnut were removed, and after surgery, the child was admitted to the Intensive Care Unit and subsequently transferred to the ward, where she remained for another three days for treatment and observation. She was then discharged fully recovered.
The case ended well, but experts are using this incident as a starting point to warn parents. Among foods, the statement explains, special attention should be paid to nuts: in young children, incomplete teeth and an immature swallowing mechanism increase the risk of aspiration. "For this reason, nuts should not be offered to young children whole or in pieces," Sonego explains. "If you wish to include them in their diet, they should be offered exclusively in the form of a very soft spread, according to the pediatrician's instructions. Prevention is essential. Young children should not be left with objects or foods that could be inhaled or ingested. Even a healthy food like a hazelnut, if not offered in the appropriate form, can become very dangerous."
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