When attempts to remove the bulb stuck in five-year-old's lungs led to cardiac arrest, which is extremely rare, Lilavati doctors had to race against time to ensure she lived
Samruddhi Pawar
Following Diwali celebrations at her home in Uran, Samruddhi Sanjay Pawar, all of 5, had an idea that was not the brightest bulb - the curious kid decided to gulp an LED one. What followed was a series of surgeries to get the foreign object out of her body, one of which also led to cardiac arrest.
The incident occurred on November 16, 2018, when Samruddhi put the LED bulb, used for Diwali decorations at her home, in her mouth and gulped it. "She suddenly started coughing and became breathless," her mother Rupali told mid-day, adding, "We rushed her to a local hospital, where while undergoing bronchoscopy, she became unconscious and she was put on the ventilator."
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The child seen here with mother Rupali, is back home
First procedure fails
At the first hospital, an attempt was made to remove the object through endoscopic surgery, as it was presumed to be in the food pipe. But once it was confirmed to be in the lower lobe of the left bronchus, a bronchoscopy was done. However, that procedure failed and the child developed a cardiac arrested during sugery. She was revived with cardiopulmonary resuscitation and four DC shocks to the heart. In addition to that, she also suffered a lot of bleeding in the lung, because of which she had to be put on a ventilator and subsequently transferred to Lilavati hospital. "The next day, we took her to Lilavati hospital, where doctors removed the bulb along with the pin through a surgery on November 18. She is fine now but she has to undergo regular follow-ups," said Rupali.
An X-ray of the LED bulb in the five-year-old's chest, dangerously close to her heart
Major surgery
"At Lilavati, an urgent CT scan of the chest was done to delineate the exact location of the object, which her father confirmed was an LED bulb with two sharp metallic prongs. This was placed inverted in the bronchus, leading to the difficulty in its removal by bronchoscopy. The CT also confirmed that the prongs were dangerously close to large arteries, so an emergency retrieval was planned," said Dr V Ravishankar, consultant cardiothoracic surgeon, who along with Dr Rajiv Redkar, consultant paediatric surgeon, performed the procedure along with anaesthetists Dr Namrata Kothari and Dr Madhuri Kharwadkar.
Samruddhi had swallowed the LED bulb which had sharp metallic prongs
The child's chest was opened by a left thoracotomy [a major surgical procedure that allows surgeons to access the chest cavity during surgery] and after locating the sharp object, a bronchotomy was done to open the bronchus. The LED bulb was finally removed after carefully taking out the metallic prongs embedded in the wall of her lungs.
Dr PV Battalwar, additional medical superintendent at Lilavati hospital said, " Children between 3-6 years of age have a tendency to put small objects in their mouth like peanuts, small toys, safety pins, some metallic parts, etc. But this is the first time we have seen an LED bulb with two sharp metallic prongs being accidentally swallowed, which could not be removed by bronchoscopy and was mal-positioned. Almost all foreign objects in the respiratory passage can be usually removed by bronchoscopy; surgery is required in just 0.5 to 4 per cent of cases. However we did not attempt bronchoscopy again as there was already an episode of bleeding and cardiac arrest in the first attempt."
Removing the bulb
The child's chest was opened by a left thoracotomy [a major procedure that allows surgeons to access the chest cavity during surgery] and after locating the sharp object, a bronchotomy was done to open the bronchus. The LED bulb was finally removed after carefully taking out the metallic prongs embedded in the wall of her lungs.
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