OVERLOOKED FOREIGN BODY ASPIRATION IN AN ADOLESCENT WITH AUTISM SPECTRUM DISORDER

Teodora Fržović; Gordana  Vilotijević Dautović; Jovan Lovrenski; Milena Bjelica; Aleksandar Mladenović

doi:10.46793/PP260131025F

Autori

Teodora Fržović Institut za zdravstvenu zaštitu dece i omladine Vojvodine, Novi Sad https://orcid.org/0009-0009-3967-2385
Gordana Vilotijević Dautović Institute for Child and Youth Health Care od Vojvodina, Novi Sad, Serbia ; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia https://orcid.org/0000-0002-5430-577X
Jovan Lovrenski Institute for Child and Youth Health Care od Vojvodina, Novi Sad, Serbia, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia https://orcid.org/0000-0002-5572-0967
Milena Bjelica 1Institute for Child and Youth Health Care od Vojvodina, Novi Sad, Serbia 2University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia https://orcid.org/0000-0003-1702-0270
Aleksandar Mladenović Institute for Child and Youth Health Care od Vojvodina, Novi Sad, Serbia https://orcid.org/0009-0003-1255-6620

DOI:

https://doi.org/10.46793/PP260131025F

Ključne reči:

aspiracija stranog tela, bronhoskopija, poremećaj iz spektra autizma, adolescenti, perzistentni kašalj

Apstrakt

Uvod: Aspiracija stranog tela predstavlja hitno i potencijalno životno ugrožavajuće stanje koje se najčešće javlja kod dece mlađe od tri godine. Kod starije dece i adolescenata je ređa i često ostaje neprepoznata zbog nespecifične kliničke slike i odsustva pouzdanih anamnestičkih podataka. Posebno su ugrožene osobe sa poremećajem iz spektra autizma i drugim neurorazvojnim poremećajima, kod kojih su ponašajne osobenosti i otežana komunikacija značajni faktori rizika za aspiraciju, ali i za kasnu dijagnozu.

Prikaz slučaja: Prikazan je slučaj petnaestogodišnjeg adolescenta sa poremećajem iz spektra autizma koji je hospitalizovan zbog perzistentnog kašlja i febrilnosti koji su trajali mesec dana, uprkos primenjenoj antibiotskoj terapiji. Nepouzdani anamnestički podaci i odsustvo svedoka aspiracije su doprineli odloženom postavljanju dijagnoze. Tokom hospitalizacije radiološkim ispitivanjem uočena je atelektaza i konsolidacije bazalnih segmenata desnog plućnog krila. Fleksibilnom bronhoskopijom uočena je potpuna opstrukcija lumena desnog intermedijarnog bronha stranim telom (figurica od društvene igre „Čoveče ne ljuti se”), dok je njegova ekstrakcija uspešno izvršena rigidnom bronhoskopijom. Nakon uklanjanja stranog tela došlo je do brzog kliničkog poboljšanja i potpune radiološke regresije patoloških promena.

Zaključak: Aspiraciju stranog tela treba uzeti u obzir kod starije dece i adolescenata sa poremećajem iz spektra autizma koji se javljaju sa dugotrajnim, nespecifičnim respiratornim simptomima. U prisustvu visokog stepena kliničke sumnje, bronhoskopija predstavlja nezamenljivu dijagnostičku i terapijsku metodu i potrebno je sprovesti kako bi se sprečile ozbiljne respiratorne komplikacije.

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PREVIĐENA ASPIRACIJA STRANOG TELA KOD ADOLOSCENTNA SA POREMEĆAJEM IZ SPEKTRA AUTIZMA

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