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      Traumatic xylophagia leading to foreign body removal and tracheostomy in the setting of postpartum psychosis

      case-report

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          Abstract

          Postpartum psychosis (PPP) is a severe mood disorder following childbirth that rarely leads to injurious or suicidal behavior. This report illustrates otolaryngologic intervention for pharyngeal laceration and airway instability following traumatic foreign body ingestion in the setting of PPP.

          A 25-year-old woman with PPP presented with hemoptysis after attempting suicide by traumatically forcing tree branches into her oropharynx. Imaging revealed pneumomediastinum, and flexible laryngoscopy and esophagoscopy showed a large foreign body (tree branch) extending from the hypopharynx to the gastroesophageal junction. She was taken to the operating room for direct microlaryngoscopy, bronchoscopy and esophagoscopy with removal of the 25-cm tree branch. Panendoscopy revealed a mucosal laceration at the cricopharyngeus with supraglottic and hypopharyngeal edema but no injury to the larynx. Due to airway concerns, a cuffed tracheostomy was placed along with a gastrostomy tube for feeding access. She tolerated her postoperative course with successful decannulation and oral feeding prior to discharge.

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          Most cited references15

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          Management of ingested foreign bodies and food impactions.

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            A systematic review of paediatric foreign body ingestion: presentation, complications, and management.

            Foreign body ingestion is a common problem among paediatric populations. A variety of foreign bodies are ingested, some of which are particularly harmful and life threatening such as button batteries, magnets and bones. Common household items such as small toys, marbles, batteries and erasers are often ingested. The aim of this systematic review is to study the problem of foreign body ingestion among paediatric populations in terms of commonly ingested objects, and attempt to identify the link between location of impaction, associated symptoms, complications, spontaneous passage, methods and timing of removal.
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              Evidence-based guidelines for the use of tracheostomy in critically ill patients.

              To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research.
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                Author and article information

                Contributors
                Journal
                J Surg Case Rep
                J Surg Case Rep
                jscr
                Journal of Surgical Case Reports
                Oxford University Press
                2042-8812
                December 2021
                11 December 2021
                11 December 2021
                : 2021
                : 12
                : rjab467
                Affiliations
                Department of Otorhinolaryngology–Head and Neck Surgery , McGovern Medical School at the University of Texas Health Science Center , Houston, TX, USA
                Department of Otorhinolaryngology–Head and Neck Surgery , McGovern Medical School at the University of Texas Health Science Center , Houston, TX, USA
                Department of Otorhinolaryngology–Head and Neck Surgery , McGovern Medical School at the University of Texas Health Science Center , Houston, TX, USA
                Department of Otorhinolaryngology–Head and Neck Surgery , McGovern Medical School at the University of Texas Health Science Center , Houston, TX, USA
                Department of Otorhinolaryngology–Head and Neck Surgery , McGovern Medical School at the University of Texas Health Science Center , Houston, TX, USA
                Author notes
                Correspondence address: Sancak Yuksel, Division of Pediatric Otolaryngology, Department of Otolaryngology, McGovern School of Medicine, University of Texas Health Science Center, 6410 Fannin Street, Suite 1400, Houston, TX 77030, USA. E-mail: Sancak.Yuksel@ 123456uth.tmc.edu
                Author information
                https://orcid.org/0000-0002-6955-797X
                Article
                rjab467
                10.1093/jscr/rjab467
                8666155
                34909161
                8f069a0e-ffd5-4021-8165-d198b7cf6e09
                Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2021.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 August 2021
                : 26 September 2021
                Page count
                Pages: 3
                Categories
                Case Report
                AcademicSubjects/MED00910
                jscrep/070

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