A two-year-old toddler was rushed to the pediatric emergency room at Shaare Zedek Medical Center after she swallowed a piece of almond and suffered from symptoms of choking at home. Through extensive and multidisciplinary collaboration, a piece of almond measuring approximately 5 mm was removed from her trachea.
""As soon as my daughter swallowed the small piece of almond, she began to suffer from breathing difficulties that came and went. We didn't know what to do and consulted our neighbors. At first, we thought that the fact that she was able to cry and scream indicated that she was breathing, and combined with the fact that the symptoms had weakened, we didn't think we needed to go to the hospital. Her sleep at night was also normal, and it wasn't until the morning she started coughing that we arrived at Shaare Zedek," says the toddler's mother.
Upon her arrival at the M.R.D., the toddler underwent a series of comprehensive tests, including a chest x-ray and a physical examination, which did not indicate the presence of the finding, apparently due to its small size.
Despite this, Dr. Ali Abdiat and Dr. Efrat Blankenstein, specialists in the pediatrics department, suspected that the girl had swallowed something and therefore decided to hospitalize her for observation and further investigation, a decision that may have saved her life.
During the night, her breathing gradually worsened and she was transferred to the pediatric intensive care unit under the direction of Dr. Jacques Brown. The next day, when her condition did not improve, it was decided to perform a bronchoscopy on the toddler, an invasive test for diagnosing and treating the airways and lungs.
The examination revealed that there was a small foreign object between the vocal cords, which moved intermittently during the examination between the lower and upper trachea – and almost completely blocked it, a situation that could lead to a decrease in oxygen supply and be life-threatening. Using the ENT department's equipment, the doctors were able to push the foreign object to an area where it did not block breathing and successfully extracted it.
""After we extracted the foreign body, we found out that it was a small piece of almond, about 5 mm in size. This is a difficult diagnosis because of its size. Although it is a small finding, for toddlers of this age, whose vocal cord area is 7 mm in size, this could be a real life-threatening condition," says Dr. Leon Joseph, a senior pediatric pulmonologist.
""Unfortunately, although it is strictly forbidden to let children under the age of 5 eat nuts, this is a phenomenon that never stops. In the case of the toddler, it ended well, but it could have ended completely differently. In addition, it is recommended to be careful when eating sausages, cherry tomatoes, and grapes, which are recommended to be cut lengthwise and widthwise in order to ensure safe eating.".
""I knew that children my daughter's age were not allowed to eat almonds, but I didn't think that such a small piece she ate would lead to such an extreme and life-threatening situation," says the toddler's mother. "I call on all parents of small children - do not give your children nuts. In addition, as soon as there are symptoms of choking - call the rescue services immediately and go to the hospital immediately.".
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