George Washington School of Medicine and Health Sciences
Objective: Foreign body misplacement is a common occurrence in the pediatric population. However, oral tongue entrapment is a rarely described event secondary to foreign body impingement, particularly due to metal water bottles.
Method: Current literature is scarce and limited to case reports of water bottle entrapment. Metal water bottles present a distinct challenge for removal given the strength of material, which can lead to acute airway compromise as well as trauma to the tongue including edema and ischemia. This video submission is prepared to depict one specific means of removing an orally metal water bottle while minimizing damage to the oral tongue.
Results: A 6-year-old female presented with her oral tongue trapped in a threaded aluminum water bottle. At time of admission, her tongue was significantly edematous with active bleeding, but the patient was spontaneously breathing. She was taken to the operating room for emergency removal of the foreign body given risk for airway compromise. Using a combination of drill cutting burrs and metal shears, the bottle was removed successfully with minimal oral tongue injury. The patient, however, required nasal intubation for 7 days while the tongue edema subsided.
Conclusion: The increasing popularity of reusable bottles has the potential for an increased incidence over time.The approach to relieving entrapment in this patient is described and presented with supporting video to demonstrate one particular approach to management.