4-year-old swallows whistle, undergoes surgery at AIIMS

A four-year-old boy in India swallowed a whistle attached to a new pair of shoes he was given for Eid. His mother took him to Delhi's All India Institute of Medical Sciences where doctors successfully removed the whistle. The institute sees 80 to 100 cases a year of children ingesting foreign objects that can block their airways, and is warning parents to monitor their children closely.

Basmina, a housewife in Haryana’s Nuh district, was busy with Eid festivities on Saturday when she heard her four-year-old son Sahim crying. Curiously, each time he took a breath, Basmina heard a squeak, like that of a whistle. As he cried louder and louder, the squeaks too became louder.

Doctors said the child is currently under observation. (File)

It took her a while to figure out that while she was busy in the kitchen or attending to guests, her son had swallowed the whistle attached to a new pair of shoes that his father had gifted him for Eid.

“He started crying at around 8pm. When I saw his shoe on the side, I immediately knew what he had done and called the family. The local clinics were shut for Eid, and we were told by our village elders to rush him to Delhi,” Basmina, a resident of Malab village, said.

The family said that after a long drive on a neighbour’s mini truck, they reached Delhi’s All India Institute of Medical Sciences (AIIMS) at 3.30am on Sunday. At 5am, Sahim was taken for a bronchoscopy to remove the whistle, which was partially blocking the child’s airway.

Doctors were able to successfully remove the whistle, and the four-year-old is currently admitted to the hospital’s mother and child block.

Bronchoscopy is an endoscopic technique of visualising the inside of the airways for diagnostic and therapeutic purposes. Doctors said it is a common technique to remove objects ingested by children, which get logged in the airway.

Dr Prabudh Goel, assistant professor (paediatric surgery), AIIMS, who performed the surgery, said that as soon as Sahim was brought to AIIMS he was rushed for surgery and the process took nearly an hour.

“It is very important for such children to be given immediate medical attention. There have been cases where delays have caused brain damage and even death. The child is under observation currently and we are hoping to discharge him by Tuesday,” Dr Goel said.

Dr M Bajpai, head of the department of paediatric surgery at AIIMS, said the hospital witnesses 80-100 cases a year of children — especially toddlers — ingesting foreign objects such as peanuts, almonds, safety pins, whistles, beads and pendants of necklaces, batteries and parts of toys.

“Children tend to explore the world through their mouths, and it is extremely important to keep a close watch on them when they are in contact with such items. The biggest risk in such cases is that these objects can slide down and block the entire airway of the child. Many children who ingest foreign objects turn blue because there is blockage to the airway and even die if not given timely medical attention,” said Dr Bajpai.

A study released in January by doctors in New York analysed cases of “paediatric foreign body ingesting” to highlight the symptoms that parents and caretakers can look for in their wards.

“In cases of suspected foreign body ingestion, the airway (including the oropharynx) and breathing should be evaluated promptly. A foreign body that has become obstructed within or injured the oesophagus may cause chest pain or a foreign body sensation,” the study highlighted.

It added, “Symptoms may be more notable when swallowing. Younger children may drool, gag, vomit, or refuse food. Hematemesis and cough may be present. A foreign body lodged in the stomach or intestines may cause abdominal pain, vomiting, or bloody stools. If present for a prolonged period, fever or weight loss may develop. A foreign body that has completely obstructed the oesophagus will cause more dramatic symptoms.