Case History
A thirteen years old girl presented to ENT OPD of BPKIHS with chief
complaints of shortness of breath and throat pain for 4 days. Her throat
pain was continuous and associated with difficulty in swallowing both
solid and liquid food. One month back she had tried to commit suicide by
partial hanging. Then she was taken to a local health centre and was
intubated and kept in intensive care unit for 5 days. After extubation
she again developed difficulty in breathing and was tracheostomized for
further 20 days. Decannulation of tube was done 7 days prior to the
presentation in our OPD.
On examination, she had noisy breathing with stridor. Furthermore, she
had a stomal opening on the anterior neck of size 3×1
cm2. She had increased respiratory rate with use of
accessory muscle of respiration. We suspected her as a case of
subglottic stenosis and admitted for further evaluation and kept under
injectable antibiotics and corticosteroid. During her stay Computed
Tomography (CT) scan of her neck was done and it showed ‘a soft tissue
attenuating thick band like structure causing luminal narrowing
extending obliquely from the right posterolateral wall of subglottic
portion of larynx to the left anterolateral wall of proximal trachea-
likely granuloma/ inflammatory membrane’ (Figure 1). We also did a
psychiatry consultation and was diagnosed as ‘Intentional Self Harm by
hanging (impulsive) with borderline personality trait ’and was started
on olanzapine.