Morimatsu Yoshitaka, Aoki Yuka, Mizoguchi Yusuke, Kitasato Hirohiko, Aizawa Hisamichi
National Hospital Organization, Kumamoto Medical Center, Division of Internal Medicine.
Nihon Kokyuki Gakkai Zasshi. 2005 Dec;43(12):746-50.
We report a case of a bronchial foreign body in a 76-year-old citrus fruit farmer. The patient was detected patchy infiltration (ground-glass attenuation) of the right upper lung field on the chest X-ray on Dec. 26th, 2003. The shadow tended to disappear after treatment with antibiotics. The same shadow was detected again 10 months later and the patient underwent a bronchoscopic examination. A foreign body was found lodged in the center of the right upper bronchus, associated with bronchial stenosis due to mucosal edema. The abnormal shadow disappeared after the foreign body, which we decided was a citrus fruit seed, was removed. From the time course of the present illness and a retrospective evaluation of previous chest X-rays, the patient had aspirated the foreign body 18 months prior to his admission for bronchoscopy. We should be careful of the possibility of foreign bodies even when the elderly do not present a history of foreign body aspiration. It is important to consider the possibility of a bronchial foreign body in patients with repeated pneumonia, and to perform bronchoscopy aggressively.
我们报告一例76岁柑橘种植农民支气管异物病例。2003年12月26日胸部X线检查发现该患者右上肺野有斑片状浸润（磨玻璃影）。经抗生素治疗后阴影趋于消失。10个月后再次发现相同阴影，患者接受了支气管镜检查。发现异物嵌顿于右上叶支气管中央，伴有黏膜水肿导致的支气管狭窄。取出我们判定为柑橘籽的异物后，异常阴影消失。从本次发病的病程及对既往胸部X线片的回顾性评估来看，患者在接受支气管镜检查入院前18个月已吸入该异物。即使老年人没有异物吸入史，我们也应警惕异物存在的可能性。对于反复发生肺炎的患者，考虑支气管异物的可能性并积极进行支气管镜检查很重要。
