Marouf R, Hamraoui S, Alloubi I
Service de chirurgie thoracique et cardiovasculaire, CHU Mohammed VI, Oujda, Maroc.
Service de chirurgie thoracique et cardiovasculaire, CHU Mohammed VI, Oujda, Maroc.
Rev Mal Respir. 2019 Oct;36(8):1002-1007. doi: 10.1016/j.rmr.2019.06.010. Epub 2019 Sep 11.
Foreign body inhalation is a clinical emergency requiring prompt action to ensure speedy recovery and minimize the development of complications. It is more common in children than adults. We report a case of a neglected foreign body present in the bronchus of an adult for 23 years and treated as intermittent asthma. The diagnosis was revealed following the development of severe sepsis of a pulmonary origin. The foreign body was removed by rigid bronchoscopy, antibiotic therapy instituted and pre- and post-interventional respiratory physiotherapy carried out. Satisfactory progress was marked by the complete clearing of pulmonary suppuration, with only a small localized and asymptomatic focus of bronchial dilatation remaining. The persistence of chronic, unexplained respiratory complaints should prompt the use of imaging and endoscopy to exclude an endobronchial cause, especially to consider the possible presence of a previously unknown foreign body. Early diagnosis and intervention can help to avoid potentially serious complications.
异物吸入是一种临床急症，需要迅速采取行动以确保快速康复并尽量减少并发症的发生。它在儿童中比成人更常见。我们报告一例成人支气管内存在23年的被忽视异物病例，该病例一直被当作间歇性哮喘治疗。在发生肺源性严重脓毒症后才明确诊断。通过硬质支气管镜取出异物，给予抗生素治疗，并在介入前后进行呼吸物理治疗。令人满意的进展表现为肺部化脓完全清除，仅残留一个小的局限性且无症状的支气管扩张灶。对于持续存在的慢性、不明原因的呼吸道症状，应采用影像学和内镜检查以排除支气管内病因，尤其要考虑可能存在先前未知的异物。早期诊断和干预有助于避免潜在的严重并发症。
