Marouf Rachid, Zerrouki Sara, Alloubi Ihsan, Housni Brahim
Department of Thoracic and Cardiovascular Surgery, Mohammed VI University Hospital Center, Oujda, Morocco.
Department of Anesthesiology and Reanimation, Mohammed VI University Hospital Center, Oujda, Morocco.
Lung India. 2020 Mar-Apr;37(2):140-144. doi: 10.4103/lungindia.lungindia_345_19.
The accidental aspiration of foreign bodies (FBs) is a rare occurrence in adults. However, inhalation of scarf pin is a phenomenon more and more common in the context of Muslim nations. The aim of our study was to describe the characteristics of this particular FB and illustrate the circumstances and consequences of inhalation.
This retrospective study involved patients with a history of scarf pin aspiration admitted to the Thoracic Surgery Department of Mohammed VI University Hospital Center, Oujda, Morocco, over a period of 10 years. Their main presentation, diagnosis, treatment, and outcome were analyzed.
The average age of the 30 cases was 18 years (13-43). No antecedent was found in all cases. The penetration syndrome was found in all cases, with a transient moment of suffocation in 19 cases (63.33%), a dry cough in 15 cases (50%), minimal hemoptysis in 4 cases (13.33%), and purulent sputum in 3 cases (10%). The clinical examination was normal in all cases. The chest X-ray showed the FB in the form of linear right sided opacity in 14 cases (46.66%), left sided in 8 cases (26.66%), and in the trachea in 8 cases (26.66). Rigid bronchoscopy visualized the scarf pin at the level of the right basal pyramid in 5 cases (16.66%) and on the left side in 2 cases (6.66%), at the level of the main right and intermediate trunk in 7 cases (23.33%), at the level of the left main bronchus in 4 cases (13.33%) and in the trachea in 5 cases (16.66%). The pin was extracted by rigid bronchoscopy in 23 cases (76.66%) and was expelled spontaneously in 5 cases (16.66%). Thoracotomy was required in 2 cases (6.66%). Medical treatment, including antibiotic therapy and short-course oral corticosteroids, was administered in all cases.
Scarf pin inhalation is common in women who wear the Islamic headscarf. Bronchoscopy is an important tool to manage these FBs, but the best prevention treatment is careful handling of these potentially sharp objects away from the mouth.
成人意外吸入异物（FBs）的情况较为罕见。然而，在穆斯林国家，吸入别针是一种越来越常见的现象。我们研究的目的是描述这种特殊异物的特征，并说明吸入的情况及后果。
这项回顾性研究纳入了摩洛哥乌季达穆罕默德六世大学医院中心胸外科收治的有别针吸入史的患者，研究时间跨度为10年。分析了他们的主要临床表现、诊断、治疗及结果。
30例患者的平均年龄为18岁（13 - 43岁）。所有病例均无既往史。所有病例均出现穿透综合征，19例（63.33%）有短暂窒息，15例（50%）有干咳，4例（13.33%）有少量咯血，3例（10%）有脓性痰。所有病例临床检查均正常。胸部X线显示，14例（46.66%）异物呈右侧线状致密影，8例（26.66%）呈左侧线状致密影，8例（26.66%）位于气管内。硬质支气管镜检查发现，5例（16.66%）别针位于右基底椎体水平，2例（6.66%）位于左侧，7例（23.33%）位于右主支气管和中间支气管水平，4例（13.33%）位于左主支气管水平，5例（16.66%）位于气管内。23例（76.66%）通过硬质支气管镜取出别针，5例（16.66%）别针自行排出。2例（6.66%）需要开胸手术。所有病例均接受了包括抗生素治疗和短期口服糖皮质激素在内的药物治疗。
佩戴伊斯兰头巾的女性中吸入别针的情况较为常见。支气管镜检查是处理这些异物的重要工具，但最佳的预防措施是小心处理这些可能尖锐的物品，使其远离口腔。
