Hospital Regional Docente de Trujillo, Trujillo, Perú; Facultad de Medicina de la Universidad Nacional de Trujillo, Trujillo, Perú. Email:
Hospital Regional Docente de Trujillo, Trujillo, Perú; Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Perú. ORCID: 0000-0003-0462-3101.
Medwave. 2021 Mar 25;21(2):e8136. doi: 10.5867/medwave.2021.02.8136.
Foreign body aspiration is a rare but life-threatening event. Most accidental aspiration events occur in children. In adults, it can represent up to 25% of cases. Bronchoscopy remains the gold standard for diagnosing and treating foreign body aspiration from the lower respiratory tract. A 63-year-old female smoker with a history of chronic alcoholism and exposure to pyrotechnic smoke presented a productive cough, with whitish expectoration, dyspnea and pleuritic chest pain on the right side. On chest X-ray, she presented opacity in 2/3 of the right hemithorax. Computed axial tomography revealed consolidation with an air bronchogram on the right hemithorax, cylindrical bronchiectasis, ground glass pattern and centrilobular nodules. Bronchoscopic examination revealed a foreign body covered with granulation tissue in the right segmental bronchus (B6). The granulation tissue was integrated into the foreign body. In a second attempt, the foreign body could be removed, which was of bone consistency, seemingly a bird bone, confirmed by pathological anatomy results. After further questioning, the patient reported that two years before, she had choked when eating chicken. She had a cough and an episode of hemoptysis, but she chose not to ask for medical advice.
异物吸入是一种罕见但危及生命的事件。大多数意外吸入事件发生在儿童中。在成年人中，它可能占 25%。支气管镜检查仍然是诊断和治疗下呼吸道异物吸入的金标准。一位 63 岁的女性吸烟者，有慢性酗酒和接触烟花烟雾的病史，表现为咳嗽有痰，咳出白色痰，呼吸困难，右侧胸痛。胸部 X 线片显示右侧胸腔 2/3 密度增高。计算机轴向断层扫描显示右侧胸腔实变，伴有空气支气管征、柱状支气管扩张、磨玻璃影和小叶中心结节。支气管镜检查显示右段支气管（B6）有一个被肉芽组织覆盖的异物。肉芽组织与异物融为一体。第二次尝试时，可以取出异物，异物质地坚硬，看起来像一根鸟骨，这一结果通过病理解剖得到了证实。进一步询问后，患者报告说，两年前她吃鸡时被噎到了。她咳嗽并咯血，但她选择不寻求医疗建议。
