Ul Haq Irfan, Hameed Mansoor, Ahmed Shakeel, Hussein Mousa
Pulmonary Division, Department of Medicine, Hamad Medical Corporation E-mail:
Qatar Med J. 2022 Apr 4;2022(2):23. doi: 10.5339/qmj.2022.fqac.23. eCollection 2022.
Foreign body (FB) aspirations in adults are relatively uncommon. The most commonly aspirated FBs in adults are organic, especially vegetable matter, peanuts, and fragments of bones. We report a rare case of a FB discovered in the left main bronchus of an adult male admitted to the intensive care unit. A 52-year-old male smoker with COPD presented to the emergency department with a two-day history of increasing dyspnea and cough. He was hypoxic and febrile with a temperature of 38°C. Auscultation revealed decreased breath sounds over the left lung and a few rhonchi on the right side. Chest x-ray showed left lung collapse. His condition rapidly worsened, and he was immediately intubated for acute respiratory failure. CT chest identified a large endobronchial mass obstructing the left main bronchus. Flexible bronchoscopy confirmed a soft and mobile brownish lesion in the left main bronchus. The histological appearance of the specimen retrieved was consistent with an organic foreign body. This was later identified as a melon chunk. It was removed successfully via flexible bronchoscopy by cutting it into smaller pieces to aid retrieval. FB aspiration can occur in all age groups but is less common in adults accounting for only 0.16%-0.33% of adult bronchoscopic procedures. Early detection of an aspirated FB is essential to avoid significant complications, morbidity, and mortality.
成人异物（FB）吸入相对少见。成人最常吸入的异物是有机物，尤其是植物性物质、花生和骨头碎片。我们报告一例罕见病例，一名入住重症监护病房的成年男性左主支气管发现异物。一名52岁男性吸烟者，患有慢性阻塞性肺疾病（COPD），因呼吸困难和咳嗽加重两天就诊于急诊科。他缺氧且发热，体温38°C。听诊发现左肺呼吸音减弱，右侧有少许哮鸣音。胸部X线显示左肺萎陷。他的病情迅速恶化，因急性呼吸衰竭立即插管。胸部CT发现一个大的支气管内肿块阻塞左主支气管。纤维支气管镜检查证实左主支气管内有一个柔软可移动的褐色病变。取出标本的组织学表现与有机异物一致。后来确定为一块瓜。通过纤维支气管镜将其切成小块后成功取出。异物吸入可发生于所有年龄组，但在成人中较少见，仅占成人支气管镜检查的0.16%-0.33%。早期发现吸入的异物对于避免严重并发症、发病率和死亡率至关重要。
