Šimon Róbert, Šimonová Jana, Čuchrač Lukáš, Klimčík Roman, Vašková Janka
1st Department of Surgery, Pavol Jozef Šafarik University, Košice, SVK.
1st Department of Anaesthesiology and Intensive Medicine, Pavol Jozef Šafarik University, Košice, SVK.
Cureus. 2024 Apr 19;16(4):e58584. doi: 10.7759/cureus.58584. eCollection 2024 Apr.
Foreign body (FB) aspiration is an infrequent cause of respiratory distress in adults. Advancing age, central nervous system disorders or trauma, drug or alcohol addiction, neuromuscular diseases, and mental health issues and illnesses are the main risk factors. The authors present an atypical clinical presentation of a 3-week-lasting foreign body aspiration mimicking a tumour that led to severe acute respiratory insufficiency and required aggressive artificial lung ventilation. Diagnosis of FB was based on the results of the chest computed tomography (CT) scans and flexible bronchoscopy, which, however, initially assumed a neoplastic disease in the right main bronchus. During FB extraction via flexible fiberoptic bronchoscopy inserted through an 8.5 mm endotracheal tube high-frequency ventilation through a catheter placed between the vocal cords was used to ensure adequate alveolar ventilation and maintain sufficient oxygenation. After extraction of the FB, thoracosurgical intervention was performed to resolve empyema as a septic complication of the FB aspiration. After this therapy, a complete resolution of pleural empyema and lung atelectasis was observed.
异物吸入是成人呼吸窘迫的罕见原因。年龄增长、中枢神经系统疾病或创伤、药物或酒精成瘾、神经肌肉疾病以及心理健康问题和疾病是主要危险因素。作者介绍了一例持续3周的异物吸入的非典型临床表现,该表现酷似肿瘤,导致严重的急性呼吸功能不全,需要进行积极的人工肺通气。异物诊断基于胸部计算机断层扫描(CT)和纤维支气管镜检查结果,然而,最初在右主支气管诊断为肿瘤性疾病。在通过8.5毫米气管插管插入的纤维支气管镜进行异物取出过程中,通过放置在声带之间的导管进行高频通气,以确保足够的肺泡通气并维持足够的氧合。取出异物后,进行了胸外科手术干预以解决作为异物吸入的脓毒症并发症的脓胸。经过这种治疗后,观察到胸膜脓胸和肺不张完全消退。