Ikeda M, Kitahara S, Inouye T
Department of Otolaryngology, National Defense Medical College, Tokorozawa, Saitama, Japan.
Surg Endosc. 1996 Feb;10(2):164-5. doi: 10.1007/BF00188364.
A 25-year-old male patient with a sharp, large, and radiolucent tracheobronchial foreign body which was inhaled at the time of a traffic accident is reported on. CT scan was quite useful in finding this radiolucent foreign body. The patient had no respiratory disturbance because the foreign body was located in the level between bifurcation and left main bronchus; however, a flexible fiberscopic procedure performed to remove the body caused an airway obstruction and a dyspnea because the foreign body lodged in the subglottis. Remarkable progress has been made in the development of the flexible fiberscope system. Almost all medical facilities in Japan have flexible systems. However, the opportunities for young physicians to learn about rigid systems may now become limited. This case may warn us not to have too much confidence in the ability of flexible fiberscope system to remove this kind of large foreign body and remind us of the need to continue adequate training in the rigid systems.
本文报道了一名25岁男性患者，其在交通事故时吸入了一个尖锐、巨大且透光的气管支气管异物。CT扫描对于发现这个透光异物非常有用。由于异物位于气管隆突和左主支气管之间的水平，患者没有呼吸障碍；然而，为取出异物而进行的纤维支气管镜检查导致气道阻塞和呼吸困难，因为异物嵌顿在声门下。纤维支气管镜系统的发展取得了显著进展。日本几乎所有的医疗机构都配备了纤维支气管镜系统。然而，年轻医生学习硬质支气管镜系统的机会现在可能变得有限。这个病例可能警示我们，不要对纤维支气管镜系统取出此类大异物的能力过于自信，并提醒我们有必要继续进行硬质支气管镜系统的充分培训。
