al-Majed S A, Ashour M, al-Mobeireek A F, al-Hajjaj M S, Alzeer A H, al-Kattan K
Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Respir Med. 1997 May;91(5):293-6. doi: 10.1016/s0954-6111(97)90033-0.
The present paper describes eight patients (two teenagers and six adults) who had chronic symptoms (haemoptysis, cough, recurrent pneumonia) caused by foreign body (FB) inhalation which went undetected for 3 months to 25 yr. None of the patients had the usual predisposing conditions like mental retardation, seizures or brain tumour. The diagnosis of FB was made by radiography in one patient only. Computerized tomography visualized one FB (a beef bone), and bronchoscopy identified FB in another two patients. The remaining four cases were diagnosed at thoracotomy. Removal of FB was curative in three of five cases who required surgical resection for irreversible bronchiectatic changes. The severity of pulmonary changes correlated with duration of symptoms. It is concluded that chronic, unexplained respiratory symptoms should warrant further investigation to exclude FB despite negative history and normal chest radiography. Finding of granulation tissue or cicatricial stenosis of the bronchus could be the only clue to the presence of a FB. Early diagnosis would avoid irreversible parenchymal changes which necessitate lung resection.
本文描述了8例患者（2例青少年和6例成年人），他们因吸入异物（FB）而出现慢性症状（咯血、咳嗽、反复肺炎），这些异物在3个月至25年的时间里都未被发现。所有患者均无智力发育迟缓、癫痫或脑肿瘤等常见的易感因素。仅1例患者通过X线摄影诊断出异物。计算机断层扫描发现了1个异物（一块牛骨），支气管镜检查在另外2例患者中发现了异物。其余4例在开胸手术时确诊。在5例因不可逆性支气管扩张改变而需要手术切除的病例中，3例通过取出异物治愈。肺部改变的严重程度与症状持续时间相关。结论是，尽管病史阴性且胸部X线摄影正常，但对于慢性、不明原因的呼吸道症状仍应进行进一步检查以排除异物。发现肉芽组织或支气管瘢痕性狭窄可能是异物存在的唯一线索。早期诊断可避免需要肺切除的不可逆实质性改变。
