Aspiration of a huge foreign body in a young patient: teeth prosthesis aspiration

Genç bir hastada dev yabancı cisim aspirasyonu: diş protezi aspirasyonu

Gürhan Öz¹, Ertan Aydın¹, Ülkü Yazıcı¹, Suat Gezer², Erkmen Gülhan¹, İrfan Taştepe¹, Nurettin Karaoğlanoğlu¹

¹Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery, Training and Research Hospital, Ankara
²Department of Thoracic Surgery, Medicine Faculty of Düzce University, Düzce

DOI : 10.5606/tgkdc.dergisi.2011.070

A 36-year-old man presented with dyspnea, was referred to our clinic. The chest roentgenogram and thorax computed tomography revealed a foreign body in left main bronchus (Figure 1a, b). On physical examination; decrease in respiratory voices and rhoncus on left hemithorax and brutal rales on both sides were found. Laboratory tests revealed that pO₂: 85 mmHg, PCO₂: 37 mmHg, O₂ saturation: 93%. Bronchoscopy was revealed that the foreign body at the left main bronchus was teeth prosthesis consist of six teeth. It was removed by the help of rigid bronchoscope (Figure 2).

Figure 1: (a) Tooth prosthesis at left main bronchus in chest roentgenogram. (b) Teeth prosthesis at left main bronchus in computed tomography.

Figure 2: Aspirated foreign body.

Aspiration of a foreign body can cause fatal complications like laryngeal edema, bronchospasm, tracheal or bronchial rupture, cardiac arrest and pneumothorax in early period.[1,2] In most cases, the diagnosis is confirmed by chest radiography. The history of patient that can be taken from him or his relatives can be helpful when the chest X-ray and physical examination is normal. Atelectasis, obstructive emphysema and mediastinal shift are the main secondary signs.[3,4] Computed tomography of the chest may be valuable in identifying small aspirated objects or when associated chest disease is suspected. Bronchoscopy is frequently both diagnostic and therapeutic. Surgery constitutes the final, definitive option and is generally well tolerated, particularly when the lung parenchyma is spared.[5]

References

1) Singer MI. Voice rehabilitation after laryngectomy. In: Bailey BJ, Jhonson JT, Kohut RI, Phillsburry HC III, Tardy ME Jr, editors. Head and neck surgery-otolaryngology. 1st ed. Philadelphia: Lippincott; 1993. p. 1361-72.

2) Carluccio F, Romeo R. Inhalation of foreign bodies: epidemiological data and clinical considerations in the light of a statistical review of 92 cases. Acta Otorhinolaryngol Ital 1997;17:45-51. [Abtract]

3) Bhatia PL. Problems in the management of aspirated foreign bodies. West Afr J Med 1991;10:158-67.

4) Mu LC, Sun DQ, He P. Radiological diagnosis of aspirated foreign bodies in children: review of 343 cases. J Laryngol Otol 1990;104:778-82.

5) Yıldırım M Dogusoy I, Okay T, Yasaroglu M, Demirbag H, Aydemir B,et al. Trakeobronsiyal yabancı Cisimler. Türk Gögüs Kalp Damar Cer Derg 2003;11: 228-31.

References

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