Large radiolucent tracheal foreign body found by CT scan caused dyspnea: an admonition on flexible fiberscopic foreign body removal.

Abstract

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.