Intrabronchial Foreign Body Research Articles

An Intrabronchial Foreign Body Revealed by Bronchiectasis (Bone Fragment)

Tracheobronchial foreign bodies (FB) by inhalation accidental are serious incidents and particularly common in children. In adults, they are less frequent, very often unrecognized and therefore diagnostic often difficult. Passed unnoticed or neglected, these intrabronchial FBs are responsible for repeated respiratory infections, bronchectasis, which can lead to destruction of the pulmonary parenchyma. We report a case of a neglected foreign body (bone fragment) present in the bronchus of an adult for 53 years revealed by bronchopulmonary suppurations causing bronchiectasis and treated surgically.

Lower Left Lobectomy for Bronchial Dilation Revealing a Food Foreign Body (Sunflower Seed) about of an Observation

Inhalation of a food foreign body is a rare phenomenon in adults, it can be serious and life-threatening. We report the observation of a 37-year-old patient with chronic bronchitis for 10 years, without notion of ingestion of an obvious digestive foreign body but who presents a progressive worsening of her bronchorrhea becoming purulent associated with a single episode of hemoptysis of low abundance. Chest radiography revealed an alveolar type opacity with left paracardiac projection. The chest CT scan showed dilatation of the bronchi downstream of a lesion at the left lower lobar level. The flexible bronchoscopy showed a foreign body which is a sunflower seed obstructing the orifice of the left lower lobar bronchus with notion of regular consumption of Sunflower seeds for 20 years later found during interrogation. The extraction of the foreign body was carried out surgically or a lower lobectomy was carried out in connection with the failure of the endoscopic extraction and the patient benefited from antibiotic therapy and respiratory physiotherapy, as well as awareness raising in order to avoid subsequent penetration syndrome. The development was very favorable. Intrabronchial foreign bodies after failure of their extraction by bronchial endoscopy.

Unusual longstanding intrabronchial foreign body masquerading as intractable bronchial asthma in an adult: Case report and literature review

Introduction and importanceTracheo-bronchial foreign body inhalation is a very common encounter in clinical practice among pediatric patients and rarely seen among adults. When inhalation of foreign bodies occurs in adults then it tends to lodge within the right bronchial tree but in children it lodges in the central airways.Case presentationWe present a 58 year old woman, known asthmatic for 20 years and non-smoker who presented to our clinic which history of chronic cough, wheezing and pulmonary infections that did not respond to regular antibiotics and the usual antiasthmatic medications. She reported to have inhaled a foreign body about 18 years earlier. Extraction of the foreign body was performed without complications.Clinical discussionA chest x-ray done was found to be normal and computerized tomography scan (CT scan) of the chest was ordered and revealed bronchial wall thickening with a calcified foreign body seen in the right intermediate bronchus.A combined rigid and flexible endoscopic bronchoscopy was performed and a chicken bone (measuring 2 cm × 1.5 cm) was extracted from the right intermediate bronchus with very minimal bleeding being encountered during and post bronchoscopy. Extraction of the foreign body was performed without complications. Post endoscopic intrabronchial foreign body removal, the patient recovered completely.ConclusionAn intrabronchial foreign body being masked for more than a decade by co-existent bronchial asthma is a rare encounter. Moreover, adult patients with chronic cough should be handled with caution to rule out the possibility of FB aspiration.

A Case Report on Cyanotic Spell: Suspected Foreign Body

Tracheobronchial Foreign Body Aspiration (FBA) remains a significant cause of morbidity and mortality in children less than three years of age. High index of suspicion leads to early diagnosis and treatment thus preventing further deleterious complications. This case report is about a 15-month-old female child who presented with intermittent low-grade fever, cough, cold for 20 days and rapid breathing since one day. On examination, she had pallor, grade 3 protein energy malnutrition according to Indian Academy of Paediatrics classification, heart rate was 128/min, respiratory rate was 44/min, oxygen saturation was 88% on room air with nasal flaring, intercostal and subcostal retractions. Bilateral rhonchi with reduced air entry was present in all areas of the lung. Bilateral bronchopneumonia was seen on chest X-ray and tuberculosis work up was negative. Child was started on oxygen, antibiotics, nebulisations and intravenous fluids. On day two of admission child developed rigorous bouts of cough associated with hypoxia, bradycardia, cyanosis and listlessness which improved on bag and mask ventilation. Following a strong suspicion of obstruction in the tracheobronchial tree, a Computed Tomography (CT) neck and chest was done which was suggestive of either an intratracheal or intrabronchial foreign body. Child was urgently taken up for rigid bronchoscopy and a ground nut was found in the right main bronchus. The FBA as a differential diagnosis of chronic cough in children should always be ruled out.

A Case Report on Cyanotic Spell: Suspected Foreign Body

Tracheobronchial Foreign Body Aspiration (FBA) remains a significant cause of morbidity and mortality in children less than three years of age. High index of suspicion leads to early diagnosis and treatment thus preventing further deleterious complications. This case report is about a 15-month-old female child who presented with intermittent low-grade fever, cough, cold for 20 days and rapid breathing since one day. On examination, she had pallor, grade 3 protein energy malnutrition according to Indian Academy of Paediatrics classification, heart rate was 128/min, respiratory rate was 44/min, oxygen saturation was 88% on room air with nasal flaring, intercostal and subcostal retractions. Bilateral rhonchi with reduced air entry was present in all areas of the lung. Bilateral bronchopneumonia was seen on chest X-ray and tuberculosis work up was negative. Child was started on oxygen, antibiotics, nebulisations and intravenous fluids. On day two of admission child developed rigorous bouts of cough associated with hypoxia, bradycardia, cyanosis and listlessness which improved on bag and mask ventilation. Following a strong suspicion of obstruction in the tracheobronchial tree, a Computed Tomography (CT) neck and chest was done which was suggestive of either an intratracheal or intrabronchial foreign body. Child was urgently taken up for rigid bronchoscopy and a ground nut was found in the right main bronchus. The FBA as a differential diagnosis of chronic cough in children should always be ruled out.

LncRNA MALAT1 Affects Mycoplasma pneumoniae Pneumonia via NF-κB Regulation.

Our aim was to determine whether the long non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is involved in Mycoplasma pneumoniae pneumonia (MPP), and its possible mechanism of action. MALAT1 expression in the bronchoalveolar lavage fluid of 50 hospitalized children with MPP was compared to its expression in 30 children with intrabronchial foreign bodies. MALAT1 expression was higher in children with MPP, accompanied by increased inflammatory mediators interleukin 8 (IL-8) and tumor necrosis factor alpha (TNF-α), compared to the controls. In human airway epithelial cells infected with wild-type Mycoplasma pneumoniae (strain M129), MALAT1, IL-8, and TNF-α expression significantly increased, and increased expression of IL-8 and TNF-α could be suppressed by MALAT1 knockdown. Luciferase reporter gene assay and western blot showed that knockdown of MALAT1 reduced nuclear factor-κB (NF-κB) activation. In vivo, RNAi packaged with adenovirus (Adv) was nasally transfected into BALB/c mice to silence MALAT1, and an MP-infected mouse pneumonia model was prepared. The results demonstrated that the degree of pulmonary inflammatory injury, vascular permeability, secretion of inflammatory factors, and expression of phosphorylated p65 (pp65) in MP-infected mice were partly reversed after MALAT1 knockdown compared to those in the controls. In conclusion, MALAT1 is involved in the regulation of airway and pulmonary inflammation caused by MP infection via NF-κB regulation.

Aspiration of a bullet after a gunshot wound to the face

There are very few reports of penetrating injuries to the head and neck resulting in aspiration of and retained intrabronchial foreign bodies. We present a pediatric patient who sustained a gunshot injury to the face with subsequent aspiration of the bullet. Removal of the retained bullet was achieved with flexible bronchoscopy. Additionally, we review the available literature on this rare injury pattern.

Pneumonia associated with intrabronchial foreign body

Pneumonia associated with intrabronchial foreign body

A Case of Concrete Fragments Constituting Intrabronchial Foreign Bodies in Bilateral Bronchi

A Case of Concrete Fragments Constituting Intrabronchial Foreign Bodies in Bilateral Bronchi

Two interesting cases of long standing non-asphyxiating intrabronchial foreign bodies

The long standing intrabronchial foreign body presents problems of diagnosis and treatment which are very different from those associated with the recently inhaled foreign body There may be no history to suggest the original incident the clinical picture is usually clouded by superadded pathological changes atelectasis pneumonitis or bronchiectasis Two such cases are presented in an attempt to find common characteristics recognition of which may assist correct diagnosis The tracheobronchial foreign bodies are best managed by rigid bronchoscopy Preventative educational strategies should be implemented to reduce such an avoidable risk

Aspergillome pulmonaire sur corps étranger résiduel post-traumatique. Diagnostic et prise en charge

Aspergillomas occur due to colonization of a pre-existing pulmonary, bronchial or pleural cavity by Aspergillus spp. Often asymptomatic, this pathology can reveal itself by recurrent haemoptysis or when bacterial superinfections occur. Aspergillomas occurring in post-traumatic cavities are rare and their management is poorly codified. A child suffered from a chest wound at the age of 13 years. Two years later, investigation of recurrent haemoptysis revealed a residual pneumatocele in the right lower lobe colonized by Aspergillus spp. Initial treatment with systemic azole antifungals was unsuccessful because of digestive and ophthalmological intolerance. Surgical treatment by right lower lobectomy was finally decided on by the multidisciplinary team. This revealed an intrabronchial foreign body of vegetal type with cellulosic reinforcement, causing a polymorphic granulomatous reaction around, and associated with a proliferation of filamentous fungi including Aspergillus fumigatus. Surgery was followed by liposomal amphotericin B treatment for three weeks with a favourable outcome. This clinical case illustrates the benefits of surgical management of post-traumatic aspergillomas, even in children, in order to eradicate the aspergillus implant and to remove any foreign body to prevent recurrence.

Résultats chirurgicaux à propos de 64 patients opérés pour dilatations des bronches

Bronchiectasis is a serious and disabling disease. Surgical treatment is an interesting alternative to be proposed early to patients in case of complications or deterioration of quality of life, despite an optimal medical treatment. Through this retrospective study and literature review, we analyze surgical results for bronchiectasis. We conducted a monocentric, retrospective, descriptive and analytical study in the Department of thoracic surgery of CHU Hassan II Fès, about 64patients operated for bronchiectasis during the period from January 2009to December 2016. There were 30men and 34women with an average age of 32years. Twenty six percent (26%) had a history of recurrent lung infection, and 17.18% would have been treated for pulmonary tuberculosis and declared cured. Productive cough (93%), morning chronic bronchorrhea (92%) and repeatedly hemoptysis (62.5%) were the main symptoms. On CT scanning, the bronchiectasis was unilateral and localized in 49cases. The right lung was involved in 27cases and the location was bilateral in 15cases. It was 38cystic bronchiectasis, 16cylindrical bronchiectasis, and 10mixed lesions predominantly cylindrical. The flexible bronchoscopy carried out in 34cases, had shown a carcinoid tumor in 1case, a bronchiolithiasis in 1case and a intrabronchial foreign body in 1case. The incision was a conservative posterolateral thoracotomy in all cases. The performed surgical procedure was lobectomy in 53% of patients. The morbidity rate was 32.80% and dominated by septic complications. After a mean follow-up of 20.52months, 2cases of recurrence minimal hemoptysis and 1case of renewed bronchorrhea are noted. For all other patients the outcome was favorable and no deaths have been noted to date. The surgery of bronchiectasis requires a perfect collaboration between the pulmonologist, the thoracic surgeon, the anesthesiologist, the biologist and particularly the physiotherapist for an optimal care of patients.

気管支内異物(魚骨)が誘因となり発生したと考えられた肺癌の1例

気管支内異物(魚骨)が誘因となり発生したと考えられた肺癌の1例

気管支異物 : 内視鏡的摘除の 2 例ならびに文献的考察

気管支異物 : 内視鏡的摘除の 2 例ならびに文献的考察

Traumatic Tracheostomy and Spent Bullet Aspiration after a Gunshot Injury: A Case Report

Penetrating tracheal injuries are rare. Even rarer is the finding of intrabronchial foreign bodies caused by penetrating objects. We report a patient who experienced a gunshot injury to the trachea and mandible. The tracheal wound was debrided and used as a tracheostomy; a spent bullet in the bronchial tree was missed on initial evaluation but later successfully retrieved bronchoscopically. Spent bullet aspiration is a very rare occurrence. A careful examination of radiographs is essential to aid with the diagnosis. Flexible bronchoscopy is the best means of bullet retrieval. Management of any associated injuries is made easier after the airway is secured.

Diagnostic difficulties in chronic obstructive pulmonary disease exacerbations: A case report

Exacerbations of COPD (chronic obstructive pulmonary disease) influence, by their frequency and severity, the life prognosis of patients with COPD. Most exacerbations are caused by respiratory infections with negative impact on patient quality of life. The impact of frequent exacerbation in COPD is manifested by the rapid decline of lung function, decreased quality of life increased airway inflamation and high mortality. Bronchial obstruction by foreign bodies meets frequently during childhood but can occur in adults under certain conditions of loss of consciousness (sleep, administration of tranquilizers, after anesthesia, intoxicated). The longstanding intrabronchial foreign body presents problems of diagnosis and treatment which are very different from those associated with the recently inhaled foreign body. We herein report a 77-year-old male, smoker (40 pack-year) presented to the clinic with severe dyspnoea, fever and cough with purulent sputum for about 6 months. Persistent symptoms require repeated hospitalizations for receiving different regimens of antibiotics, but they have not helped. Chest radiography showed extensive consolidation of the right lower lobe, intensity rib, heterogeneous and Chest CT scan showed metallic foreign body in right lower lobar bronchus with secondary pneumonic process in the lower right lobe. Emergency was performed bronchoscopy and extracted dental crown consists of three teeth and then the patient received combined antibiotic therapy for 14 days, in association with anti-inflammatory, mucolytics and bronchodilators. After 2 weeks he was overall in very good condition and all other complaints disappeared and Chest X-ray control showed full resorption of pneumonia opacity, without disabling signs. In this particular case, only minor symptoms are seen at the beginning and the aspirated foreign body was forgotten until later symptoms (inflammation, infection) were developed and developing clinically manifest. The diagnosis was delayed due to lack of radiographic view which may be aspirated foreign body embedded in granulation tissue formed around.

Extraction de corps étranger intra-bronchique chez l'adulte par fibroscopie bronchique

Extraction de corps étranger intra-bronchique chez l'adulte par fibroscopie bronchique

20年間長期介在した気管支異物(魚骨)により慢性咳嗽と肺炎を繰り返した1例

20年間長期介在した気管支異物(魚骨)により慢性咳嗽と肺炎を繰り返した1例

Intrabronchial Foreign Body Extracted With Tranilast and Corticosteroid

We present a case of intrabronchial foreign body buried in granulation tissue, which was successfully extracted administrating tranilast (n-[3,4-dimethoxycinnamoyl] anthranilic acid), suppressing collagen synthesis by fibroblasts in keloid and hypertrophic scars, and corticosteroid. Bronchoscopy of a 74-year-old man showed the nail was buried in reactive granulation tissue and could not be observed from the surface. Tranilast at 300 mg/day and methylprednisolone at 250 mg/day were prescribed for 4 days, followed by a reduction of the corticosteroid to 40 mg/day for 3 days. Seven days later, the granulation tissue and mucosal edema were diminished, and the nail was successfully extracted.

Airway foreign bodies and brain abscesses: Report of two cases and review of the literature

We report two cases of intracranial abscess in pediatric patients secondary to aspirated foreign bodies. Although foreign bodies are a significant cause of morbidity and mortality in the pediatric population, only four previous cases have been reported that resulted in a brain abscess. Our patients presented with neurological symptoms, and both were found to have a sharp foreign body in the bronchus. Both had brain abscesses caused by bacteria that normally colonize the aerodigestive tract with no other source of bacterial foci. When respiratory flora are isolated from brain abscesses in the absence of other possible sources, intrabronchial foreign body should be considered in evaluation of the etiology.