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Tracheobronchial foreign body aspiration demonstrating serial bronchopulmonary changes on computed tomography
Hidehiro Watanabe1, Tomonori Uruma1, Gen Tazaki2
1Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan ; Division of Respiratory Medicine, Tokai University Hachioji Hospital, Tokyo, Japan.
Iranian Red Crescent Medical Journal
|July 18, 2014
Summary
A persistent cough in an elderly patient was misdiagnosed for months due to a foreign body. Flexible bronchofiberscopy revealed a vegetable core, highlighting the value of computed tomography (CT) in diagnosing such cases.
Area of Science:
- Pulmonology
- Radiology
Background:
- Tracheobronchial foreign bodies are often misdiagnosed as asthma or chronic bronchitis, particularly when aspiration is not recalled.
- Delayed diagnosis can lead to significant bronchopulmonary complications.
Observation:
- A 74-year-old woman presented with persistent cough, initially misdiagnosed.
- Computed tomography (CT) showed evolving bronchial wall thickening, "tree-in-bud" pattern, bronchiectasis, and atelectasis over six months.
- No significant bacterial infection was detected during this period.
Findings:
- Flexible bronchofiberscopy successfully extracted a vegetable core foreign body.
- Symptoms resolved post-extraction, but residual bronchopulmonary lesions remained.
Implications:
- Chronological CT findings are crucial for diagnosing foreign body aspiration.
- This case highlights the importance of considering foreign bodies in persistent respiratory symptoms, even without reported aspiration.
- Radiological monitoring can reveal subtle changes indicative of retained endobronchial material.
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