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Foreign body aspiration in an adult: An endobronchial "Melon-oma"
Irfan Ul Haq1, Mansoor Hameed1, Shakeel Ahmed1
1Pulmonary Division, Department of Medicine, Hamad Medical Corporation
Abstract:
Background: Foreign body (FB) aspirations in adults are relatively uncommon. The most commonly aspirated FBs in adults are organic, especially vegetable matter, peanuts, and fragments of bones. We report a rare case of a FB discovered in the left main bronchus of an adult male admitted to the intensive care unit. Case report: A 52-year-old male smoker with COPD presented to the emergency department with a two-day history of increasing dyspnea and cough. He was hypoxic and febrile with a temperature of 38°C. Auscultation revealed decreased breath sounds over the left lung and a few rhonchi on the right side. Chest x-ray showed left lung collapse. His condition rapidly worsened, and he was immediately intubated for acute respiratory failure. CT chest identified a large endobronchial mass obstructing the left main bronchus. Flexible bronchoscopy confirmed a soft and mobile brownish lesion in the left main bronchus. The histological appearance of the specimen retrieved was consistent with an organic foreign body. This was later identified as a melon chunk. It was removed successfully via flexible bronchoscopy by cutting it into smaller pieces to aid retrieval. Conclusion: FB aspiration can occur in all age groups but is less common in adults accounting for only 0.16%-0.33% of adult bronchoscopic procedures. Early detection of an aspirated FB is essential to avoid significant complications, morbidity, and mortality.
Insights
Foreign body aspiration in adults is rare, but this case highlights a melon chunk lodged in the left main bronchus. Successful removal via bronchoscopy prevented serious complications.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Emergency Medicine
Background:
- Adult foreign body (FB) aspiration is uncommon, with organic matter like vegetable matter, peanuts, and bone fragments being most frequent.
- This report details a rare instance of FB aspiration in an adult, specifically a melon chunk lodged in the left main bronchus.
Purpose of the Study:
- To report a rare case of foreign body aspiration in an adult.
- To emphasize the importance of early detection and intervention for aspirated foreign bodies in adults.
Main Methods:
- A 52-year-old male smoker with COPD presented with dyspnea and cough, leading to intubation for respiratory failure.
- Computed tomography (CT) chest imaging revealed an endobronchial mass obstructing the left main bronchus.
- Flexible bronchoscopy confirmed and successfully retrieved a melon chunk foreign body after fragmentation.
Main Results:
- A 52-year-old male with COPD presented with acute respiratory failure due to a left main bronchus obstruction.
- CT and bronchoscopy identified the obstruction as an organic foreign body, later identified as a melon chunk.
- The foreign body was successfully removed using flexible bronchoscopy, resolving the obstruction.
Conclusions:
- Foreign body aspiration, though infrequent in adults (0.16%-0.33% of bronchoscopies), can lead to severe respiratory compromise.
- Prompt diagnosis and removal of aspirated foreign bodies are crucial to prevent significant morbidity and mortality.
- This case underscores the need for considering foreign body aspiration in adult patients with unexplained respiratory symptoms.
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