Melatonin aspiration: Treatment with flexible bronchoscopy

Area of Science:

• Pulmonology
• Gastroenterology
• Medical Devices

Background:

• A 68-year-old male with significant smoking history (84 pack-years), mild chronic obstructive pulmonary disease (COPD), treated lung adenocarcinoma, and prior melanoma presented with a month of worsening cough and dyspnea.
• The patient's symptoms were refractory to standard antibiotic and corticosteroid therapy, suggesting an alternative underlying cause.

Observation:

• Flexible bronchoscopy was performed to investigate the persistent respiratory symptoms.
• The procedure identified a foreign body, specifically an aspirated pill, lodged within the airways.

Findings:

• The aspirated pill was successfully retrieved in the same bronchoscopy session using a flexible bronchoscope.
• Removal of the foreign body led to the resolution of the patient's cough and dyspnea.

Implications:

• This case highlights the importance of considering foreign body aspiration, even in the absence of typical risk factors or initial presentation.
• Flexible bronchoscopy is an effective diagnostic and therapeutic tool for managing aspirated foreign bodies in the airways.
• Prompt identification and removal of aspirated pills can prevent prolonged respiratory morbidity and complications.