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Difficult removal of an endobronchial foreign body: pen cap aspiration: a case report
Hujun Wu1,2, Xiaofen Tao1,2, Liqin Ke1
1Department of Pediatric Pulmonology, The Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang, China.
Insights
Foreign body aspiration in children can be life-threatening and is often missed. This case highlights the challenges of removing impacted foreign bodies, even with advanced bronchoscopic techniques.
Area of Science:
- Pediatric Pulmonology
- Pediatric Surgery
- Emergency Medicine
Background:
- Foreign body aspiration is a significant cause of childhood morbidity and mortality.
- Delayed diagnosis of aspirated foreign bodies can lead to severe complications like recurrent pneumonia or life-threatening conditions.
- This case underscores the risks associated with foreign body aspiration, particularly when symptoms are subtle.
Purpose of the Study:
- To report a challenging case of foreign body removal in a child.
- To emphasize the importance of early recognition and treatment of foreign body aspiration.
- To illustrate the utility of bronchoscopic intervention for difficult foreign body removal.
Main Methods:
- A 12-year-old boy presented with symptoms suggestive of foreign body aspiration.
- Chest computed tomography confirmed a bronchial foreign body.
- A combination of bronchoscopic interventional techniques was employed to remove granulation tissue and the impacted foreign body.
Main Results:
- The impacted foreign body was successfully removed using advanced bronchoscopic techniques.
- The foreign body was identified as a pen cap, not the initially suspected magnetic bead.
- The procedure involved managing peripheral granulation tissue due to prolonged retention.
Conclusions:
- Foreign body aspiration in children necessitates prompt diagnosis and intervention to prevent serious outcomes.
- Bronchoscopy is the definitive diagnostic tool for foreign body aspiration.
- Bronchoscopic intervention technology is valuable for managing complex cases of foreign body removal.
Background:
Foreign body aspiration represents an important cause of morbidity and mortality during childhood. Foreign body aspiration is often missed clinically, especially in some children whose symptoms and signs are not obvious. A neglected aspirated foreign body can last for years, leading to recurrent pneumonia in mild cases and the potential to be life-threatening in severe cases. We herein report a case of difficult foreign body removal in the left upper lobe to help us better understand the risk of foreign body aspiration.
Case Presentation:
The patient was a 12-year-old boy of East Asian ethnicity who complained of a history of magnetic bead aspiration 17 days earlier. He was admitted to hospital due to fever 5 days previously with a mild cough and chest pain. Chest computed tomography confirmed a bronchial foreign body. Due to the special location of the foreign body impaction and prolonged retention, it was very difficult to remove. We successfully removed the peripheral granulation tissue with the help of a combination of various bronchoscopic interventional techniques and finally removed the foreign body. However, to our surprise, the foreign body was not a magnetic bead but a pen cap.
Conclusion:
Foreign body aspiration is common in childhood and requires early recognition and treatment to avoid complications that can be very serious or even fatal. Bronchoscopy is the gold standard for the diagnosis of foreign body aspiration. For difficult foreign body removal, bronchoscopic intervention technology can be useful.
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