Successful Removal of Long-standing Bronchial Foreign Body (Dental Prosthesis) by Flexible Bronchoscopy Under Local Anesthesia: a Case Report

• Published in: The Journal of the Japan Society for Respiratory Endoscopy Vol. 41; no. 2; pp. 127 - 132
• Main Authors: Tokoro, Yayoi, Yasuo, Masanori, Agatsuma, Toshihiko, Yamamoto, Hiroshi, Tani, Naoki, Koike, Takeshi, Hanaoka, Masayuki
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Respiratory Endoscopy 25.03.2019
• Subjects: Argon plasma coagulation; Bronchial foreign body; Dental prosthesis; Flexible bronchoscopy; Long-standing foreign body
• ISSN: 0287-2137; 2186-0149
• DOI: 10.18907/jjsre.41.2_127

Background. It is often difficult to remove long-standing bronchial foreign bodies (FB) by bronchoscopy. Case. The patient was a 76-year-old man with a medical history of impaired consciousness because of sequela of intracerebral hemorrhage and who had undergone permanent tracheotomy. He was diagnosed with pneumonia and underwent treatment in a hospital three months previously. On presentation, his chief complaint was purulent sputum and fever and he was diagnosed with pneumonia again in a hospital. A chest X-ray showed a bronchial FB in the right lower lung field. He was transferred to our hospital for the removal of the FB. The FB was found in a chest X-ray taken three months previously; thus, it was considered to be a long-standing bronchial FB. The bronchoscopic examination detected the FB as well as remarkable granulation tissue in the surrounding area; however, it was difficult to clearly visualize the FB due to the purulent secretion from an accompanying lung abscess. The purulent secretion was reduced and the granulation was diminished after antibiotic therapy. Under local anesthesia, the bronchial FB (dental prosthesis) was successfully removed without any complications by flexible bronchoscopy in combination with the use of argon plasma coagulation (APC). Conclusion. Although the long-standing bronchial FB was surrounded by remarkable granulation tissue, with the aid of antibiotic treatment and APC for cauterization and hemostasis using coagulation, the FB was safely and successfully removed by flexible bronchoscopy.