心臓血管および胸部外科の実録

抽象的な

Unusual aspiration of foreign body in adults.

Reza Afghani

Aspiration of foreign body can occur in children and adults. Children swallow objects due to their curiosity and are prone to aspiration. However in adults there are different risk factors for aspiration; such as alcohol consumption, addiction, drug consumption, senility, seizure, trauma, mental retardation, and artificial dentures [1]. In some cases, it may happen accidentally, and risk factors are not involved. In this particular case, air gun bullet has been swallowed (Figure 1). The shooter had put a bullet in his mouth in order to reload his gun and shoot rapidly; then swallowing and aspiration happened. In this case, because the foreign body is opaque, chest X-ray can be helpful for diagnosis (Figure 2). The alternative way to diagnose is fiberoptic bronchoscopy; which is sometimes considered a therapeutic strategy (Figure 3). Foreign body aspiration in tracheobronchial tree requires immediate diagnosis and removal; because the ignored objects may result in complications like infection, abscess, empyema, and haemoptysis or even bronchopleural fistula [2]. Therapeutic options to remove aspirated foreign bodies from the respiratory tract are carried out through fiberoptic and rigid bronchoscope [3]. In cases of immediate removal of the foreign body, the outcome will be excellent; and there will be no specific complication and sequel. In some rare cases, surgery is needed to remove the foreign body; however, surgery is mostly required in situations with late diagnosis and occurrence of complications.