Journal List > Tuberc Respir Dis > v.61(6) > 1001040

Tuberc Respir Dis. 2006 Dec;61(6):567-572. Korean.
Published online December 30, 2006.  https://doi.org/10.4046/trd.2006.61.6.567
Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases
A Case of Massive Hemoptysis & Pneumonia Caused by Metallic Foreign Body
Choon Hee Chang, M.D., Jang Eun Lee, M.D., Hyung wook Park, M.D., Jeong hwa Lee, M.D., Seung Ah Yang, M.D., Young Kun Park, M.D.,1 Sang Rok Lee, M.D.,1 and Jin Young An, M.D.1
Department of Internal Medicine, The Catholic University of Korea, Korea.
1Department of Internal Medicine, Cheongju St. Mary's Hospital. Cheongju, Korea.

Adress for Correspondence: Jin Young An, M.D. Department of Internal medicine, Cheongju St. Mary's Hospital, 589-5, Jujungdong, Sangdangku, Cheongju 360-568, Korea. phone:043-219-8118, Fax:043-211-9030, Email: drahnjy@mdhouse.com
Received August 23, 2006; Accepted October 09, 2006.

Abstract

Endobronchial foreign bodies are difficult to diagnose as the cause of obstructive pneumonia and atelectasis, However, once discovered, they can generally be removed, leading to an immediate and dramatic resolution of the symptoms. Occasionally, small foreign bodies that lodge in the peripheral airway are often initially asymptomatic but become symptomatic several years later.

We reported a case of obstructive pneumonia and massive hemoptysis caused by a foreign metallic body. The patient knew that the foreign body was lodged in the peripheral airway on the chest X-ray, but did not want treatment. Several years later, he had a massive hemoptysis and obstructive pneumonia. Removal with a flexible bronchoscope failed, but the metallic foreign body was self-expectorated by coughing after the procedure. The pneumonia was resolved after removing the foreign body. The patient improved and was discharged without any sequela.

Keywords: Foreign body; Hemoptysis; Obstructive pneumonia

Figures


Figure 1
Chest radiography in a 26-year-old man with hemoptysis and cough.

A. The initial chest radiograph shows radio-opaque foreign body in left main bronchus(arrow) and pneumonia infiltration in left lower lung field.

B. two days later, Chest X-ray shows nearly complete atelectasis of left lung except some upper lobe.

Click for larger image


Figure 2
Chest CT shows metallic foreign body(arrow,A) with nearly complete obstruction in left main bronchus (B).
Click for larger image


Figure 3
Bronchoscope shows foreign body covered with mucoid material obstructing left main bronchus.
Click for larger image


Figure 4
The photograph shows 6 × 8mm sized, rusty-colored, metallic material, which was expectorated with cough.
Click for larger image


Figure 5
Two weeks later. Chest X-ray shows disappearance of radio-opaque foreign body in left Main bronchus and nearly normalized findings.
Click for larger image

References
1. Son CY, Wee JO, Kim SO, Oh IJ, Park CM, Kim KS, et al. A retrospective review of tracheobronchial foreign bodies. Tuberc Respir Dis 2005;58:600–606.
2. Jo KG, Baek MS, Kim MS, Hur JM, Jeon JI, Park KS, et al. A case of occult foreign body lodged in bronchus for a long period and removal by flexible bronchoscopy. Tuberc Respir Dis 1997;44:1166–1171.
3. Lan RS. Non-asphyxiating tracheobronchial foreign bodies in adults. Eur respire J 1994;7:510–514.
4. Chen CH, Lai CL, Tsai TT, Lee YC, Perng RP. Foreign body aspiration into the lower airway in Chinese adults. Chest 1997;112:129–133.
5. al Majed SA, Ashour M, al Mobeireek AF, al Hajjaj MS, Alzeer AH, al Kattan K. Overlooked inhaled foreign bodies: late sequelae and the likelihood of recovery. Respir Med 1997;91:293–296.
6. Baharloo F, Veyckemans F, Francis C, Biettlot MP, Rodenstein DO. Tracheobronchial bodies: presentation and management in children and adults. Chest 1999;115:1357–1362.
7. Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med 1990;112:604–609.
8. Lee BJ, Lee YW, Jung JW, Shin JW, Kim JY, Park IW, et al. A case of bronchial foreign body misdiagnosed as bronchial asthma. Tuberc Respir Dis 2004;57:484–488.
9. Kwon KS, Park MY, Kim KC, Yeon KH, Lee CS, Jung KY, et al. A case of Pneumonia due to Occult aspiration of a twig. Tuberc Respir Dis 1997;44:1166–1171.
10. Hong SB, Song JH, Kwak SM, Cho CH. A case of removal of pushpin by flexible bronchoscopy. Tuberc Respir Dis 1995;42:772–776.
11. Rafanan AL, Mehtan AC. Adult airway foreign body removal. Clin Chest Med 2001;22:319–330.
12. Wain JC. Rigid bronchoscopy: the value of a venerable procedure. Chest Surg Clin N Am 2001;11:691–699.
13. Debeljak A, Sorli J, Music E, Kecelj P. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998. Eur Respir J 1999;14:792–795.
14. Igoe D, Lynch V, McNicholas WT. Broncholithiasis: bronchoscopic vs. surgical management. Respir Med 1990;84:163–165.
TOOLS
Similar articles

Penetrating Orbitocranial Metallic Foreign Body Injury - A Case Report -

A Case of Epitheloid Sarcoma on Metal Cutoff Worker

A Case of Broncholithiasis Caused by Aspergillus with Broncho-Obstructive Pneumonia and Massive Hemoptysis

A Case of Intraorbital Foreign Body Removed Using A Magnet Under C-arm Fluoroscopy

A Case of an Asymptomatic Intralenticular Foreign Body