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

Chang, Lee, Park, Lee, Yang, Park, Lee, and An: A Case of Massive Hemoptysis & Pneumonia Caused by Metallic Foreign Body

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.

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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.
trd-61-567f1.tif
Figure 2.
Chest CT shows metallic foreign body(arrow,A) with nearly complete obstruction in left main bronchus (B).
trd-61-567f2.tif
Figure 3.
Bronchoscope shows foreign body covered with mucoid material obstructing left main bronchus.
trd-61-567f3.tif
Figure 4.
The photograph shows 6 x 8mm sized, rusty-colored, metallic material, which was expectorated with cough.
trd-61-567f4.tif
Figure 5.
Two weeks later. Chest X-ray shows disappearance of radio-opaque foreign body in left Main bronchus and nearly normalized findings.
trd-61-567f5.tif
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