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Joseph Junewick, MD FACR
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Bronchial Foreign Body

Case Detail

Anatomy: Chest
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CR CT
Activities:
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History

8 year old male with hemoptysis.


Case Images


Diagnosis

Bronchial Foreign Body

Clinical Notes

Needle retrieved on bronchoscopy.

Findings

CR – Long thin metallic foreign body in lingula with plate-like atelectasis.

CT – Sagittal reformatted image confirms foreign body.

Discussion

Aspirated foreign bodies are common, most often encountered in preschool children. Foreign bodies are usually related to food (peanuts and candy) but occasionally broken teeth or glass in the trauma setting, toy pieces, jewelry, and other accidentally inhaled items are seen.

Classic symptoms include coughing, choking, cyanosis, and sudden onset of wheezing. The lower lobes are most commonly involved; the right side is twice as commonly involved compared to the left. The foreign body is radiographically visible in only about 10% of cases.

Acutely, endobronchial foreign bodies can lead to varying degrees of obstruction and ventilation-perfusion mismatch. Long standing foreign body can result in hemoptysis (which can be massive and life threatening), chronic atelectasis, recurrent pneumonia, bronchiectasis and pseudomass.

Reference

Kosucu P, et al. Low-dose MDCT and virtual bronchoscopy in pediatric patients wtih foreign body. AJR (2004); 183:1771-1777.



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