Treatment of Occult Bronchial Foreign Body with 30-Year Retention - A case report -

30년간 잠복한 기관지 내 이물의 치험 - 1예 보고 -

  • Choi, Jae-Sung (Department of Thoracic and Cardiovascular Surgery, Dongguk University International Hospital, College of Medicine, Dongguk University) ;
  • Kim, Eung-Joong (Department of Thoracic and Cardiovascular Surgery, Dongguk University International Hospital, College of Medicine, Dongguk University)
  • 최재성 (동국대학교 의과대학 일산동국대학교병원 흉부외과학교실) ;
  • 김응중 (동국대학교 의과대학 일산동국대학교병원 흉부외과학교실)
  • Published : 2008.10.05

Abstract

Occult bronchial foreign bodies are rare in adults, whereas tracheobronchial aspiration of foreign bodies occurs commonly in children. Treatment guidelines, according to the severity of the bronchial or lung parenchymal damage and the duration of foreign body retention, have not been established. A 40-year-old man with chronic cough, sputum production, and fever was transferred for treatment of right middle and lower lobe collapse and obstructive pneumonitis as evidenced by imaging studies. He had aspirated the cap of a felt-tipped pen 30 years before presentation, which was unrevealed until his medical history was carefully reviewed during this episode. The patient was treated with right middle-lower bilobectomy because fiberoptic bronchoscopic removal of the foreign body failed. This case added important information to our body of knowledge concerning the various clinical features of occult bronchial foreign bodies.

성인에서의 잠복 기관지 이물은 소아의 기관지내 이물 흡인과 달리 매우 드물며 아직까지 기관지나 폐의 연관손상 정도와 잠복기간에 따른 치료전략이 정립되어 있지 않은 상태다. 과거력상 반복적인 기침과 객담, 발열을 경험하였으나 30년 전에 사인펜 뚜껑이 기도내로 흡인되었던 사실을 인지하지 못하던 40세 남자 환자가 동일 주소와 영상검사상 우중엽 및 하엽의 허탈과 폐쇄성 폐간질염 소견으로 전원되었다. 처음엔 기관지경 이물 제거와 내과적 치료를 계획하였으나 제거가 불가능하였고 결국 개흉후 양엽 절제를 통해 치료하였다. 저자들은 본 증례가 잠복성 기관지 이물의 다양한 임상상 축적에 중요한 정보를 제공하였다고 생각한다.

Keywords

References

  1. Jackson C, Jackson CL. Diseases of the air and food passages of foreign body origin. Philadelphia: WB Saunders Co. 1936
  2. Chen CH, Lai CL, Tsai TT, Lee YC, Perng RP. Foreign body aspiration into the lower airway in chinese adults. Chest 1997;112:129-33 https://doi.org/10.1378/chest.112.1.129
  3. McGuirt WF, Holmes KD, Feehs R, Browne JD. Tracheobronchial foreign bodies. Laryngoscope 1988;98:615-8
  4. Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med 1990;112:604-9 https://doi.org/10.7326/0003-4819-112-8-604
  5. Lee SJ, Oh JY, Lee SY, Lee CS, Lee KR. Middle lobe syndrome caused by occult foreign body in the bronchus intermedius. Korean J Thorac Cardiovasc Surg 2006;39:498-501
  6. Dicpinigaitis PV, Bleiweiss IJ, Krellenstein DJ, Halton KP, Teirstein AS. Primary endobronchial actinomycosis in association with foreign body aspiration. Chest 1992;101:283-5 https://doi.org/10.1378/chest.101.1.283
  7. Weissberg D, Schwartz H. Foreign bodies in the tracheobronchial tree. Chest 1987;91:730-3 https://doi.org/10.1378/chest.91.5.730
  8. Turut H, Gulhan E, Tastepe I. Occult bronchial foreign body in the middle lobe in an adult: should it be removed or not? Respirology 2006;11:833 https://doi.org/10.1111/j.1440-1843.2006.00935.x