Spontaneous expulsion of an intrabronchial sharp metallic foreign body and migration to the gastrointestinal tract at Muhimbili National Hospital: Case report and literature review

Abstract

Introduction: Aspirated foreign bodies continue to pose challenges to Otorhinolaryngologists and are potentially life threatening thus an otorhinolaryngological emergency. The main stay of treatment of foreign bodies (FBs) in the tracheobronchial tree remains to be bronchoscopy while bearing in mind earlier and safer removal of such foreign bodies. Spontaneous expulsion of an Intrabronchial foreign body is a rare entity with few cases reported in the available literatures.

Presentation of case: We are reporting a rare case of a 3-year old male child who presented to otorhinolaryngology department with a 2-days history of foreign body inhalation (sharp metallic pin) prior admission which undergone spontaneous migration and went to be excreted in feaces after passing through the gastrointestinal tract.

Discussion: It is unwise, dangerous and inadvisable to wait for spontaneous expulsion in cases of intrabronchial foreign body but while preparing for endoscopy, a constant watch should be kept over the patient and every forceful bout of cough should be looked with suspicion of spontaneous expulsion and a danger of foreign body lodgment into subglottis during such rare but possible occurrence should be kept in mind.

Conclusion: It's always worth to rule out the possibility of foreign body inhalation in children with sudden onset of difficulty in breathing to avoid diagnostic delays.

Keywords: Expulsion; Foreign body; Intrabronchial; Spontaneous; Tanzania.

Fig. 1

Chest x-ray showing the metallic pin being located in the left main bronchus.

Fig. 2

Showing the pin after being passed in stool.