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. 2021 Sep:86:106340.
doi: 10.1016/j.ijscr.2021.106340. Epub 2021 Aug 24.

Unusual longstanding intrabronchial foreign body masquerading as intractable bronchial asthma in an adult: Case report and literature review

Zephania Saitabau Abraham  1 , Faustine Bukanu  2 , Olivia Michael Kimario  3 , Aveline Aloyce Kahinga  4
Affiliations

Unusual longstanding intrabronchial foreign body masquerading as intractable bronchial asthma in an adult: Case report and literature review

Zephania Saitabau Abraham et al. Int J Surg Case Rep. 2021 Sep.

Abstract

Introduction and importance: Tracheo-bronchial foreign body inhalation is a very common encounter in clinical practice among pediatric patients and rarely seen among adults. When inhalation of foreign bodies occurs in adults then it tends to lodge within the right bronchial tree but in children it lodges in the central airways.

Case presentation: We present a 58 year old woman, known asthmatic for 20 years and non-smoker who presented to our clinic which history of chronic cough, wheezing and pulmonary infections that did not respond to regular antibiotics and the usual antiasthmatic medications. She reported to have inhaled a foreign body about 18 years earlier. Extraction of the foreign body was performed without complications.

Clinical discussion: A chest x-ray done was found to be normal and computerized tomography scan (CT scan) of the chest was ordered and revealed bronchial wall thickening with a calcified foreign body seen in the right intermediate bronchus. A combined rigid and flexible endoscopic bronchoscopy was performed and a chicken bone (measuring 2 cm × 1.5 cm) was extracted from the right intermediate bronchus with very minimal bleeding being encountered during and post bronchoscopy. Extraction of the foreign body was performed without complications. Post endoscopic intrabronchial foreign body removal, the patient recovered completely.

Conclusion: An intrabronchial foreign body being masked for more than a decade by co-existent bronchial asthma is a rare encounter. Moreover, adult patients with chronic cough should be handled with caution to rule out the possibility of FB aspiration.

Keywords: Bronchial asthma; Foreign body; Intrabronchial; Longstanding.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Photograph 1
Photograph 1
CT scan of the chest showing a calcified foreign body in the right intermediate bronchus.
Photograph 2
Photograph 2
A piece of chicken bone upon its removal by means of bronchoscopy.
Photograph 3
Photograph 3
Intraoperative endoscopic view of the foreign body in the right intermediate bronchus.
See this image and copyright information in PMC

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