Case of Missing Plastic: Foreign Body Bronchiectasis

Abstract

Bronchiectasis is a well-known entity where the airways abnormally dilate losing their natural function. Most common causes of non-cytic fibrosis bronchiectasis in the middle age group include secondary immunodeficiency, aspiration, and allergic bronchopulmonary aspergillosis (ABPA). Obstructive foreign body is an uncommon cause of bronchiectasis and is often a missed diagnosis in a localized disease. Foreign bodies can be missed making the diagnosis and treatment more challenging and hence foreign body bronchiectasis should be considered in patients presenting with focal disease. Here we describe a patient with a retained foreign body that was discovered post lobectomy during gross pathological examination of the specimen with no significant aspiration history, non-diagnostic imaging of the chest and negative bronchoscopy.

Where is the missing chicken bone? A case of foreign body cystic bronchiectasis

“…Amongst organic foreign body aspirated are nuts or seeds, corn kernel, vegetable matter and bones while regular inorganic foreign body retrieved are dental material, denture fragments, plastic pieces, pills or even nasal ring as reported in one article. (Al-Majed et al, 1997;Castillo-Latorre et al, 2021;Dikensoy et al, 2002;James et al, 2006;Jawarkar et al, 2016;Palasamudram Shekar et al, 2018;Swanson et al, 2003). Clinical presentation for FBA varies according to the level of obstruction and depends on either acute or chronic occurrence.…”

“…In neglected or overlooked FBA, the impacted foreign body usually small and tend to lodge distally within the bronchi, leading to chronic respiratory symptoms. In this case, clinical presentations might be due to complication of aspirated foreign body such as bronchiectasis or obstructive pneumonia, which consist of prolonged productive cough, haemoptysis and recurrent pneumonia that is not fully responded to adequate antibiotic; or it can be completely asymptomatic (Al-Majed et al, 1997;Jawarkar et al, 2016;Palasamudram Shekar et al, 2018;Wu et al, 2012).…”

“…In acute setting of FBA or obstruction of the larynx, there will be a brief episode of choking and gagging which later developed into inspiratory stridor with bouts of coughing, associated with hoarseness, aphonia and cyanosis once the foreign body passes through the vocal cords into the subglottic and tracheal region. The moment foreign body dislodges further into the bronchi, in case of smaller size, these symptoms might resolve with a relatively 2016; Palasamudram Shekar et al, 2018;Wu et al, 2012).…”

Untitled

“…It can also be used as a means to preserve the natural teeth postponing implant placement to later stages. Shekar et al, 2018;Wu et al, 2012).…”

Current Approach to Diagnosis and Treatment of Foreign Body in Otorhinolaryngology

“…Some of the possible complications are pneumonia, bronchiectasis, emphysema, empyema, and so forth. For that reason, in every patient with recurrent or long-standing pneumonia, FB must be considered [43,44].…”