The “wandering needle”

Brand, Paul; Rosingh, H. J.

doi:10.1002/ppul.10214

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…A common problem in pin aspiration is that pins can migrate into the airways even with only minor coughing, and due to this, it may be difficult to find them in the same location as they had been in the plain X-ray taken before bronchoscopy (3,14). When faced with a difficult, or distally Figure 1 A chest X-ray of a patient in group II who aspirated two pins, one in the trachea and the other in the left main bronchus located foreign body, fluoroscopic guidance may provide the needed visibility required for successful removal (4,10).…”

Section: Discussionmentioning

confidence: 99%

The role of fluoroscopy in the removal of tracheobronchial pin aspiration

Yüksel

Özyurtkan

Laçin

et al. 2006

International Journal of Clinical Practice

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In this study, we investigated the role of fluoroscopy in the bronchoscopic removal of aspirated pins. Of 373 patients who underwent bronchoscopy for presumed tracheobronchial foreign body aspiration, 56 pin aspiration cases were selected and divided into two groups according to whether fluoroscopic guidance was required (group I) or not (group II). The localisation of foreign bodies, mortality and morbidity ratios and the duration of the procedures were investigated. Pin aspiration percentage was 15. Pins were mostly located in peripheral airways in group I, and in central airways in group II (p < 0.05). The mean duration of the procedure was 42 +/- 30 min in group I and 17 +/- 13 min in group II (p < 0.01). There was no mortality. Morbidity percentage was 7 in group I and 12 in group II (p > 0.05). No thoracotomy was required in any cases. Fluoroscopic guidance is safe and carries no additional morbidity and mortality and can be used for pins in the tracheobronchial tree.

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Section: Discussionmentioning

confidence: 99%

The role of fluoroscopy in the removal of tracheobronchial pin aspiration

Yüksel

Özyurtkan

Laçin

et al. 2006

International Journal of Clinical Practice

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“…In the literature, there is one report of an 8-yearold boy who must have expectorated a needle without noticing, because the bronchoscopy performed a little later also revealed no foreign body after chest-film confirmed aspiration of a needle into his right main bronchus. 4 However, there is no other report of a needle aspiration with concomitant ingestion without this being suspected by the patient.…”

Section: Discussionmentioning

confidence: 94%

Christmas surprise: The unnoticed journey of a needle—from bronchus to intestine

Graffstädt

Dieckow

Grüber

et al. 2005

Respiratory Medicine

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We report on a 14-year-old Arabian girl who suddenly developed coughing after having aspirated a needle used for fixing her headscarf. The chest X-ray showed the needle located in the right main bronchus. However, subsequent flexible bronchoscopy could not detect any foreign body. A further X-ray of the abdomen showed the needle now behind the diaphragm. Gastro-oesophageal endoscopy was also uneventful. On the third day, the needle was excreted naturally. Astonishingly, this journey of the wandering needle from bronchus to intestine was not realised by the patient at any time. Our case highlights that children and adolescents should be warned repeatedly about the risks of putting needles between their teeth. It also reminds the physician to diagnose aspirated foreign bodies as early as possible to prevent wandering and migrating, which may induce new risks and unnecessary diagnostic and therapeutic procedures.

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“…Spontaneous expectoration is not totally safe, there is a risk that the foreign body will get stuck in the subglottic area or even injure the airway if sharp enough, thus causing a lifethreatening emergency [18]. In some patients, the foreign body can be expectorated and ingested to the gastrointestinal tract, this may lead to unnecessary bronchoscopy especially if the x-ray is not repeated prior to bronchoscopy or if the family and patient did not mention any history of bouts of coughing [24]. In our case, despite a long sharp nail having been expectorated, the patient showed no signs or symptoms of post expectoration complications and was sent home in a stable condition.…”

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confidence: 99%

Distal Airway Aspirated Metallic Foreign Body, Case Report of Spontaneous Expectoration

Maary

Alahmari

2020

Am J Case Rep

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Unusual clinical course Background: Foreign body aspiration is one of the life-threatening conditions seen in the adult and pediatric population with most cases occurring within the first 3 years of life. It can result in serious complications or even lead to death. Bronchoscopic removal has been described as the management of choice. Spontaneous expectoration could happen, though it is extremely rare. Case Report: A 7-year-old male presented to the Emergency Department within 3 hours of aspirating a metallic nail. He had a brief choking episode at the beginning and remained asymptomatic thereafter. The initial chest x-ray showed a metallic foreign body (nail) at the retrocardiac area with patent centralized tracheobronchial tree. No radiologic signs of pneumothorax nor pleural or pericardial effusion. Computed tomography (CT) scan was performed the night of admission and revealed a 2 cm nail at the posterior basal segment of the left lower lobe bronchus. Bronchoscopy, thoracoscopic-removal, and possible thoracotomy were discussed. Management options and complications were explained. The parents preferred to wait and observe before making any decision regarding surgical intervention. Surprisingly, while in the hospital, the patient had repetitive cough and the nail was spontaneously expectorated. Conclusions: Urgent bronchoscopy for foreign body aspiration is mandatory as early as possible, however, expectant management in asymptomatic distal airway foreign body aspiration is reasonable. Spontaneous expectoration is a possible outcome though extremely rare.

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The “wandering needle”

Cited by 6 publications

References 9 publications

The role of fluoroscopy in the removal of tracheobronchial pin aspiration

The role of fluoroscopy in the removal of tracheobronchial pin aspiration

Christmas surprise: The unnoticed journey of a needle—from bronchus to intestine

Distal Airway Aspirated Metallic Foreign Body, Case Report of Spontaneous Expectoration

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