Optimal intervention: Flexible Fiberoptic Bronchoscopy’s Role in Chronic Aspiration Foreign Body Removal

Teuku Zulfikar; Syarial Akbar; Rifian Arnanda

doi:10.60084/ijcr.v1i1.64

Authors

Teuku Zulfikar Department of Pulmonology and Respiratory Medicines, Faculty of Syiah Kuala, Univeristas Syiah Kuala/Zainoel Abidin Hospital, Banda Aceh, Indonesia
Syarial Akbar Resident of Pulmonology and Respiratory Medicines, Faculty of Syiah Kuala, Universitas Syiah Kuala/Zainoel Abidin Hospital, Banda Aceh, Indonesia
Rifian Arnanda Resident of Pulmonology and Respiratory Medicines, Faculty of Syiah Kuala, Universitas Syiah Kuala/Zainoel Abidin Hospital, Banda Aceh, Indonesia

DOI:

https://doi.org/10.60084/ijcr.v1i1.64

Keywords:

Intervention, Flexible bronchoscopy, Chronic aspiration, Lower airway aspiration

Abstract

Foreign body aspiration in the lower airway is prevalent among children under 5 years old and rare among adults, except in cases of neurodegenerative or neuromuscular conditions. This condition is linked to substantial morbidity, necessitating awareness of potential complications. Flexible bronchoscopy stands as a primary method for foreign body removal. We present a case of a 56-year-old male who aspirated a denture 15 years ago. Recent symptoms encompassed persistent hemoptysis, worsening over two weeks, accompanied by mucopurulent sputum, fever, chest pain, and dyspnea. Physical examination indicated shortness of breath with positive rhonchi. X-ray revealed tubular opacities and atelectasis. Two days post-admission, flexible bronchoscopy exposed moderate mucopurulent secretion in both bronchial trees, with multifocal hyperemic edematous mucosal changes in the right bronchial tree. A denture was successfully extracted from the lower left lobe during the procedure. Treatment included antibiotics, bronchodilators, and mucolytics. Flexible fiberoptic bronchoscopy's adaptability allows local anesthesia usage, reducing costs and risks. The integration of high-definition imaging in flexible bronchoscopes enhances airway visualization and foreign body localization, ensuring precise and safe removal.

Downloads

Download data is not yet available.

References

Jang, G., Song, J. W., Kim, H. J., Kim, E. J., Jang, J. G., Cha, S.-I. (2022). Foreign-body aspiration into the lower airways in adults; multicenter study., PloS One, Vol. 17, No. 7, e0269493. doi:10.1371/journal.pone.0269493
Blanco Ramos, M., Botana-Rial, M., García-Fontán, E., Fernández-Villar, A., Gallas Torreira, M. (2016). Update in the extraction of airway foreign bodies in adults., Journal of Thoracic Disease, Vol. 8, No. 11, 3452–3456. doi:10.21037/jtd.2016.11.32
Sarkar, A., Murthy, V. (2021). Foreign body aspiration: A review of current strategies for management, Shanghai Chest, Vol. 5, No. July, 1–8. doi:10.21037/shc-20-38
Cramer N, Jabbour N, Tavarez MM, et al. (2023). Foreign Body Aspiration, StatPearls Publishing, Treasure Island (FL)
Moslehi, M. A. (2019). A rare case of massive foreign body aspiration mimic asthma., Respiratory Medicine Case Reports, England, 100963. doi:10.1016/j.rmcr.2019.100963
Sehgal, I. S., Dhooria, S., Ram, B., Singh, N., Aggarwal, A. N., Gupta, D., Behera, D., Agarwal, R. (2015). Foreign Body Inhalation in the Adult Population: Experience of 25,998 Bronchoscopies and Systematic Review of the Literature., Respiratory Care, Vol. 60, No. 10, 1438–1448. doi:10.4187/respcare.03976
Cravo, J., Marques, M. A. T. (2018). Endobronchial foreign bodies in adults - Flexible bronchoscopy as a first approach., Pulmonology, Spain, 198–199. doi:10.1016/j.pulmoe.2018.01.003
Hewlett, J. C., Rickman, O. B., Lentz, R. J., Prakash, U. B., Maldonado, F. (2017). Foreign body aspiration in adult airways: therapeutic approach., Journal of Thoracic Disease, Vol. 9, No. 9, 3398–3409. doi:10.21037/jtd.2017.06.137
Sancho-Chust, J. N., Molina, V., Vañes, S., Pulido, A. M., Maestre, L., Chiner, E. (2020). Utility of Flexible Bronchoscopy for Airway Foreign Bodies Removal in Adults., Journal of Clinical Medicine, Vol. 9, No. 5. doi:10.3390/jcm9051409
Fang, Y.-F., Hsieh, M.-H., Chung, F.-T., Huang, Y.-K., Chen, G.-Y., Lin, S.-M., Lin, H.-C., Wang, C.-H., Kuo, H.-P. (2015). Flexible bronchoscopy with multiple modalities for foreign body removal in adults., PloS One, Vol. 10, No. 3, e0118993. doi:10.1371/journal.pone.0118993