A Case with Pneumonia and Empyema Caused by a Bronchial Foreign Body (Crab Meat)

DOI
  • Kuwabara Masayoshi
    Department of Chest Diseases and Thoracic Surgery Kansai Denryoku Hospital
  • Itoi Kazumi
    Department of Chest Diseases and Thoracic Surgery Kansai Denryoku Hospital
  • Ariyasu Tetsuya
    Department of Chest Diseases and Thoracic Surgery Kansai Denryoku Hospital
  • Yanagihara Kazuhiro
    Department of Chest Diseases and Thoracic Surgery Kansai Denryoku Hospital
  • Nasu Takashi
    Department of Chest Diseases and Thoracic Surgery Kansai Denryoku Hospital
  • Fukuse Tatsuo
    倉敷中央病院呼吸器科

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Other Title
  • 気管支内異物(カニの肉)により肺炎, 膿胸をきたした 1 切除例

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Description

A 46-year-old male aspirated crab meat during a meal. He underwent bronchoscopy in a near-by hospital, but the foreign body was not identified. The patient visited our hospital 3 months later because of bad-smelling breath and repeated pneumonia. Chest X-ray examination showed no abnormalities, but bronchoscopy revealed putrid crab meat in the right basal bronchi, B^7 B^8 B^9 and their peripheral bronchi. The foreign body was removed bronchoscopically by suction and lavage. The mucosa of the basal bronchus was narrowed by granulation. The clinical caurse was observed for one month, but improvement of the thickened bronchial mucous membrane was not recognized bronchoscopically. The granulation was cauterized by Nd-YAG-laser and the stenosis in the basal bronchus disappeared. Three months later, the patient suffered from pneumonia repeatedly and empyema in the right side. Chest drainage was not successful, so, decortication and right inferior lobectomy were performed. The resected specimen showed hypertrophy of the bronchial walls extending to the segmental bronchi. In this case, pulmonary problems were caused by aspiration of crab meat, based on the local eating habits.

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