Successful Removal of Long-standing Bronchial Foreign Body (Dental Prosthesis) by Flexible Bronchoscopy Under Local Anesthesia: a Case Report

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  • Tokoro Yayoi
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Yasuo Masanori
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Agatsuma Toshihiko
    Department of Respiratory Medicine, Shinshu Ueda Medical Center
  • Yamamoto Hiroshi
    First Department of Internal Medicine, Shinshu University School of Medicine
  • Tani Naoki
    Department of Respiratory Medicine, Suwa Central Hospital
  • Koike Takeshi
    Department of Dental and Oral Surgery, Ina Central Hospital
  • Hanaoka Masayuki
    First Department of Internal Medicine, Shinshu University School of Medicine

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Other Title
  • 局所麻酔下軟性気管支鏡で摘出し得た長期介在気管支異物（歯冠補綴物）の1例

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<p>Background. It is often difficult to remove long-standing bronchial foreign bodies (FB) by bronchoscopy. Case. The patient was a 76-year-old man with a medical history of impaired consciousness because of sequela of intracerebral hemorrhage and who had undergone permanent tracheotomy. He was diagnosed with pneumonia and underwent treatment in a hospital three months previously. On presentation, his chief complaint was purulent sputum and fever and he was diagnosed with pneumonia again in a hospital. A chest X-ray showed a bronchial FB in the right lower lung field. He was transferred to our hospital for the removal of the FB. The FB was found in a chest X-ray taken three months previously; thus, it was considered to be a long-standing bronchial FB. The bronchoscopic examination detected the FB as well as remarkable granulation tissue in the surrounding area; however, it was difficult to clearly visualize the FB due to the purulent secretion from an accompanying lung abscess. The purulent secretion was reduced and the granulation was diminished after antibiotic therapy. Under local anesthesia, the bronchial FB (dental prosthesis) was successfully removed without any complications by flexible bronchoscopy in combination with the use of argon plasma coagulation (APC). Conclusion. Although the long-standing bronchial FB was surrounded by remarkable granulation tissue, with the aid of antibiotic treatment and APC for cauterization and hemostasis using coagulation, the FB was safely and successfully removed by flexible bronchoscopy.</p>

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