Page 85 - ECBIP 2021_Program

MODERATED e-POSTER SESSION 09:
Miscellaneous and Rare Diseases
PP59
Introduction: Foreign body aspiration is rarely observed in adults. The major risk factors are advancing age, depressed mental status and impairment in the swallowing reflex. Aspirations can happen by accident. The habit of holding pins in between the lips to free hands is very common among dressmakers, shoemakers and carpenters. However, if in that moment they need to talk, laugh or cough they might accidently aspirate the pin into the tracheobronchial tree. The major risks are associated with mobilization of the pin that can pierce the bronchial wall and cause haemoptysis, pneumothorax or pneumomediastinum.
Methods: The authors report a clinical case that happened in a Portuguese tertiary hospital.
Results: A healthy 44-year-old dressmaker presented in the emergency department after accidental aspiration of a pin. She presented hemodynamically stable, with only a single episode of small volume haemoptysis. On the chest X-ray, no pneumothorax or other complications were detected. An urgent rigid bronchoscopy showed the pin located in the anterior segment of the right basal pyramid, however as the sharp end of the pin was firmly stuck on the bronchial wall with surrounding hyperemic and edematous mucosa, the removal was not achieved. A thoracic computed tomography (CT) confirmed the presence of a 3.2cm pin in the anterior segmental bronchus of the right lower lobe, associated with bronchial parietal thickening,and no other complications (fig 1.A-B.).The patient was admitted and started intravenous corticosteroids. Four days later, she underwent a new rigid bronchoscopy: as the pin was still stuck, when trying to pull it out, it pierced further into the bronchial wall. Flexible bronchoscope was introduced through rigid bronchoscope and it was possible to pass by the pin, grab it from underneath and then pull it up and remove it (fig 1.C-D.). The later chest X-ray showed no complications.The patient was discharged with prophylactic Amoxicillin-Clavulanate and presented a full recovery.
Conclusion: Right side is the most common site of aspiration due to its more vertical and wider structure. Chest X-ray and thoracic CT can be important in locating aspirated pins and exclude complications. Still, the most important approach remains direct visualisation of the tracheobronchial tree, by flexible or rigid bronchoscopy. Rigid bronchoscopy is usually preferred for the removal of sharp objects since it reduces the risk of piercing the bronchial wall and it is safer in case of haemorrhage.The prognosis is excellent if a rapid and uncomplicated extraction is achieved.
Figure 1
PP60
PUT A PIN IN THAT...OR MAYBE NOT! - CLINICAL REPORT OF AN ACCIDENTAL ASPIRATION OF A PIN
Catarina Gouveia Cardoso1, Cláudia Freitas1,2, Gabriela Fernandes1,2, Adriana Magalhães1 1 Pulmonology Department, Centro Hospitalar E Universitário De S. João, Porto, Portugal
2 Faculty of Medicine, University of Porto, Porto, Portugal
WITHDRAWN
ECBIP 2021 85
6th European Congress
for Bronchology and Interventional Pulmonology
OCTOBER ECBIP 15 - 17
ATHENS - GREECE 2021
Book of Abstracts