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Vol. 53. Num. 7.July 2017Pages 357-412
Vol. 53. Num. 7.July 2017Pages 357-412
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DOI: 10.1016/j.arbr.2017.05.004
An Unusual Case of Bronchoaspiration of a Foreign Body in a Polytraumatized Patient
Un caso particular de broncoaspiración de cuerpo extraño en el paciente politraumatizado
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María A. Ballesterosa,
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gelesballesteros@yahoo.com

Corresponding author.
, Enrique Chicote Álvareza, Victor M. Mora Cuestab
a Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
b Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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Cases of bronchoaspiration of teeth have been described in polytrauma patients,1 but aspiration of other foreign bodies is less common. Clinical suspicion, a detailed clinical history, and a comprehensive evaluation of diagnostic tests are essential to rule out aspiration in this type of patient.2

We report the case of 45-year-old man who was admitted to the intensive care unit for multiple injuries resulting from a high-impact accident. He had Glasgow coma scale score 8, anisocoria, periorbital hematoma, and facial wounds. Airway patency was ensured with a cervical collar, and sedation and analgesia were given along with mannitol to control intracranial hypertension. A radiological study was performed, showing severe cranioencephalic trauma and facial injuries. A review of the chest computed tomography revealed a radio-opaque image in the tracheal carina (Fig. 1A). The oral cavity was examined and all teeth were found to present. Flexible fiberoptic bronchoscopy was performed, showing that the object was a stone measuring 1cm in its longest diameter. The foreign body had moved to the right primary bronchus so a balloon was used to bring it up to the carina, from where it was extracted (Fig. 1B). After it was removed, the bronchial tree was examined again with fiberoptic bronchoscopy, and no other fragments were found. The patient progressed favorably and could be extubated 48h after admission.

Fig. 1.
(0.12MB).

(A) Chest tomography sagittal slice showing a radio-opaque foreign body in the carina. (B) Stone, 1cm in largest diameter, extracted by fiberoptic bronchoscopy.

References
[1]
K. Madan,A.N. Aggarwal,H. Bhagat,N. Singh
Acute respiratory failure following traumatic tooth aspiration
BMJ Case Rep, 201 (2013),
pii:bcr2012008393
[2]
L. Wang,B. Pudasaini,X.F. Wang
Diagnose of occult bronchial foreign body: a rare case report of undetected Chinese medicine aspiration for 10 long years
Medicine (Baltimore), 95 (2016), pp. e4076

Please cite this article as: Ballesteros MA, Chicote Álvarez E, Mora Cuesta VM. Un caso particular de broncoaspiración de cuerpo extraño en el paciente politraumatizado. Arch Bronconeumol. 2017;53:398.

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