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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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Ballesteros, Enrique Chicote Álvarez, Victor M. Mora Cuesta" "autores" => array:3 [ 0 => array:4 [ "nombre" => "María A." "apellidos" => "Ballesteros" "email" => array:1 [ 0 => "gelesballesteros@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Enrique" "apellidos" => "Chicote Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Victor M." "apellidos" => "Mora Cuesta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Un caso particular de broncoaspiración de cuerpo extraño en el paciente politraumatizado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 643 "Ancho" => 1500 "Tamanyo" => 127555 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest tomography sagittal slice showing a radio-opaque foreign body in the carina. (B) Stone, 1<span class="elsevierStyleHsp" style=""></span>cm in largest diameter, extracted by fiberoptic bronchoscopy.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cases of bronchoaspiration of teeth have been described in polytrauma patients,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">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 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). 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 1<span class="elsevierStyleHsp" style=""></span>cm 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 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). 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 48<span class="elsevierStyleHsp" style=""></span>h after admission.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">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.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 643 "Ancho" => 1500 "Tamanyo" => 127555 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest tomography sagittal slice showing a radio-opaque foreign body in the carina. (B) Stone, 1<span class="elsevierStyleHsp" style=""></span>cm in largest diameter, extracted by fiberoptic bronchoscopy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "pii:bcr2012008393" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute respiratory failure following traumatic tooth aspiration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Madan" 1 => "A.N. Aggarwal" 2 => "H. Bhagat" 3 => "N. Singh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "BMJ Case Rep" "fecha" => "2013" "volumen" => "201" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnose of occult bronchial foreign body: a rare case report of undetected Chinese medicine aspiration for 10 long years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Wang" 1 => "B. Pudasaini" 2 => "X.F. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2016" "volumen" => "95" "paginaInicial" => "e4076" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917301738/v1_201706290145/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000007/v1_201706290145/S1579212917301738/v1_201706290145/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917301738?idApp=UINPBA00003Z" ]
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