Successful Removal by Flexible Fiberopitc Bronchoscopy of a Denture Firmly Impacted in the Left Main Bronchus: A Case Report

以軟式光纖支氣管鏡成功移除緊塞於左側主支氣管的一列假牙：病例報告

杜美玉(May-Yu Tu) ； 林恆毅(Hen-I Lin) ； 張炎德(Yen-Teh Chang)

《輔仁醫學期刊》 2卷4期 (2004/12) Pp. 253-257

摘要

成人發生異物吸入呼吸道的機會比幼兒少見，並且異物卡在左側王支氣管的案例更少見。我們報告一個罕見的病例，一個成年男子於睡覺時吸入一列假牙，而且它剛好緊緊塞住了左側主支氣管。這個四十一歲男性因發燒求診，同時主訴前三週出現間歇性咳嗽有痰的症狀。胸部X光檢查顯示患者左側主支氣管部位有一個異物，當以軟式光纖支氣管鏡檢查時，發現是一個金屬假牙緊緊塞住了左側主支氣管。我們曾經嚐試使用夾子及異物擷取籃皆無法取出此假牙，後來我們利用一支雙關節刮匙(double-jointed curette)，終於勾出這一列假牙。在取出這一個異物後，患者說不再發燒，也順利出院。此一成功處置可讓這位患者免除了非必要的全身麻醉，同時也縮短了住院期間，減少費用。臨床工作者可嚐試喜用手邊的工具，來解決困難。

關鍵字

異物吸入 ； 左側主支氣管 ； 假牙 ； 較式光纖支氣管鏡 ； 雙關節刮匙

並列摘要

Foreign body aspiration into the airway is less common in adults than in children. The left main bronchus is also a less frequent site of foreign body aspiration in adults. We report an unusual case of a 41 year old man who aspirated a denture during sleep. It became tightly lodged in his left main bronchus. He presented withal day history of fever and intermittent productive cough for 3 weeks. His chest x ray revealed a radiopaque foreign body positioned in the left main bronchus. We performed flexible fiberoptic bronchoscopy and detected a denture firmly impacted in the left main bronchus. It could not be grasped by the use of forceps, nor could it be extracted by baskets. We finally used a double jointed curette to hook it and successfully extract it. The fever subsided after its removal. This management prevented unnecessary general anesthesia and reduced the hospital stay for this patient. Clinicians should make use of available instruments in difficult situations.

並列關鍵字

foreign body aspiration ； left main bronchus ； denture ； flexible fiberoptic bronchoscopy ； double-jointed curette