ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Chicken Bone Gone Wrong
Session Title
TP38 - TP038 INTERESTING AND CHALLENGING CASES IN INTERVENTIONAL PULMONOLOGY
Abstract
A2196 - Chicken Bone Gone Wrong
Author Block: Z. Deen1, S. Chauhan2, R. Dadhwal3, U. Kulsum4; 1Jamaica Hospital Medical Center, Richmond Hill, NY, United States, 2Pulmonology, Jamaica Hospital Medical Center, Richmond Hills, NY, United States, 3Pulmonology, Corpus Christi Medical Center, Corpus Christi, TX, United States, 4Pulmonology, Jamaica Hospital Medical Center, Jamaica, NY, United States.
Foreign body aspiration (FBA) is more common in children. Adults account for approximately 20 % of the cases[1]. They usually have risk factors such as dysphagia, loss of consciousness, intoxication, etc. Presentation is usually with mild symptoms such as intermittent chronic cough or wheezing. Patients can also develop symptoms similar to that of pneumonia. Most patients don’t recall the aspiration episode. The most common location of aspiration is the right mainstem bronchus. Here we present a case of aspiration of a chicken bone in the left mainstem bronchus of an adult with an alcohol abuse history.
A 65-year-old male with a past medical history of hypertension, hyperlipidemia, and alcohol abuse presented to the ED with worsening shortness of breath and productive cough. He also had a chronic intermittent cough for three months. He was treated for suspected pneumonia two-three times as well. On physical exam, he had mild wheezes on the left lung field. Chest X-Ray showed some mild venous congestion. Computed tomography (CT) of the chest showed a 1.8 cm linear hyperattenuating structure in the left bronchus suggestive of a foreign body. Flexible bronchoscopy was done which showed the bone adhered to the bronchial wall and retrieval was unsuccessful due to lack of needed instruments. The patient was referred to another center where it was removed via rigid bronchoscopy with forceps.
The initial modality of choice for foreign body removal is flexible bronchoscopy as it can be done under moderate sedation. Different types of equipment such as forceps, claws, nets, and basket can be used to extract the foreign body. Contact cryotherapy can also be used with flexible bronchoscopy. Care should be taken not to push the foreign body more forward. If flexible bronchoscopy is unsuccessful, rigid bronchoscopy is done which provides excellent airway access with space for multiple instruments to be used while optimum gas exchange takes place.[1]Baharloo F, Veyckemans F, Francis C, et al. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest 1999;115:1357-62.
Author Block: Z. Deen1, S. Chauhan2, R. Dadhwal3, U. Kulsum4; 1Jamaica Hospital Medical Center, Richmond Hill, NY, United States, 2Pulmonology, Jamaica Hospital Medical Center, Richmond Hills, NY, United States, 3Pulmonology, Corpus Christi Medical Center, Corpus Christi, TX, United States, 4Pulmonology, Jamaica Hospital Medical Center, Jamaica, NY, United States.
Foreign body aspiration (FBA) is more common in children. Adults account for approximately 20 % of the cases[1]. They usually have risk factors such as dysphagia, loss of consciousness, intoxication, etc. Presentation is usually with mild symptoms such as intermittent chronic cough or wheezing. Patients can also develop symptoms similar to that of pneumonia. Most patients don’t recall the aspiration episode. The most common location of aspiration is the right mainstem bronchus. Here we present a case of aspiration of a chicken bone in the left mainstem bronchus of an adult with an alcohol abuse history.
A 65-year-old male with a past medical history of hypertension, hyperlipidemia, and alcohol abuse presented to the ED with worsening shortness of breath and productive cough. He also had a chronic intermittent cough for three months. He was treated for suspected pneumonia two-three times as well. On physical exam, he had mild wheezes on the left lung field. Chest X-Ray showed some mild venous congestion. Computed tomography (CT) of the chest showed a 1.8 cm linear hyperattenuating structure in the left bronchus suggestive of a foreign body. Flexible bronchoscopy was done which showed the bone adhered to the bronchial wall and retrieval was unsuccessful due to lack of needed instruments. The patient was referred to another center where it was removed via rigid bronchoscopy with forceps.
The initial modality of choice for foreign body removal is flexible bronchoscopy as it can be done under moderate sedation. Different types of equipment such as forceps, claws, nets, and basket can be used to extract the foreign body. Contact cryotherapy can also be used with flexible bronchoscopy. Care should be taken not to push the foreign body more forward. If flexible bronchoscopy is unsuccessful, rigid bronchoscopy is done which provides excellent airway access with space for multiple instruments to be used while optimum gas exchange takes place.[1]Baharloo F, Veyckemans F, Francis C, et al. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest 1999;115:1357-62.
