CT findings of the chest in adults with aspirated foreign bodies

The aim of this study was to assess the imaging findings in adult patients with tracheobronchial foreign body aspiration. Nineteen patients (11 men and 8 women; age range 26-89 years) with foreign-body aspiration were retrospectively reviewed. Nine patients were outpatients with non-specific symptom...

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Bibliographic Details
Published in:European radiology 2001-01, Vol.11 (4), p.606-611
Main Authors: Zissin, R, Shapiro-Feinberg, M, Rozenman, J, Apter, S, Smorjik, J, Hertz, M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Bronchi
Female
Foreign Bodies - complications
Foreign Bodies - diagnostic imaging
Humans
Inhalation
Lung Diseases - diagnostic imaging
Lung Diseases - etiology
Male
Middle Aged
Radiography, Thoracic
Retrospective Studies
Tomography, X-Ray Computed
Trachea - diagnostic imaging
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Summary:The aim of this study was to assess the imaging findings in adult patients with tracheobronchial foreign body aspiration. Nineteen patients (11 men and 8 women; age range 26-89 years) with foreign-body aspiration were retrospectively reviewed. Nine patients were outpatients with non-specific symptoms and ten were hospitalized with nonresolving pneumonia (n = 6), after detection of a dental fragment on a chest radiograph following intubation (n = 3), and there was one mentally retarded patient with empyema. An aspirated dental fragment was seen on a chest radiograph in 3 patients and an endobronchial foreign body on CT in 16, appearing as a dense structure within the bronchial lumen. The foreign body was right sided in 14 cases and left sided in 5. Three cases were missed at first interpretation. Associated findings on CT were volume loss, hyperlucency with air trapping and bronchiectasis in the affected lobe. Thirteen patients were managed with bronchoscopy, whereas 2 needed thoracotomy. In 1 patient bronchoscopy failed to detect a foreign body, indicating a false-positive CT diagnosis. One patient expelled an aspirated tablet and two refused invasive procedure. The foreign bodies found mainly were bones and dental fragments. A high clinical suspicion is necessary to diagnose a foreign body. Since CT is often used to evaluate various respiratory problems in adults, it may be the first imaging modality to discover an unsuspected aspirated foreign body in the bronchial tree.
ISSN:0938-7994
1432-1084
DOI:10.1007/s003300000619