抄録
A 68-year-old woman was introduced as a case of bronchial foreign body of long sojourn to my clinic by a surgeon. When she had complained of stomachache, the surgeon had taken a X-ray photograph of her chest and happened to f ind a hook staying in her right bronchus. Peroral bronchoscopical removal was attempted at f irst. The hook which was buried in granulation seemed to be moving slightly, but the procedure was unavoidably given up because of bleeding. Since there appeared the subcutaneous emphysema in the neck and face 10 minutes after the bronchoscopy, tracheotomy was performed immediately. Within a week all evidence of subcutaneous emphysema completely disappeared, and the hook was easily removed percervical bronchoscopically.
What was extraordinary in this case was that in spite of the patient being adult a hook was inspirated unconsciously and by chance found staying in the bronchus after an erroneous treatment for some period for bronchial asthma because of stridor and cough. In the adult so rarely happens an accident of foreign body which has been unconsciously inspirated that it is apt to be overlooked. At the diagnosis of the chest disease therefore we should have it in mind that the case might be of foreign body notwithstanding a clear history of foreign body accident of air passage.
It was considered that the subcutaneous emphysema in the first procedure was caused by the mediastinal emphysema due to the microperforation in bronchial wall by the stirring of the hook.
