A Case of a Bronchial Foreign Body Consisting of a Fish Bone Which Was Difficult to Remove Bronchoscopically

Abstract

Background. We report a bronchial foreign body consisting of a V-shaped fish bone which flexible bronchoscopic removal was difficult. Case. A 75-year-old man presented at another hospital complaining of laryngopharyngeal discomfort cough and bloody sputum. He was referred to our hospital with a diagnosis of a bronchial foreign body in the left main bronchus on chest computed tomography. Six weeks previously, he had a fit of coughing while ingesting sea bream soup. Flexible bronchofiberscopic examination showed a V-shaped fish bone in the left main bronchus (longer axis 2.5cm, shorter axis 1.5cm). We grasped the shorter part of the V-shaped fish bone with alligator forceps and tried to remove it. However, it was difficult to remove it, because the longer axis of the V-shaped fish bone exceeded the length of the bronchial lumen diameter. After that, we grasped the long part of V-shaped fish bone with the alligator forceps and removed it successfully. Conclusion. Clinicians can generally remove needle-like fish bones relatively easily by flexible bronchoscopy. However, if the fish bone is V-shaped, it can become difficult to remove it when one side is long and the angle is wide. In such cases, clinicians should consider the indications of rigid bronchoscopy or surgical operation.