A Rare Cause of Hemoptysis

Figure

Computed tomography (CT) of the thorax. a) Coronal reconstruction in the lung window with a radiopaque foreign body (arrow); b) Axial reconstruction in the soft tissue window showing destroyed lung tissue of the right lower lobe and coarse cystoid remodeling

A 23-year-old female patient presented to the emergency department with progressive cough and pronounced hemoptysis. In her patient history, she reported having “swallowed” a foreign body (FB) at the age of 6 years. No further diagnostic evaluation had been carried out at that time. Contrast-enhanced computed tomography was performed on the patient, who was unstable. This revealed a FB in a right lower lobe bronchus (segment 10) (Figure a). The lung tissue was destroyed and exhibited coarse cystoid remodeling (Figure b). By means of bronchoscopy, it was possible to stop the hemorrhage using a bronchus blocker combined with the administration of suprarenin, but the FB could not be identified. Due to destruction of the lower lobe, resection that included the FB (small pipe) was performed. The patient was symptom-free in the further course. FB aspiration generally occurs in young children aged between 6 months and 4 years. Predominantly food is aspirated, while older toddlers tend to aspirate small toys and objects. The immediate result is usually coughing, which abates or disappears in the further course. The event is often forgotten and manifests secondarily, for example, as a chronic respiratory infection.

Dr. med. Daniel Vogele, Dr. med. Benedikt Haggenmüller, Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm,

Dr. med. Gunter Lang, Klinik für Herz-, Thorax- und Gefäßchirurgie, Universitätsklinikum Ulm

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Vogele D, Lang G, Haggenmüller B:A rare cause of hemoptysis. Dtsch Arztebl Int 2023; 120: 2. DOI: 10.3238/arztebl.m2022.0383