Cases reported "Foreign Bodies"

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1/8. Successful bronchoscopic retrieval of Timothy grass from the airway.

    Aspiration of Timothy grass in the airway is a well-recognized cause of bronchiectasis, and management often requires pulmonary resection. The authors describe 2 cases of Timothy grass aspiration with established pulmonary infection that were successfully managed by bronchoscopic removal with subsequent improvement. Every effort should be made to accomplish this goal, and pulmonary resection should be considered a last resort in these cases.
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2/8. Group F streptococcal empyema from aspiration of a grass inflorescence.

    A previously healthy 15-year-old boy was seen with a loculated right lower lobe empyema. Group F beta-hemolytic streptococci were cultured from the pleural fluid. Surgical intervention was required. An unsuspected aspirated grass inflorescence and a bronchopleural fistula were discovered during a decortication procedure.
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3/8. An unusual case of empyema; intrapleural migration of an inhaled oat head in an adult.

    We report an unusual case of unnoticed aspiration of an oat head by a healthy 19-year-old male. The foreign body migrated to the right pleural cavity and caused a severe persistent empyema, which resolved only after a thoracotomy . The lodging of a grass head in the pleura is a very rare event, almost never reported in an adult.
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4/8. Grassheads in the tracheobronchial tree: two different outcomes.

    Many vegetable foreign bodies can produce serious pulmonary complications because of chemical irritation to the airway. Barley grass, a type of grasshead, does not induce such a reaction because of its resistance to organic decay. Complications which may occur are illustrated by the clinical course of two patients with aspiration of this foreign body. In the first patient the grasshead entered the trachea with the flowering unit first and the stem following. In the second patient the stem entered the trachea first. Recurrent pneumonias were noted in the first patient. Despite its presence in the right stem bronchus for three years, no further episodes of pneumonia followed its removal. In the second patient the grassheads could not be removed endoscopically. They migrated into the right lower lobe producing pneumonia and ultimately resulting in a brain abscess. The difference of entry of the same foreign body into the trachea, stem first versus flowering unit first, is an essential factor in altering the clinical outcome.
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5/8. bronchiectasis in pediatric patients resulting from aspirated grass inflorescences.

    A grass inflorescence (flowering head) aspirated by a child is difficult to diagnose, and frequently cannot be retrieved by bronchoscopy. Of four pediatric patients with aspirated grass inflorescences, two had severe hemoptysis and the other two were septic at the time of diagnosis. Their chronic debilitation and bronchiectasis necessitated an eventual pulmonary resection, with full recovery in all four patients.
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6/8. Foreign body aspiration of grass inflorescences as a cause of hemoptysis.

    Although the sparsity of reports in the literature suggest aspiration of grass inflorescence is rare, in certain areas of the southern united states, aspiration of this type of foreign body is not so uncommon. Four cases of aspiration of hordeum pusillium, often referred to as "cheat grass" are reported: three of the four patients had hemoptysis. The highest incidence of inhaled foreign bodies usually occur in young children, but all our four patients were older children or adolescents. The clinical manifestations of grass inflorescence are of the following two types: (1) the "lodging" type in which inflorescences remain in the respiratory passages causing bronchial obstruction with pneumonitis; and (2) the "extrusive type" in which the inflorescences migrate into the periphery of the lung and through the chest wall.
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7/8. A bronchopleurocutaneous fistula caused by an unusual foreign body aspiration simulating acute abdomen.

    A 12-year-old boy was admitted to hospital for abdominal pain, vomiting and fever. On physical examination he had rales on the lower right hemithorax without any respiratory complaints. Chest X-ray revealed a condensation in the right lower chest. Abdominal findings were secondary to lobar pneumonia. Treatment of pneumonia with antibiotics showed no improvement over 2 days. On bronchoscopy no foreign body was seen, but pus was aspirated. Two days later a mass appeared on the right hemithorax and fistulized. An organic foreign body, hordeum murinum, with 3-5 ml of pus was observed. Chest X-ray taken at the day of fistulization showed no pneumothorax or subcutaneous emphysema. Less than 11 cases of pneumocutaneous fistulas secondary to aspiration of grasses have been reported in literature. Why an ear of hordeum murinum can migrate only in a forward direction and why a pneumothorax had not developed is discussed.
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8/8. Tension pneumothorax secondary to grass head aspiration.

    Aspiration of inflorescence or grass heads (seed head of grasses) often presents with atypical signs and symptoms because grass heads have a tendency to rapidly migrate to the periphery of the lung. If this is not recognized, it can lead to delay in diagnosis and serious complications. Removal with rigid bronchoscopy maybe difficult, and surgery is often needed. We report a case of a seven-month-old child who had a delayed diagnosis of grass head aspiration and subsequently presented with a life threatening tension pneumothorax. This case highlights the importance of obtaining a detailed history in cases of foreign body aspiration and the need to include it in the differential diagnosis of unexplained respiratory symptoms, especially those of sudden onset in children.
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