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S-388 Two cases Pill induced bronchitis : Showing importance of timely removal by bronchoscopy
( Mi Ran Lee ),( Eun Joo Lee ),( Yoon Jung Kim ),( Byung Joon Lee ),( Hyo Jeong Lim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Introduction:?An aspirated pill can dissolve in the tracheobronchial tree causing inflammation and stenosis. Prompt recognition and timely removal of aspirated pill is essential to avoid serious sequelae in the airways. Here we report two cases of pill induced bronchitis resulted in airway inflammation and narrowing.?Case1:?A 83-year-old man presented with a 1-week history of blood tinged sputum, chest discomfort. A chest computed tomography (CT) scan showed 1.1cm sized ovoid material in right lower lobar (RLL) bronchus. We found out a partially dissolved pill impacted in RLL bronchus by bronchoscope. Bronchial mucosa were swollen and covered with inflammatory exudates. Four days after, inflammation of bronchus was still ongoing. Growth of granulation tissue, swelling and necrotic debris led to narrowing of bronchus.?Case2:?A 87-year-old man was visited our emergency room for chest discomfort and cough. A chest CT scan revealed a foreign body in RLL bronchus with peribronchial consolidation. We could perform the bronchoscopy. A pill was not present but we presumed that the pill had dissolved into the bronchial mucosa. After 1 week, necrotic change of bronchus intermedius and narrowing of RLL bronchus were progressing. After one month, narrowing of RLL bronchus was aggravated with granulation tissue, necrotic debris and fibrotic changes.?Conclusions:?Our cases suggest that if pill aspiration is suspected, early diagnosis and urgent management by bronchoscope is necessary in order to reduce the serious sequelae in the airway.