Case report – An iatrogenic foreign body in the airway

Abstract

We report a case of an iatrogenic foreign body in the airway. An 80-year-old patient who had undergone major head and neck surgery several weeks early presented as an inpatient with a persistent cough and recurrent chest infections. Fibreoptic nasendoscopy revealed the presence of a nasopharyngeal airway sitting vertically in the airway. This foreign body presented indolently as it was cannulated. We suggest that in such patients, readers should be aware of this possible underlying iatrogenic cause of respiratory complications.

Who “Nose” Where the Airway Is?

“…In the course of perioperative airway management, it is possible for the NPA to be aspirated or become lodged in the airway. Although the incidence of airway device aspiration is not known from any systematic study, published case reports 1‐4 and anecdotal evidence suggest that this case is not unique.…”

“…Patients who have aspirated airway devices can have different clinical presentations, depending on the degree of airway occlusion. The aspiration of an NPA may not be obvious because the open lumen of the airway device may allow air to pass with little or no obvious obstruction 1‐3 . Providers should be aware that patients who have undergone procedures that involved NPAs are at risk for immediate and delayed airway complications.…”

“…Providers should be aware that patients who have undergone procedures that involved NPAs are at risk for immediate and delayed airway complications. In one case, the discovery of the aspirated NPA was delayed for weeks after the event and was discovered only after a persistent cough and recurrent chest infection triggered further evaluation 1 . One death was reported in a case of an aspirated airway, although the death occurred in the context of significant underlying respiratory failure 4 …”

Iatrogenic Airway Foreign Body. A Case Study. - Cuerpo Extraño en Vía Aérea De Origen Iatrogénico. Estudio De Un Caso.

“…e) Punta de la funda de un nasofaringoscopio 4 . f) cánula nasofaríngea 5 . g) partes de un broncoscopio 6 h) cánula metálica de traqueostomía 7 .…”

Iatrogenic aspiration of a large piece of a wooden spoon in a 14-year-old epilepsy patient

“…[1,2] Iatrogenic foreign body aspiration cases seen in a health center, with varying ages, were reported previously. [3][4][5] Patients with epilepsy are considered to be at risk of dental foreign body aspiration while experiencing seizure. [6] Cases of unusual foreign body aspiration during seizure have been presented.…”