Haemoptysis in an intravenous drug user: injection needle impacted in the left main bronchus

Abstract

SUMMARYWe report a case of a 35-year-old man who presented with 4-week history of haemoptysis, with a history of intravenous drug use. There was no other significant medical or surgical history and no recollection of any foreign body aspiration. Chest X-ray and CT scan showed 40 mm long needle in left main bronchus, partly lying outside the bronchus into the mediastinum. Flexible and rigid bronchoscopes proved to be unsuccessful in retrieving the needle. We proceeded with left posterolateral thoracotomy and the left main bronchus was explored to take out this 21-gauge (green) injection needle. The distal half of the needle with the sharp end was lying in the mediastinum piercing through the bronchial wall. Surgery was uneventful with good postoperative recovery and the patient was discharged 4 days later. BACKGROUND

An injection needle as a cause of aspiration pneumonia in a male HIV(+) intravenous drug user

“…It was confirmed by our observations [3]. A similar case was described by Shah et al; however, the foreign body revealed in the chest X-ray was removed only by a thoracic surgeon [6].…”