OVERLOOKED INHALED FOREIGN-BODIES - LATE SEQUELAE AND THE LIKELIHOOD OF RECOVERY

The present paper describes eight patients (two teenagers and six adul ts) who had chronic symptoms (haemoptysis, cough, recurrent pneumonia) caused by foreign body (FB) inhalation which went undetected for 3 mo nths to 25 yr. None of the patients had the usual predisposing conditi ons like mental retardation, seizures or brain tumour. The diagnosis o f FB was made by radiography in one patient only. Computerized tomogra phy visualized one FB (a beef bone), and bronchoscopy identified FB in another two patients. The remaining four cases were diagnosed at thor acotomy. Removal of FB was curative in three of five cases who require d surgical resection for irreversible bronchiectatic changes. The seve rity of pulmonary changes correlated with duration of symptoms. It is concluded that chronic, unexplained respiratory symptoms should warran t further investigation to exclude FB despite negative history and nor mal chest radiography. Finding of granulation tissue or cicatricial st enosis of the bronchus could be the only clue to the presence of a FB. Early diagnosis would avoid irreversible parenchymal changes which ne cessitate lung resection.