CT findings of the chest in adults with aspirated foreign bodies

The aim of this study was to assess the imaging findings in adult patients with tracheobronchial foreign body aspiration. Nineteen patients (11 men an d 8 women; age range 26-89 years) with foreign-body aspiration were retrosp ectively reviewed. Nine patients were outpatients with non-specific symptom s and ten were hospitalized with non-resolving pneumonia (n = 6), after det ection of a dental fragment on a chest radiograph following intubation (n = 3), and there was one mentally retarded patient with empyema. An aspirated dental fragment was seen on a chest radiograph in 3 patients and an endobr onchial foreign body on CT in 16, appearing as a dense structure within the bronchial lumen, The foreign body was right sided in 14 cases and left sid ed in 5. Three cases were missed at first interpretation, Associated findin gs on CT were volume loss, hyperlucency with air trapping and bronchiectasi s in the affected lobe. Thirteen patients were managed with bronchoscopy, w hereas 2 needed thoracotomy, In 1 patient bronchoscopy failed to detect a f oreign body, indicating a false-positive CT diagnosis. One patient expelled an aspirated tablet and two refused invasive procedure. The foreign bodies found mainly were bones and dental fragments. A high clinical suspicion is necessary to diagnose a foreign body. Since CT is often used to evaluate v arious respiratory problems in adults, it may be the first imaging modality to discover an unsuspected aspirated foreign body in the bronchial tree.