Foreign body removal: A case report

Sivagami

Assistant Nursing Superintendent, Department of Nursing, Kauvery Hospital, Salem

Case Presentation

Patient came with the following complaints

  1. Coughing with blood, of sudden onset (almost 50-100 ml).
  2. History of evening rise of temperature x 1 month.
  3. History of shortness of breath for the past 1 hour.

No history of poor appetite or loss of weight.

Patient was initially treated in an outside hospital and came here for further management.

Past History

Known case of SHTN x 1 year on Siddha medications

On Examination at Admission: Patient conscious, oriented, afebrile

Vitals

  • BP:150/100mmHg, PR:102/min, SpO2 :85% in room air, RR: 24/min

Systemic Examination

  • CVS: S1S2(+)
  • RS: Bilateral crept (+) / scattered wheeze (+)
  • P/A: Soft
  • CNS: NFND

MDCT Chest Plain Report on: 27.03.25

  • Partial collapse consolidation of right middle lobe
  • Aspirated blood in right middle lobe bronchus
  • Diffuse peri bronchial and sub pleural ground glass opacities in bilateral lower lobes — Aspirated related changes

CT pulmonary angiography report on: 27.03.25

  • No evidence of pulmonary thrombo embolism / Rasmussen’s aneurysm
  • Partial collapse consolidation of right middle lobe with aspirated content in right middle lobe bronchus
  • Diffuse peri bronchial and sub pleural ground glass opacities in bilateral lower lobes — Aspirated related changes

Hyper dense content in right middle lobe bronchus region.? Foreign body

Bronchoscopy procedure on 28.8.25 under IV sedation

  • Thick clots noted in right middle lobe clots were removed, foreign body was visualized in right middle lobe foreign was removed (Nose ring was found).
  • BAL AFB sent, it showed negative., BAL CBNAAT sent, also negative for Tb
  • BAL culture sent revealed Klebsiella pneumoniae.

Post Procedure

Post procedure patient had bleeding from bronchus. Hemostasis achieved, she was Intubated in view of airway protection at 3pm & after evaluation by x ray chest and VBG, she was extubated at 6 PM. VBG was done at 10 PM revealed respiratory acidosis, kept on overnight BIPAP, she was tolerating on BIPAP. Vitals were stable .5th day patient symptomatically better, no further complaints of hemoptysis.

Hence patient was discharged with medication.

Discharge advice

DrugsDoseMorningNoonNightInstructionsDuration
Tab.Clindamycin300 mg111After food5 days
Tab. Tranexamic acid500 mg101After food3 days
Tab. Para500 mg101After food5 days
Syp. Reswas111After food5 days
Tab. Taxim o200 mg101After food5 days
Tab. Sompraz40 mg100Before food10 days

 

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