An unusual foreign body in tracheobronchial tree
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ABSTRACT :
Foreign body (FB) in tracheobronchial tree is a serious and potentially fatal condition in all age groups. Early diagnosis and removal are imperative to prevent mortality as well as complications.

A 45 year old heroine (diamorphine) addict was brought to the emergency department in a gasping state, with a history of substance abuse. The patient was intubated with Portex® cuffed endotracheal tube No. 8 and was shifted to intensive care unit for ventilation. Follow up x-ray chest revealed a metallic wire like FB in the bronchus. In the operating room, rigid bronchoscopy under general anesthesia failed to remove FB. Fibreoptic bronchoscope revealed an intubation stylet below carina. Subsequent attempts were unsuccessful so tracheostomy was done and the stylet was removed through tracheal stoma under fibreoptic visualization. The ventilation strategies used being ventilating bronchoscope, intermittent mask ventilation and intubation twice.

CASE :
A 45 year-old male was brought to emergency department by relatives with signs of difficulty in breathing and altered sensorium and a history of consumption of heroine (diamorphine). At the time of admission, patient was unconscious, and his both pupils were pin-point and non-reacting to light. On chest auscultation, bilateral basilar fine crepitations were present. Considering respiratory distress, patient was intubated by direct laryngoscopy with Portex® endotracheal tube no. 8 by resident who used metallic stylet to assist intubation......

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