Tracheobronchial foreign body aspiration is an important life-threatening clinical condition that requires emergency intervention. Compared with children, foreign body aspiration is rare in adults and sometimes could be fatal. The most common symptom is severe coughing that appears after choking. Foreign body aspiration should be considered in the diagnosis of patients with wheezing, chronic cough, voice alteration, hoarseness, or recurrent pulmonary infections. A 78-year-old male patient with tracheostomy due to laryngeal cancer was admitted to the emergency department on account of aspiration of tweezers after coughing when he was cleaning the tracheostomy cannula. The patient complained of shortness of breath and coughing. Physical examination revealed decreased breath sounds on the right side of the lung, and he had dyspnea and central cyanosis. There was a foreign body extending from the carina to the right main bronchus on the posteroanterior radiograph of the lung. In the operating room, rigid bronchoscopy was performed from the tracheostomy stoma and the foreign body was removed using forceps. This case shows that patients with tracheostomy and their relatives must be well educated in the care of stoma. Rigid bronchoscopy by an experienced specialist for foreign body aspiration is a safe and effective method for diagnosis and treatment.
Keywords: Tracheostomy, foreign body, emergency medicine