UNASSIGNED: Foreign body aspiration is a common occurrence, with severe outcomes seen in all age groups. It can present like any chronic respiratory disease with a wide spectrum of misleading symptoms, resulting in misdiagnosis and delays in appropriate treatment.
METHODS: Here we present a case of a 11 year boy diagnosed with occult foreign body aspiration, chronically impacted in the left secondary bronchus, presented with bronchiectasis and multiple failed attempts at bronchoscopic retrieval.
UNASSIGNED: Surgically managed by a left lower lobe lobectomy via a mini thoracotomy, reinforced with a pedicled latissimus dorsi flap. Upfront surgery will reduce the bronchoscopic morbidity incurred in repeated attempts needing pot-op ventilatory support due to edema and repeated general anaesthesia risks.
CONCLUSIONS: A high degree of suspicion is a key to diagnosis. There should be a low threshold for surgical management in chronic impactions.

UNASSIGNED: Bronchial foreign body aspiration is a life-threatening emergency. Largely, the published literature focuses on the removal of foreign bodies by bronchoscopy, while the surgical removal of endobronchial foreign bodies is rarely reported on. Thus, we presented a case of a bronchial foreign body that was successfully removed by a video-assisted thoracoscopic surgical (VATS) bronchotomy, after multiple failed bronchoscopic attempts.
METHODS: A 77-year-old male patient presented with a 2-month duration of a persistent cough and low-grade fever after undergoing dental treatment. Bronchoscopy revealed a dental crown surrounded by granulation tissue in the right basal bronchus. The patient was referred to our department for open surgery after undergoing multiple unsuccessful extractions. The bronchial foreign body was removed by a VATS bronchotomy. The postoperative course was uneventful, and the patient was discharged 2 days postoperatively without any complications.
UNASSIGNED: Most aspirated tracheobronchial foreign bodies can be removed through bronchoscopy; nonetheless, certain aspirated foreign bodies may require surgical intervention. Furthermore, the indications for bronchotomies encompass the failure to remove the foreign body despite repeated attempts, due to immobility, with or without distal bronchial placement. Thoracoscopy is beneficial in providing superior visualization, with an increased likelihood of post-bronchotomy recovery.
CONCLUSIONS: VATS bronchotomy is a safe and effective alternative for the removal of bronchial foreign bodies without sacrificing the functioning of the lung parenchyma.

Children and older adults are prone to unintentional foreign body aspiration. A 69-year-old man with fever and anorexia presented with obstructive pneumonia resulting from foreign body aspiration. Attempts to remove the foreign body using a bronchoscope failed due to its adhesion to the periphery of the bronchus. Although antibiotic therapy did not improve the obstructive pneumonia caused by the bronchial foreign body, surgery enabled an improvement. The surgical specimen showed similar pathological findings as the fine brown granular material observed in root granulomas occurring as a complication following leakage of root canal filling used in the treatment of dental caries. Therefore, the bronchial foreign body may have been a dental filling. Case reports describing surgical improvement of difficult-to-remove bronchial foreign bodies with concurrent infection are rare.

The age of predilection for foreign body aspiration into the lower airway shows a bimodal distribution, with the majority of cases occurring in children or infants and in the elderly. Although several pediatric airway foreign bodies have been summarized, in adults, bronchial foreign bodies are relatively uncommon. There are a variety of symptoms induced by airway foreign bodies, although the typical symptoms of some bronchial foreign bodies are cough. Bronchial foreign bodies, especially in the elderly, may have few symptoms and it is necessary for careful identification. Therefore, it is very important to carefully perform medical consultations about current and past medical history. Herein, we report a case of an elderly Japanese with obstructive pneumonia with a bronchial foreign body of fish bone with a long history of cough. It is known that people in some countries such as Japan have a habit of eating fish. Therefore, it is necessary to more carefully explore the possibility of some bronchial foreign body such as a fish bone, when we observe symptoms of persistent cough in such countries.

Pseudobronchial crista-like change is an unusual type of inflammatory granulation tissue hyperplasia in the endobronchial membrane caused by chronic retention of bronchial foreign bodies. Here, we report a case of pseudobronchial crista-like change in a 4-year-old boy who required admission for intermittent cough for >10 days and wheezing for 2 days. The main manifestation was persistent and non-healing lobar pneumonia. Initial electronic bronchoscopy showed cristae at the distal left main bronchus, which was misdiagnosed as bronchial opening stenosis. Repeat electronic bronchoscopy was performed after standard antibiotic treatment proved ineffective. Foreign bodies were observed at the opening of the basal branch of the left lower lobe. The left main bronchial cristae were clamped. The cristae appeared to be a pseudobronchial crista-like change caused by long-term retention of bronchial foreign bodies. After CT-confirmation of no abnormal blood supply at the cristae, the bronchial foreign bodies were removed, and the distal cristae of the left main bronchus were cut-off by laser, followed by balloon dilatation. To our knowledge, no similar cases have been reported so far in our review of domestic and foreign literature. Insufficient clinical understanding of Pseudobronchial Crista-like Change increase the risk of misdiagnosis and missed diagnosis. Detailed exploration and careful identification under bronchoscopy are helpful for the timely diagnosis and treatment of Pseudobronchial Crista-like Change.

BACKGROUND: Foreign body aspiration represents an important cause of morbidity and mortality during childhood. A neglected aspirated foreign body can last for years, leading to complications that are sometimes difficult to manage, dramatically affecting the quality of life of the patient.
METHODS: We report the case of a 29-year-old female who presented with eighteen-year history of recurrent cough, choking, and respiratory infections following a foreign body aspiration. The course was complicated by a chronic secondary lung abscess, successfully managed by combined medical and surgical treatment.
CONCLUSIONS: In low-income countries like ours, foreign body aspiration is often misdiagnosed. The often delayed management due to low socioeconomic status can lead to serious complications. To the best of our knowledge, it is the longest period of bronchial foreign body retention reported in the medical literature in Africa.
CONCLUSIONS: Foreign body aspiration is common in childhood and requires early recognition and treatment, in order to avoid complications that can be very serious or even fatal.

Patients with bronchial foreign bodies often present with subjective symptoms, mainly cough, and removing the foreign bodies is difficult. Bronchial foreign bodies are mostly located in the right lower bronchus, and rarely in the right middle bronchus. An 85-year-old man had no subjective symptoms. He aspirated an artificial tooth during dental treatment the day before visiting our clinic, and consulted his home doctor. He was admitted to our hospital because a chest radiograph indicated the presence of a foreign body in the right middle and lower lung field. Chest computed tomography showed that the bronchial foreign body was located in the right middle bronchus, and it was accompanied by an artifact in the circumference of the lesion, and it seemed to be the metal piece of an artificial tooth. Three-dimensional CT showed the root of the artificial tooth located in center side of the right middle bronchus, and, considering the invasiveness, we decided to remove the tooth by flexible bronchoscopy. The bronchoscopy revealed a metal piece occluding the right middle bronchus without granulation, and we could remove the tooth immediately by grasping the root of the tooth with alligator forceps. We experienced a case of a foreign body located in the right middle bronchus without respiratory symptoms. It is important to carry out image examinations, because elderly patients may not exhibit respiratory symptoms.

A fifty year old female presented with cough, breathlessness and chest pain of eighteen months duration. She presented as a case of a non-resolving consolidation. Video bronchoscopy revealed a bronchial foreign body. This case is being reported here, to underline the role of bronchoscopy in a case of a non resolving consolidation.