A large asymptomatic foreign body in larynx and trachea

A 41-year-old asymptomatic man was referred to emergency department complaining of severe dyspnea. He had a history of psychosis and had been taking Biperiden and Lithium carbonate since 17 years ago. Routine imaging evaluation by posterioanterior and lateral chest radiographies showed a large foreign body in the trachea without subcutaneous, or mediastinal emphysema (Figure 1).

Figure 1 Chest X-rays showed a large foreign body in the trachea without any abnormality.

The primary diagnosis of swallowing metallic object was made. Then, he was referred to the division of endoscopy and other foreign bodies were demonstrated in the trachea. Two screws (3.5 cm) were extracted from the hypopharynx and the orifice of esophagus by flexible esophagoscopy, whereas a large metal object was revealed in the larynx and trachea (Figure 2); impossible to be extracted by flexible forceps.

Figure 2 Endoscopy revealed other foreign bodies in the trachea.

The largest metal object (Figure 3) was extracted under general anesthesia by rigid bronchoscopy without complication and further abnormality at bronchoscopy. The patient had a good recovery profile while the anti-psychosis treatment was continued.

Figure 3 The largest foreign body which was extracted under general anesthesia by rigid bronchoscopy. The size of foreign body was measured 6.5 cm × 2.1 cm × 0.4 cm.

Acknowledgements

Disclosure: The authors declare no conflict of interest.