Respir Case Rep. 2016; 5(3): 151-156 | DOI: 10.5505/respircase.2016.87609

Aspiration of a dental bridge: a diagnostic challenge

Petar Jovan Avramovski¹, Maja Petar Avramovska², Kosta Sotiroski³, Aleksandar Sikole^4
1Jzu Clinical Hospital “d-r Trifun Panovski”, Department Of Internal Medicine, Bitola, Republic Of Macedonia.
²University Clinic Of Obstetrics And Gynecology, Medical Faculty “ss. Cyril And Methodius University” Skopje, Republic Of Macedonia.
³Faculty Of Economics, Department Of Statistics, Prilep, University “s. Kliment Ohridski” - Bitola, Republic Of Macedonia.
⁴University Clinic Of Nephrology, Medical Faculty “ss. Cyril And Methodius University” Skopje, Republic Of Macedonia.

Although accidental aspiration of metal ceramic bridge is not uncommon, the number of cases reported in the literature is limited. Airway foreign bodies can become lodged in the larynx, trachea, and bronchus. The earliest symptoms which commonly appear during aspiration include coughing, chocking, and wheezing including long-term complications, such as lung abscess and pneumonia. A 73-year-old Macedonian female due to acute onset of incessant cough, dyspnea and an inspiratory and expiratory wheeze was admitted to our emergency department. Auscultation findings showed right-sided weakened vesicular breathing, closely mimicking an acute asthma exacerbation. Based on chest X-ray findings, the radiologist described a metallic foreign body (MFB) in the right bronchus. Using a computed tomographic (CT) scan, we confirmed 4-unit crown MFB position in the right lower lobe bronchus. Rapidly and timely intervention by bronchoscopy saved the patients from extensive reconstructive surgery.

Keywords: Foreign body aspiration, metal ceramic bridge, radiography, bronchoscopy.

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Dental köprü aspirasyonu ve tanýsal zorluklar

Petar Jovan Avramovski¹, Maja Petar Avramovska², Kosta Sotiroski³, Aleksandar Sikole⁴

Metal-seramik diþ köprüsünün kazara aspirasyonu çok seyrek olmamasýna raðmen, literatürde bildirilen olgu sayýsý sýnýrlýdýr. Hava yoluna kaçan yabancý cisimler, larinks, trakea ve bronþlara yerleþmektedirler. Aspirasyon sýrasýnda rastlanan en erken semptomlar, boðucu öksürük ve hýrýltý iken, geç dönem komplikasyonlarý ise apse ve pnömoni olmaktadýr. Yetmiþ üç yaþýnda Makedon bayan hasta, akut ve sürekli bir öksürük, nefes darlýðý ve hem inspiratuvar hem de ekspiratuvarda duyulan hýrýltý yakýnmalarý ile acil servisimize baþvurdu. Oskültasyonda, akut asým ataðýný taklit eden þekilde, saðda solunum seslerinde azalma saptandý. Radyolog, akciðer grafisinde sað bronþ sisteminde metalik bir yabancý cisim olduðunu belirledi. Tomografide, dörtlü yapýda metalik bir cismin sað alt lob bronþunda olduðu görüldü. Hýzlý ve uygun zaman içerisinde yapýlan bronkoskopik müdahale ile hasta ciddi bir cerrahi giriþimden kurtarýlmýþ oldu.

Anahtar Kelimeler: Yabancý cisim aspirasyonu, metal seramik köprü, radyoloji, bronkoskopi

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