A Case Report of an Iatrogenic Bronchial Foreign Body Extraction, using the Flexible Fiberoptic Bronchoscope

A 48 year old male who 20 years ago underwent a right upper lobectomy with thoracoplasty for pulmonary tubercuiosis, since then he did'nt have any symptom, however recently complained of repeated episodes of sudden high fever, cough, putrid sputum and occasionally bloody sputum, and was diagnosed as having a broncho-fistula. When he was examined by preoperative fiberoptic bronchoscopy (F.F.B.), he was discovered to have a gauze lodged in his right upper bronchus. The second and the third F.F.B. were done for the purpose of extracting the gauze from his bronchus. Because of our experience, the author would like to emphasize the following:1) A bronchoscopist should pay attention to local changs in the air-way, sometimes local changes tells where the foreigh body is lodged.2) There are at present, two kinds of flexible forceps which can be used but not specially made, for foreign body extraction. Thus, a bronchoscopist should know it's extractive force before operation.3) The tip of the flexible forceps should be improved for the express purpose of foreign body extraction.4) The F.F.B. can be used for limited foreign body extraction. This limited use must be appreciated and the indications must be carefully considered before the flexible fiberoptic bronchoscope is used.