Unsuspected foreign object in the bronchus

ABSTRACT

A 20-year-old man had a chest radiograph performed as part of his military service entrance examination. The posterior-anterior [PA] film revealed a linear shadow near the right hilum. Previous chest PA films had no such shadow. The patient could not give any seemingly relevant history. A chest CT scan [10-mm slice thickness] identified the shadow as an intrabronchial lesion, specifically a pin in the right anterior segmental bronchus [B3] [Figure 1]. Fiber bronchoscopic examination revealed the tip of the pin in the orifice of B3 [Figure 2]. The only active bleeding was a mild oozing from surrounding granulation tissue. The whole pin pulled smoothly and easily out of the airway. The pin was 4 centimeters in length. When the patient saw the pin, he recalled an episode of aspiration about 3 months earlier. He had been holding pins in his teeth while sewing a window curtain. A friend suddenly slapped him on the back and he inhaled suddenly and deeply