支气管异物误入消化道1例报告

患者　男 ,5 8岁。误吸水泥钉 3小时急诊入院。轻呛咳 ,咽痛。　　胸部平片 :正位片于右下叶支气管走行外显示 0 .3ｃｍ×3.5ｃｍ阻光钉形异物 ,其轴线与体轴中线约呈 35°角。侧位图 1　食管钡餐检查 ,正位片显示右下叶支气管走行处 0 .3ｃｍ×3 .5ｃｍ阻光钉形异物 ,远离食管 ;侧位片显示异物位于食管前方图 2　腹部正位片显示相同钉形阻光异物位于乙状结肠部位片异位位于气管分叉下方 ,由后上斜向前下。　　食管钡餐检查 :食管充盈良好。正位片显示金属钉形异物远离食管 ,其距食管最近处为 3.5ｃｍ ,侧位片显示异物位于食管前方 (图 1) ,…     

支气管异物误人消化道1例报告

患者男，58岁。误吸水泥钉3小时急诊入院。轻呛咳，咽痛。 胸部平片：正位片于右下叶支气管走行外显示0.3cm×3.5cm阻光钉形异物，其轴线与体轴中线约呈35°角。侧位片异位位于气管分叉下方，由后上斜向前下。     

支气管异物致支气管扩张1例

1临床资料 患者,男,22岁。1996年玩耍时不慎将一玩具塑料哨子吸入气管,当时未向家人说明,未得到及时处理。此后上呼吸道感染反复发作,开始时约每年1次,给予抗生素治疗有效。近两年发作频繁,并有咯血史,抗生素治疗效果不佳。2004年4月再次发作,就诊于当地医院,患者交待了8年前有误吸史,行支气管镜检查,发现右肺下叶支气管开口分嵴处一异物,周围被肉芽组织包裹,支气管镜下取异物未成功。     

罕见的支气管异物1例报告

患者男34岁于3小时前走路时，用棉签棒插入鼻腔内清洗时，因从后面走来一位朋友，突然拍肩一下，患者不慎将棉签棒吸入，当时感咽喉部不适，来医院就诊，考虑为咽喉部异物。     

经纤维支气管镜取出双侧支气管内异物一例报告

患者,男性,59岁,1991年9月28日因头部外伤昏迷急诊入院,确诊为重型闭合性颅脑损伤行颅脑手术。术后发烧,咳嗽,呼吸困难,行气管切开吸出较多黄色痰,查双下肺可闻及温罗音,白细胞总数26×10~9/L,中性90％,10月10日拍胸片见双肺散在小斑片状阴影,考虑肺部感染,给予抗菌素治疗,但无显著效果。10月26日再拍胸片除双肺仍有小片状阴影外,在左肺门区相当左主支气管处见一“S”形金属     

小儿右支气管异物延迟取出1例

患儿，男，5岁。1月前玩耍奔跑时误吸入含于口中的塑料口哨，当即出现剧烈咳嗽，口唇发绀，呼吸困难，数分钟后症状缓解，未予诊治，此后患儿反复出现刺激性咳嗽，痰少，无畏寒、发热，曾于当地卫生院就诊，口服抗生素及止咳平喘药物（具体不详），症状无好转。我院门诊行胸部CT检查示：右肺透亮度增强，右侧支气管中下段狭窄，腔内见一半弧形高密度影，中叶支气管闭塞，     

脊柱脊髓火器伤合并多发伤及并发症

170例脊柱脊髓火器伤中合并颅、脑、胸、腹和四肢等多发伤的危重伤员92例,死亡率为4.7％,本文重点讨论脊柱脊髓火器伤合并多发伤的特点;急救处理;防止漏诊;早期注意防治多器官功能衰竭。     

医源性支气管异物1例

患者男性21岁。于2004年10月5日中午13时左右，行牙科检查时髓管扩张针不慎掉入气管，无明显咳嗽、胸闷、胸痛、呼吸困难，无畏寒、发热等不适。约下午15时左右感到左侧胸部闷痛，入院门诊胸片示：左下叶支气管内见一注射器针头影，针尖朝上，两肺未见明显异常实变．纵膈以及肺门未见明显异常，心影两膈无特殊。     

X-ray signs of foreign body aspiration in children

Preoperative chest X-rays were taken in both postanterior and partially lateral views of 94 children with foreign-body aspiration. Additional fluoroscopy was employed in 70 patients. In 7% of the cases, the foreign body was radiopaque; in an equal amount of cases, there were no radiological findings. In the remaining results we observed: emphysema as an indirect radiological sign in two-thirds of the cases; in less than one-third, poststenotic atelectasis; pneumonia in 10%; bronchitis in 9%; pneumothorax in 2%.     

Intralenticular intraocular foreign body after stone impact: CT and US findings

Introduction: Intraocular foreign body (IOFB) is a relatively common entity in emergency departments worldwide. Appropriate ocular assessment is mandatory if an intraocular foreign body is suspected because it is associated with an increased risk of endophtalmitis and a wide range of complications including hyphaema, cataract, vitreous hemorrhage, and retinal tears and detachment. Case report: We present a case of intralenticular intraocular foreign body after stone impact. Discussion: Ultrasonography (US) and computed tomography (CT) show an accurate location of the foreign body inside the lens. This finding enabled the surgeon to perform a phacoemulsification lens extraction with removal of the foreign body, the optimal method of removing intralenticular IOFB. To our knowledge, this is the first US and CT imaging report.     

Low-dose MDCT and virtual bronchoscopy in pediatric patients with foreign body aspiration

OBJECTIVE: The purpose of this study was to investigate the potential use of low-tube-current MDCT virtual bronchoscopy for the evaluation of children with suspected foreign body aspiration. SUBJECTS AND METHODS: Low-tube-current MDCT was performed in 23 patients (10 girls, 13 boys) with a mean age of 3.3 years (9 months-13 years) with suspicion of foreign body aspiration. Chest radiographs were obtained before CT was performed. MDCT was performed using 25- to 50-mA tube currents. MDCT virtual bronchoscopy images were obtained. Neither sedation nor IV contrast medium was used during CT scanning. All patients underwent endoscopic evaluation within 24 hr after MDCT was performed. MDCT virtual bronchoscopy findings were retrospectively compared with the results of rigid bronchoscopy. RESULTS: The mean tube current was 35 mA (range, 25-50 mA). Imaging quality was excellent in nine studies (39%), good in 12 studies (52%), and poor in two studies (9%). Motion artifacts were present on several slices in five examinations. In 15 patients, all foreign bodies detected by conventional bronchoscopy were also revealed on MDCT virtual bronchoscopy. The foreign body was in the right main bronchus in six patients, in the bronchus intermedius in one patient, and in the left main bronchus in eight patients. No discordance was found between the two techniques. MDCT revealed hyperaeration of the ipsilateral lung in five patients, atelectasis in five patients, infiltration in three patients, and infiltration and bronchiectasis in two patients; it showed infiltration in four patients and atelectasis in one of eight patients without a foreign body detected. There were no abnormal findings in three patients. CONCLUSION: Evaluation of foreign body aspiration of the airway in children can be accomplished by using a low-tube-current MDCT protocol. It may be useful both in showing the exact location of a foreign body before bronchoscopy and in ruling out a foreign body in patients with a low level of suspicion and normal or nonspecific findings on chest radiography.     

Tracheobronchial foreign body aspiration in laryngectomized patient with tracheoesophageal voice prosthesis

A patient with a total laryngectomy and tracheoesophageal voice prosthesis presented with tracheobronchial aspiration of a Phillips-head screw that was swallowed inadvertently and aspirated around a loose-fitting prosthesis. A modified esophagram showed a screw in the right lung and free leakage of barium from the cervical esophagus around the prosthesis into the tracheobronchial tree. Chest radiographs and CT confirmed a screw in a right lower lobe bronchus with postobstructive pneumonia. When this complication occurs, it is important to extract the foreign body and, if necessary, to adjust or remove the prosthesis to prevent future aspiration pneumonias or foreign body aspiration.     

儿童气管异物的螺旋CT扫描技术

儿童气管支气管的异物吸入是常见的严重呼吸系统急症，其诊断和治疗都很紧急，除根据病史和临床的体征诊断外，影像学的检查能为其提供非常重要的支持。常规的影像学检查包括透视、摄片和CT检查等，透视和摄片能提供有无气管支气管的阻塞及严重程度和阻塞的大致部位，对是否为异物及性质（不透X线异物除外）的判定存在一定局跟性，螺旋CT扫描，特别是冠状面扫描可提高有无异物的判断率、并能较准确的定位和定性。     

CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration

OBJECTIVE: Computed tomography (CT) virtual bronchoscopy is a noninvasive technique that provides an internal view of trachea and major bronchi by three-dimensional reconstruction. The aim of this study was to investigate the usefulness of virtual bronchoscopy in the evaluation of suspected foreign body aspiration in children. MATERIALS AND METHODS: Twenty-three children (12 girls, 11 boys) with a mean age of 2.4 years (8 months-14 years) who were admitted to emergency room with a suspicion of foreign body aspiration were included in this study. Chest radiograms, spiral computed tomography scans and virtual bronchoscopy images were obtained. Then, rigid bronchoscopy was performed within 24 h. RESULTS: CT virtual bronchoscopy and conventional bronchoscopy revealed the location of the foreign body in seven patients. It was in the right main bronchus in four patients, in the right lower lobe bronchus in one patient, and in the left main bronchus in two patients. There was no discordance between two modalities. CT examination revealed hyperaeration of the ipsilateral lung in four patients, hyperaeration of the ipsilateral lung and mediastinal shift in one patient and bronchiectatic changes in one patient. CT detected no additional finding in one patient with a foreign body in the right main bronchus. In 10 of 16 patients without foreign body, CT examination demonstrated atelectasis, infiltration, peribronchial thickening, and paratracheal lymphadenpoathy. CONCLUSION: Helical CT scanning with virtual bronchoscopy should be performed in only selected cases with suspected foreign body aspiration. When the chest radiograph is normal and the clinical diagnosis suggests aspirated foreign body, helical CT and virtual bronchoscopy can be considered in order to avoid needless rigid bronchoscopy.