
==== Front
Respirol Case Rep
Respirol Case Rep
10.1002/(ISSN)2051-3380
RCR2
Respirology Case Reports
2051-3380
John Wiley & Sons, Ltd Chichester, UK

10.1002/rcr2.70011
RCR270011
Clinical Image
Clinical Image
Pull‐up surprise: Chronic foreign body aspiration
FOREIGN BODY ASPIRATION
Halim and Breen
Halim Dzufar https://orcid.org/0009-0008-4244-1695
1 dzufarahalim@gmail.com
dzufar.abdulhalim@hse.ie

Breen David 1
1 Department of Respiratory Medicine Galway University Hospital Galway Ireland
* Correspondence
Dzufar Halim, Department of Respiratory Medicine, Galway University Hospital Ireland. Newcastle Rd, Galway H91 YR71, Ireland.
Email: dzufarahalim@gmail.com; dzufar.abdulhalim@hse.ie

02 9 2024
9 2024
12 9 10.1002/rcr2.v12.9 e7001109 8 2024
18 8 2024
© 2024 The Author(s). Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.
https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Key message

Foreign body aspiration is rare in adults but can be life‐threatening. This case highlights the subtlety of chronic foreign body aspiration presentation and the importance of judicious use of radiological tool and comprehensive history‐taking especially in patients with chronic cough.

The use of reconstruction of CT Thorax revealed an unusual appearance at where the pulmonary lesion was, raising possibility of a complicated foreign body aspiration. Bronchoscopy confirmed the endobronchial mass and subsequent revelation of foreign body; half of a pull‐up can.

asthma
bronchiectasis
bronchoscopy
foreign body aspiration
pneumonia
source-schema-version-number2.0
cover-dateSeptember 2024
details-of-publishers-convertorConverter:WILEY_ML3GV2_TO_JATSPMC version:6.4.8 mode:remove_FC converted:03.09.2024
Halim D , Breen D . Pull‐up surprise: Chronic foreign body aspiration. Respirology Case Reports. 2024;12 (9 ):e70011. 10.1002/rcr2.70011

Associate Editor: Simon A Joosten
==== Body
pmcA 20‐year‐old male, with history of childhood asthma, presented with dyspnea, left‐sided chest pain, and fever spanning 2 weeks. He also reported night sweats of 2 months and dry cough of at least 2 years.

He was treated as pneumonia, but radiological assessment via computed tomography (CT) Thorax showed: a substantial left‐sided loculated pleural effusion alongside an enlarged left hilum with an associated mass containing curvilinear calcification (Figure 1). This calcification was unusual and this prompted a review using reconstruction of the CT scan via bone window. This displayed an intriguing morphology of the calcification (Figure 2). Subsequent bronchoscopic exploration confirmed the presence of an endobronchial mass (Figure 3). After multiple biopsies, a foreign body was revealed; half of a pull‐up can (Figure 4). This revelation was substantiated by the patient's admission of a previous habit of chewing pull‐up cans. Rarely, only half was spat out. He denied choking episodes but realized his dry cough could have started since then, which possibly coincided with his diagnosis of asthma. Clinically he improved but residual localized bronchiectatic changes on follow‐up CT scan was suggestive of a complicated recovery (Figure 5).

FIGURE 1 Initial computed tomography thorax which showed a curvilinear calcification in the mass.

FIGURE 2 Reconstruction of computed tomography thorax using bone window revealed an unusual appearance at where the lesion was.

FIGURE 3 Endobronchial mass seen through bronchoscopy.

FIGURE 4 Half of pull‐up can removed using bronchoscopy.

FIGURE 5 Residual localized bronchiectasis on follow up computed tomography thorax.

This case highlights the subtlety of chronic foreign body aspiration presentation and the importance of judicious use of radiological tool and comprehensive history‐taking especially in patients with chronic cough.

AUTHOR CONTRIBUTIONS

Dzufar Halim (First author) was involved in the care of the case, conception and design of the case report, and drafting of the manuscript. David Breen (Second author) was the primary clinician for the case, oversight/supervisor of the case report, securing patient consent and final approval of the version to be submitted.

CONFLICT OF INTEREST STATEMENT

None declared.

ETHICS STATEMENT

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

CONSENT FOR PUBLICATION

A written informed consent for publication was obtained from the patient of this article and accompanying images.

DATA AVAILABILITY STATEMENT

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
