[Recurrent haemoptysis for a period of five years following aspiration of a gall stone].
The article deals with a case report of a 71-years-old female who suffered from hemoptysis over a period of five years. The first hemoptysis occurred postoperatively after a cholecystectomy in December 1966 and was thought to be caused by pulmonary embolism. Persisting episodes of more or less slight hemoptysis in the following years lead to repeated different diagnostic procedures. Radiologically there was an infiltration of the right lower lobe rather constant in size. Endoscopically no bronchial obstruction was visible. In July 1972 the patient suffered from a more severe hemoptoe. X-ray findings were nearly unchanged. With bronchoscopy the hemorrhage could be localized to the segmental bronchi 8 and 9. Right lower lobectomy was done in September 1972 without an exact preoperative diagnosis. The patient had an uneventful postoperative course despite of her age. Pathological examination of the specimen showed a foreign body looking like a gallstone. This diagnosis was confirmed by chemical analysis. To get an explanation we inquired into the circumstances of the cholecystectomy performed 5 years ago. These lead to the conclusion that the concrement must have been vomited and aspirated by the evidently not intubated patient. These suggestions were supported by the fact, that the former operation has been done because of a gangrenous gallbladder with a highly delated common duct and the duodenum, stomach and transverse colon being involved in an inflammatory infiltration. Dangers of asymptomic foreign body aspiration and diagnostic problems in non-opaque peripheral foreign bodies are discussed.
D000368:Aged; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D005547:Foreign Bodies / Q000601:surgery; D006469:Hemoptysis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D001239:Inhalation; D008168:Lung / Q000601:surgery; D011013:Pneumonectomy; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000150:complications; D012008:Recurrence; D013997:Time Factors
Rezidivierende Hämoptoe über 5 Hahre. Folge einer Gallenstein-aspiration