A Case of Significant Endobronchial Injury due to Recurrent Iron Pill Aspiration.
Gastric mucosal damage by iron pills is often reported. However, iron pill aspiration is uncommon. Oxidation of the impacted iron pill causes bronchial mucosal damage that progresses to chronic bronchial inflammation, necrosis, endobronchial stenosis and rarely, perforation. We reported a case of a 92-year-old woman with chronic productive cough and significant left-sided atelectasis. Bronchoscopy revealed substantial luminal narrowing with exudative inflammation of the left main bronchus. Bronchial washing cytology showed necroinflammatory exudate and a small amount of brown material. Mucosal biopsy showed diffuse brown pigments indicative of ferrous pigments, crystal deposition, and marked tissue degeneration. After vigorous coughing, she expectorated dark sediments and her symptoms and radiological abnormalities improved. There are a few such reports worldwide; however, this was the first case reported in Korea. Careful observation of aspiration-prone patients and early detection of iron pill aspiration may prevent iron pill-induced bronchial injury.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Joo-Hee
JH
Kwak
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Gun Woo
GW
Koo
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Sung Jun
SJ
Chung
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Dong Won
DW
Park
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Hyun Jung
HJ
Kwak
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Ji-Yong
JY
Moon
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Sang-Heon
SH
Kim
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Jang Won
JW
Sohn
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Ho Joo
HJ
Yoon
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Dong Ho
DH
Shin
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Sung Soo
SS
Park
Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
Ju Yeon
JY
Pyo
Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.
Young-Ha
YH
Oh
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Tae-Hyung
TH
Kim
Iron; Pulmonary Atelectasis