# Glass in the Airways: A Bronchoscopic Challenge

## TL;DR

This case report describes the successful removal of a foreign object from a 64-year-old woman's lung using flexible bronchoscopy, highlighting the challenges of diagnosing and treating foreign body aspiration in adults.

## Contribution

The paper presents a real-world case demonstrating the effectiveness of flexible bronchoscopy in diagnosing and removing a foreign body from the airways of an adult.

## Key findings

- Flexible bronchoscopy was effective in both diagnosing and removing a foreign body from the right lower lobe of the lung.
- The case highlights the importance of a high index of suspicion for foreign body aspiration in adults with atypical respiratory symptoms.
- Prompt removal of the foreign body prevented potential long-term complications.

## Abstract

Foreign body aspiration (FBA) in adults is indeed a significant medical concern, albeit less common than in children. The increase in incidence with advancing age can be attributed to factors such as a decline in mental status and impairment of the swallowing reflex, which is more prevalent in the elderly population. The symptoms of FBA are highly variable, ranging from severe, acute asphyxiation, which may or may not involve complete airway obstruction, to more subtle signs like coughing, shortness of breath (dyspnea), choking, or fever. These varied presentations, coupled with the fact that many other medical conditions can mimic the respiratory symptoms seen in FBA, make diagnosis challenging. A high index of suspicion is often required, especially in cases where the patient's history does not clearly point toward aspiration. Immediate management focuses on supporting the airway, which is crucial given the potential for severe obstruction. Radiographic imaging plays a key role in localizing the foreign body, which is vital for planning its removal. Bronchoscopy, particularly flexible bronchoscopy, is the cornerstone of both diagnosis and treatment. This technique allows for direct visualization of the airways, localization of the foreign body, and its subsequent removal. This is crucial to avoid long-term complications, which can arise if the foreign body is not promptly and effectively removed. In this case report, we present a 64-year-old female patient who was found to have a foreign object positioned in the right lower lobe of the lungs that was removed via flexible bronchoscopy.