FOREIGN BODIES OF DENTAL ORIGIN IN THE BRONCHUS: PULMONARY COMPLICATIONS

¹ Section on Surgery, Mayo Clinic, Rochester, Minnesota

(1) Aspiration infection of the lungs is most common following operations on the mouth under general anesthesia.

(2) Symptoms may be immediate and continuous; there may be an intervening period of months or years before the symptoms appear. There may be no immediate symptoms.

(3) The most constant and characteristic immediate symptoms are cough, dyspnea, wheezy respiration, and pain in the chest. The late symptoms, varying in number and degree, are those of pulmonary suppuration.

(4) Late symptoms of foreign-body infection simulate phthisis, and that is the diagnosis often made.

(5) Positive diagnosis rests essentially on a study of the history, examination by the roentgen ray, and bronchoscopy.

(6) Bronchoscopy for diagnosis is indicated in any early doubtful case.

(7) Spontaneous expulsion is always doubtful if foreign bodies are small, irregular, and of high specific gravity. Spontaneous expulsion is often delayed until after an abscess has formed.

(8) Bronchoscopy is the only treatment to be considered in early uncomplicated cases. In cases in which there is suppuration, thoracotomy for drainage gives the best results.

(9) In fatal cases death is usually due to an abscess, bronchiectasis, or gangrene of the lung, any of which may be complicated by empyema.

(10) Tuberculosis may coexist with a suppurative process.