Volume 189 - Issue 11
Foreign body inhalation: a nut in the tree
Authors: Stefan Buchholz and George R Rudan
Med J Aust 2008; 189 (11): 636. || doi: 10.5694/j.1326-5377.2008.tb02223.x
Published online: 1 December 2008
Published online: 1 December 2008
A 69-year-old man presented with a 3-week history of intermittent interscapular dull ache, complicated by small volume haemoptysis. Contrast-enhanced computed tomography of the thorax showed no evidence of pulmonary embolism, but demonstrated a well circumscribed lesion, 10 mm in diameter, in the right bronchial tree (Figure, A), leading to suspicion of a neoplasm. Using flexible bronchoscopy, we successfully removed a whole macadamia nut (Figure, B) that was obstructing the bronchus intermedius at the level of the right middle lobe orifice.
Additional history obtained after the procedure revealed an aspiration event 3 weeks before admission. The patient reported having tripped while walking upstairs and concurrently eating a handful of macadamia nuts, resulting in a coughing spell that lasted the better part of the night.
