長期間介在せる空気銃弾気管支異物症例

A CASE REPORT OF BRONCHIAL FOREIGN BODY (A BULLET OF AN AIR-GUN) LODGED FOR MANY YEARS

　I．はじめに

　気道内異物症についてはこれまで数多くの症例報告があり，それらの統計学的考察も加えられている。今回われわれは，無症状のまま長期間介在したと思われる空気銃弾気管支異物症例を経験し，いささかの知見を得たので報告する。

　A 18-year-old female who was transferred to our outpatient clinic for the endoscopic examination, had a small metalic shadow in the left bronchial lumen on a chest x-ray film. The shadow was thought to be a bullet of an air-gun, although there were neither recent history of the foreign body aspiration nor family history of one who had used an air shot gun.

　Flexible fiberscopy was done on 22nd of June '77 and revealed the membraneous scar tissue at the orifice to the left upper lobe. On the same day, the patient underwent the foreign body removal with ventilation bronchoscope under general anesthesia. Part of the foreign body was soon identified by excision of the scar tissue with the Fischer's foreceps, but it was very difficult to remove the bullet from the scar tissue. After several trials of the removal, the patient was suddenly attacked by a coughing spell, and the foreign body had completely lost from the sight. As it was never seen through the bronchoscope, we decided to try it again in the next morning. It was, however, quite fortunate that the foreign body was spontaneously expectorated by cough onset at midnight. The post-operative bronchography revealed the ectatic changes of the B¹, B², B³, B⁴, and B⁵. The patient was discharged a week later without complications.