気管支鏡下に摘出した気管支鋳型（bronchial cast）の1症例—体内由来の気道異物—

Bronchial Casts Removed by Bronchoscopy: Endogenous Foreign Body in the Air Passage

I．緒言

　耳鼻咽喉科医にとって小児の気道異物は決して稀な疾患ではない。しかし異物の種類を取るとその大多数が体外由来の物であり，体内由来の気道異物を気管支鏡的に摘出したという報告はきわめて稀である。著者は無気肺と肺気腫を引き起こした気管支鋳型（bronchial cast）の1症例を経験したので報告するとともに，気管支鋳型および体内由来の気道異物に関して文献的考察を加える。

　A 1 year and 7 months old boy had severe coughing spell and dyspnea for 4 days before admission. Examination and chest roentgenographs revealed atelectasis of the left upper lobe and emphysema of the right lung. Two tree shaped yellowish-white foreign bodies (bronchial casts) were removed from the bronchi with a ventilation bronchoscope successfully. Microscopically matrix of these casts was layer of fibrin.

　The author discussed the formation of tracheobronchial cast, and the diagnosis of plastic bronchitis, and reviewed case reports of bronchial casts which were removed bronchoscopically.