Presentation
History of recent trauma with head injury, seizure and cardiac arrest.
Patient Data
No acute abnormality.
The patient desaturated suddenly, and a MET call was placed.
Opacity within the left main bronchus consistent with a tooth.
CTPA was requested by MET call team prior to reviewing CXR
A radiodense structure consistent with a tooth is lodged in the left lower lobe bronchus. No overt collapse is present at this time. The tooth is present on radiograph this morning but was not present on yesterdays CXR. When compared to prior imaging, there is mildly progressive air space consolidation in both lower lobes, and there are progressive bilateral pleural effusions with tracking upward between the fissures. Segmental pulmonary emboli seen in all right lobe segments apart from the posterior and lateral ones. Superior lingular segmantal emboli on the left. Serial left- sided non-displaced rib fracture. No pneumothorax.
Conclusion:
Left lower lobe bronchus foreign body consistent with a tooth in this patient with dental trauma. Multiple PEs as described.
Tooth removed.
Case Discussion
The cause for the desaturation was likely the tooth, rather than the small PEs.
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