Migrating airway foreign body
Initial workup showed elevated inflammatory markers (CRP, WBC, LDH, ferritin, lactic acid) respiratory alkalosis and hypoxia. A clinical diagnosis of acute respiratory failure was made and the patient was admitted in the ICU. Negative work up of COVID-19 and pulmonary tuberculosis. Bronchoscopy (after the initial CT chest) showed a foreign body in the proximal right main bronchus; however, it could not be retrieved due to copious thick secretions in the airways. Patient’s general condition further deteriorated during the procedure and post-bronchoscopy chest x-ray showed a right-sided tension pneumothorax which was managed with a chest tube.
2nd CT chest was done after significant improvement in the clinical condition of the patient which showed the migration of the foreign body from the right main bronchus to the left main bronchus. Bronchoscopy was done which showed a chicken vertebra in the distal left main bronchus which was successfully removed. No complications were noted and the patient was discharged the next day in a stable condition.
The patient did not remember the event of aspiration exactly.