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KMID : 0383820150780040440
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Tuberculosis and Respiratory Diseases
2015 Volume.78 No. 4 p.440 ~ p.444
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A Case of Significant Endobronchial Injury due to Recurrent Iron Pill Aspiration
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Kwak Joo-Hee
Koo Gun-Woo
Chung Sung-Jun
Park Dong-Won
Kwak Hyun-Jung
Moon Ji-Yong
Kim Sang-Heon
Sohn Jang-Won
Yoon Ho-Joo
Shin Dong-Ho
Park Sung-Soo
Pyo Ju-Yeon
Oh Young-Ha
Kim Tae-Hyung
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Abstract
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Gastric mucosal damage by iron pills is often reported. However, iron pill aspiration is uncommon. Oxidation of the impacted iron pill causes bronchial mucosal damage that progresses to chronic bronchial inflammation, necrosis, endobronchial stenosis and rarely, perforation. We reported a case of a 92-year-old woman with chronic productive cough and significant left-sided atelectasis. Bronchoscopy revealed substantial luminal narrowing with exudative inflammation of the left main bronchus. Bronchial washing cytology showed necroinflammatory exudate and a small amount of brown material. Mucosal biopsy showed diffuse brown pigments indicative of ferrous pigments, crystal deposition, and marked tissue degeneration. After vigorous coughing, she expectorated dark sediments and her symptoms and radiological abnormalities improved. There are a few such reports worldwide; however, this was the first case reported in Korea. Careful observation of aspiration-prone patients and early detection of iron pill aspiration may prevent iron pill-induced bronchial injury.
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KEYWORD
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Iron, Pulmonary Atelectasis
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