Dental Floss Pick-Related Injury Presenting With Massive Hemoptysis
Dental Floss Pick-Related Injury Presenting With Massive Hemoptysis
Introduction: A tracheobronchial foreign body is a rarely mentioned cause of massive hemoptysis. Although an aspirated toothpick is a well-known cause of traumatic injury to the respiratory tract, a similar device called a dental floss pick, which is much larger than a toothpick, has never been described as a tracheobronchial foreign body.
Case Presentation: We report a case of massive hemoptysis in a 32-year-old man due to a dental floss pick in the left main bronchus. Flexible fiberoptic bronchoscopy was successful in removing the foreign body.
Conclusion: Tracheobronchial foreign body can be a medical emergency requiring immediate intervention and massive hemoptysis may be the presenting symptom. Flexible fiberoptic bronchoscopy is recommended as the first-line treatment modality for tracheobronchial foreign body removal. A dental floss pick may present as a tracheobronchial foreign body and can reside in the airway asymptomatically for many years.
Massive hemoptysis comprises only 5 percent of hemoptysis events; however, the mortality rate for patients with massive hemoptysis can be as high as 80 percent. Three major etiologies account for 90 percent of cases: bronchiectasis; tuberculosis; and bronchogenic carcinoma; a tracheobronchial foreign body is a rare clinical entity leading to massive hemoptysis.
Accidental toothpick ingestion has often been reported as the cause of gastrointestinal and respiratory tract injuries, and under very rare circumstances, may result in constrictive pericarditis, coronary artery perforation, obstruction of the ureter, and subphrenic abscess. Dental floss picks, which are also a plaque remover, are much larger objects than toothpicks, and have never been described as a causative agent of aerodigestive tract injuries. We report herein an adult patient with a dental floss pick stuck in the left mainstem bronchus asymptomatically for 8 years, who presented to the emergency department with acute onset of massive hemoptysis. The dental floss pick was successfully removed under flexible fiberoptic bronchoscopy and soon thereafter the hemoptysis resolved. To our knowledge, this is the first case report concerning a dental floss pick as a tracheobronchial foreign body leading to massive hemoptysis.
Introduction: A tracheobronchial foreign body is a rarely mentioned cause of massive hemoptysis. Although an aspirated toothpick is a well-known cause of traumatic injury to the respiratory tract, a similar device called a dental floss pick, which is much larger than a toothpick, has never been described as a tracheobronchial foreign body.
Case Presentation: We report a case of massive hemoptysis in a 32-year-old man due to a dental floss pick in the left main bronchus. Flexible fiberoptic bronchoscopy was successful in removing the foreign body.
Conclusion: Tracheobronchial foreign body can be a medical emergency requiring immediate intervention and massive hemoptysis may be the presenting symptom. Flexible fiberoptic bronchoscopy is recommended as the first-line treatment modality for tracheobronchial foreign body removal. A dental floss pick may present as a tracheobronchial foreign body and can reside in the airway asymptomatically for many years.
Massive hemoptysis comprises only 5 percent of hemoptysis events; however, the mortality rate for patients with massive hemoptysis can be as high as 80 percent. Three major etiologies account for 90 percent of cases: bronchiectasis; tuberculosis; and bronchogenic carcinoma; a tracheobronchial foreign body is a rare clinical entity leading to massive hemoptysis.
Accidental toothpick ingestion has often been reported as the cause of gastrointestinal and respiratory tract injuries, and under very rare circumstances, may result in constrictive pericarditis, coronary artery perforation, obstruction of the ureter, and subphrenic abscess. Dental floss picks, which are also a plaque remover, are much larger objects than toothpicks, and have never been described as a causative agent of aerodigestive tract injuries. We report herein an adult patient with a dental floss pick stuck in the left mainstem bronchus asymptomatically for 8 years, who presented to the emergency department with acute onset of massive hemoptysis. The dental floss pick was successfully removed under flexible fiberoptic bronchoscopy and soon thereafter the hemoptysis resolved. To our knowledge, this is the first case report concerning a dental floss pick as a tracheobronchial foreign body leading to massive hemoptysis.
