A 101-year-old woman was admitted to our hospital with a 2-day history of productive cough and dyspnea. Chest computed tomography revealed a highly dense, club-like structure with a low-density area inside, 25×10 mm in size, obstructing the lower portion of the truncus intermedius and the right basal bronchus (Picture 1, arrows). Bronchoscopy revealed white-colored, atheromatous material in the truncus intermedius (Picture 2A), which was successfully retrieved by suction through a fiberscope (Picture 2B). An analysis by Raman spectroscopy (RAMANtouch™) showed that the retrieved material was a tablet of polycarbophil calcium (ColonelⓇ) (Picture 3), which she had been taking for the treatment of irritable bowel syndrome. Only a few cases of polycarbophil calcium as airway foreign bodies have been reported to date (1). However, care must be taken to avoid aspiration of this tablet, as it can obstruct the airway due to its water-absorbing and swelling properties (2).
Picture 1.
Picture 2.
Picture 3.
The authors state that they have no Conflict of Interest (COI).
References
- 1. Kobayashi N, Itoh H, Matsui K, et al. A case of foreign body aspiration with polycarbophil calcium. Kikanshi-gaku (J Jpn Soc Respir Endoscopy) 38: 242, 2016(in Japanese). [Google Scholar]
- 2. Yoshida N, Miki T. Medicine of irritable bowel syndrome. High molecular polymer polycarbophil calcium (PolyfulⓇ). BIO Clinica 20: 449-452, 2005(in Japanese). [Google Scholar]