IMAGES IN EMERGENCY MEDICINE
The dangers of toothpicking
Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield, UK
Correspondence to:
Mr P Vaughan, Department of Cardiothoracic Surgery, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK; paul_vaughan@hotmail.com
Accepted 26 November 2007
| The first 150 words of the full text of this article appear below. |
A 22-year-old man presented to his local hospital with sudden onset of a dry cough after picking debris from his teeth with a 4 cm metal pin. The patient was under the influence of alcohol at the time, although otherwise neurologically and psychiatrically intact. The pin had somehow become misplaced during the procedure.
A chest radiograph showed the foreign body in the left lower lobe with the point of the pin superiorly (fig 1).
Figure 1 Chest radiograph showing the foreign body in the left lower lobe.
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He underwent rigid bronchoscopy and extraction of the pin (fig 2) without complication. The underlying trachea and bronchi were normal.
Figure 2 Pin following rigid bronchoscopy.
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Contrary to popular belief, foreign bodies can become impacted in the left lung despite normal anatomy. Such patients should be referred promptly for bronchoscopic extraction. Should this fail, thoracotomy and open removal is required.
Competing interests: None.
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