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Spoon handle aspiration
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  1. C L Dickinson,
  2. S Nizar,
  3. A C Wan,
  4. M S W Lee
  1. St George’s Hospital, Urology, St George’s Healthcare NHS Trust, London, SW17 OQT, UK
  1. ldickinson{at}doctors.org.uk

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A 57-year-old man with a history of depression attended accident and emergency reportedly having swallowed several foreign bodies. He complained of abdominal pain, wheeze and coughing up blood. Vital observations were normal, and an abdominal x ray revealed several coins and a keyring within the bowel. On chest x ray, a bent over spoon handle was seen apparently lying within the mid oesophagus, and an upper gastrointestinal endoscopy was planned for the next day. On closer examination with a lateral chest x ray, it was localised instead to the right main bronchus. The spoon handle was removed uneventfully by rigid bronchoscopy during admission.

When investigating ingested or inhaled foreign bodies, it is important to delineate their precise anatomical location, in this case with lateral chest radiographs. This will guide appropriate management.

Figure 1 Chest x ray revealing bent over spoon handle.

Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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