Procedures: Procedures: Bronchoscopy |

The Clinical Features of Tracheobronchial Living Foreign Body: Leech FREE TO VIEW

Xi-Qian Xing, MD; Zhong-Chuan Yang; Yan-Ping Li; Xu-Wei Wu; Hong-Yan Liu; Li-Qiong Liu; Li-Hui Zhang
Author and Funding Information

First Department of Respiratory Medicine, Yan'an Hospital Afilliated to Kunming Medical University, Kunming, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A433. doi:10.1016/j.chest.2016.02.451
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SESSION TITLE: Procedures: Bronchoscopy

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To investigate the clinical features of tracheobronchial foreign body: leeches.

METHODS: This is a retrospective study of medical records in three tertiary hospital of Yunnan Province from August 2013 to February 2015. Data was collected from patients who were diagnosed as had tracheobronchial leeches via bronchoscopy. The associated medical information, bronchoscopic features and removal method were reviewed and analyzed.

RESULTS: Four patients with tracheobronchial leeches were enrolled. Among whom one-half were male and the mean age was 51.0 ± 3.5 years old (range, 48 years to 58 years). All the patients came from rural areas and had a history of drinking field unboiled water from streams, pools and springs. 3 patients had dyspnea, 1 case had cough and bloody sputum and 1 patient had mild anemia. The peripheral blood eosinophile granulocytes of 3 patients were increased. The coagulation function of all the patients was normal and all patients had no hemorrhagic tendency. Chest computed tomography showed tracheal foreign bodies of 2 cases, the basal segment of the lower lobe of the right lung had a lesion with high density in 1 case, and some exudation in the medial segment of the right middle lobe in the other case. Bronchoscopy revealed a leech in trachea of 3 cases and one leech in the right medial basal segmental bronchus of 1 case. 3 leeches were removed via cryotherapy by flexible bronchoscope and 1 leech was taken out through foreign body forceps by flexible bronchoscope. The symptoms of all the cases were improved obviously after removed the leeches.

CONCLUSIONS: The physician should be aware of the possibility of the tracheobronchial leeches if the patients who come from rural areas have a history of drinking field unboiled water and have the following symptom, such as dyspnea, cough, bloody sputum and increased peripheral blood eosinophilic eosinophiles. The tracheobronchial leeches can be removed via cryotherapy or foreign body forceps by bronchoscope.

CLINICAL IMPLICATIONS: The tracheobronchial leech infestation should be kept in mind especially in patients presenting with unexplained dyspnea, bloody sputum and increased peripheral blood eosinophilic eosinophiles and a history of drinking infested water from streams, pools and springs.

DISCLOSURE: The following authors have nothing to disclose: Xi-Qian Xing, Zhong-Chuan Yang, Yan-Ping Li, Xu-Wei Wu, Hong-Yan Liu, Li-Qiong Liu, Li-Hui Zhang

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