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Category: FOREIGN BODIES IN THE BRONCHI FOR PROLONGED PERIODS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
If the foreign body completely obstructs a main
bronchus, preventing both aeration and drainage, such rapid
destruction of lung tissue follows that extensive pathologic changes
may result in a few months, or even in a few weeks, in the case of
irritating foreign bodies such as peanut kernels and soft rubber. Very
minute, inorganic foreign bodies may become encysted as in
anthracosis. Large objects, however, do not become encysted. The
object is drawn down by gravity and aspirated into the smallest
bronchus it can enter. Later the negative pressure below from
absorption of air impacts it still further. Swelling of the bronchial
mucosa from irritation plus infection completes the occlusion of the
bronchus. Retention of secretions and bacterial decomposition thereof
produces first a drowned lung (natural passages full of pus); then
sloughing or ulceration in the tissues plus the pressure of the pus,
causes bronchiectasis; further destruction of the cartilaginous rings
results in true abscess formation below the foreign body. The
productive inflammation at the site of lodgement of the foreign body
results in cicatricial contraction and the formation of a stricture at
the top of the cavity, in which the foreign body is usually held. The
abscess may extend to the periphery and rupture into the pleural
cavity. It may drain intermittently into a bronchus. Certain
irritating foreign bodies, such as soft rubber, may produce gangrenous
bronchitis and multiple abscesses. For observations on pathology (see
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