Inhaled foreign body: trachea - Erler Zimmer 3D anatomy Series MP2053

This dissection model highlighting a foreign body injury in the trachea is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with ultra-high resolution color 3D printing.

Clinical History.

A 57-year-old man presented with a 3-week history of cough and left pleural chest pain. Chest radiograph showed a left upper lobe collapse with large pleural effusion on the left side. Pleurodesis aspirated frank pus from the pleural cavity. She later died despite pleural drainage and antibiotic treatment.

Pathology

This specimen shows the lower trachea and main bronchi. These were cut open and the left upper lobe was sliced to visualize the cut surface. At the point of origin of the left upper lobe bronchus is an impacted foreign body; an inhaled rabbit vertebra! Due to the obstruction, the upper lobe has collapsed, pneumonia has developed, and the pleural surface is covered with fibrinous exudate. This is an inhaled foreign body with associated collapse and lung consolidation of the left upper lobe and empyema.

Additional Information.

Foreign body inhalation or foreign body aspiration (FBA) occurs when a foreign body is inhaled into the airway causing partial or complete airway obstruction. This can be potentially fatal. It is more common in children than in adults. It is one of the leading causes of accidental death worldwide. Inhalation of a foreign body or aspiration of a foreign body has the highest risk of death for patients younger than 1 year and for patients older than 75 years.

Risk factors for FBA in adults include decreased level of consciousness, drug or alcohol intoxication, or anesthesia. In the elderly, additional risk factors include medication use (impaired coughing and swallowing), stroke-related dysphagia, and degenerative neurological diseases, such as Alzheimer's or Parkinson's disease. In adults, the most commonly aspirated foreign bodies include inorganic objects (e.g., nails, pins, dental debris) and organic material (e.g., bones, improperly chewed meat, and watermelon seeds). Symptoms at presentation vary depending on the degree of airway obstruction caused. Larger obstruction may present as suffocation or sudden asphyxia. Smaller foreign bodies may present with more insidious symptoms such as cough, dyspnea, fevers, chest pain, and hemoptysis. Collapse of the airway distal to the foreign body will lead to infection.

What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient X-ray data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.