罕見之氣道異物（筆蓋）及特殊的取出方法

Foreign body aspiration is an emergent and potentially life-threatening event. Children and toddlers under 3-5 years are usual victims. Prompt diagnosis with early treatment is essential to prevent serious complications. A 12-year-old boy was treated as asthma for 2 years after an episode of foreign body aspiration. Intractable pneumonia of left lung was developed in spite of the intervention of systemic antibiotics. Computed tomography showed a suspected foreign body with obstruction of left main bronchus. Rigid ventilation bronchoscopy demonstrated a central hollow foreign body lodged in the left main bronchus after suction of thick mucous secretion. Removal of foreign body by grasping forceps was found to be difficult because of deep embedment of foreign body in the bronchial mucosa. We decided to fully utilize the characteristic of foreign body by inserting the forceps into the hollow foreign body, opening the forceps and then pulling the foreign body out of airway. The foreign body was found to be a head-hollow pen cap. The patient was free of cough and chest x-ray showed restoration of pulmonary parenchyma one month after bronchoscopy. The case reminds that school-aged children are not spared to foreign body aspiration. Aspiration of pen cap is possible when school child is biting pen cap with accidental aspiration. Accurate diagnosis and proper removal based on the nature of foreign body can significantly improve clinical symptoms, avoid complications and subsequent salvage operation.