SHM Converge Scientific Abstract ePoster Gallery-Pill Aspiration and Subsequent Mucosal Injury in a Complex Clinical Case

Pdf Summary

This case report describes a 78-year-old man with paraplegia who presented with worsening dyspnea, fatigue, confusion, and acute hypoxic respiratory failure. Initial chest imaging showed a large left pleural effusion with left lung atelectasis, a moderate right pleural effusion, and a 5.7 cm lobulated right lower lobe mass. A chest tube drained exudative fluid without evidence of infection or malignancy, but the patient’s respiratory status worsened, leading to intubation.<br /><br />Subsequent imaging suggested right lower lobe consolidation and possible re-expansion pulmonary edema, and he was treated empirically for aspiration pneumonia. Because of persistent respiratory decline, bronchoscopy was performed and revealed copious thick mucoid secretions in the bronchus intermedius extending into the right middle and lower lobe bronchi, along with a yellow-brown plaque-like lesion. Bronchoalveolar lavage and pathology identified crystalline yellow-brown pigmented material, inflammatory debris, and reactive epithelial cells, findings consistent with pill aspiration. No malignant cells were seen.<br /><br />The patient’s history of polypharmacy, including ferrous sulfate and potassium chloride, supported the diagnosis. The report emphasizes that pill aspiration can cause severe airway injury, including inflammation, necrosis, mucus plugging, and chronic respiratory compromise, especially when pills contain caustic substances such as iron or potassium chloride. CT imaging may show consolidation or atelectasis, but bronchoscopy remains the diagnostic gold standard. The authors stress the importance of early recognition and intervention to minimize airway damage and complications.

Asset Subtitle

Nursultan Abdreyev

Meta Tag

Author List Indira Kanybekova, Nursultan Abdreyev

Category Clinical Vignettes

Concept Pill Aspiration

Concept Bronchoscopy

Concept Airway Lesion

Concept Consolidation

Concept Mucus Plugging

Distinguished Non-Finalist

Presenter Organization UPMC McKeesport

Presenting Author Nursultan Abdreyev

Track Adult

Keywords

pill aspiration

bronchoscopy

acute hypoxic respiratory failure

pleural effusion

atelectasis

mucoid secretions

polypharmacy

ferrous sulfate

potassium chloride

airway injury

Pill Aspiration

Bronchoscopy

Airway Lesion

Consolidation

Mucus Plugging