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Correspondence to Author: Menghak Heng^1*,Bunleng Kou²,Chamroeunniron Long¹, Sarin Chan¹,Vanny Sieng³,Pathy Ngeth³, Thy Try⁴, Bunpaul Chhar^1,5 

1 Pulmonologist, Pulmonology Unit, Medical Ward “A”, Calmette Hospital, Cambodia.
2 Pulmonology Residency, Faculty of Medicine, University of Health Sciences, Cambodia.
3 Anesthegist, Calmette Hospital, Cambodia.
4 Neurosurgeon, Calmette Hospital, Cambodia.
5 Chief of Pulmonology Unit, Medical Ward “A”, Calmette Hospital, Cambodia.

DOI: 10.52338/jrmr.2025.5069

Abstract:

Introduction: Foreign body aspiration (FBA) in elderly patients is an uncommon but potentially life-threatening event. Diagnosis is often delayed due to atypical presentations and the absence of radiographic evidence, particularly for radiolucent organic material.
Case Presentation: A 71-year-old woman presented with a 3-month history of productive cough, wheezing, and exertional dyspnea following accidental aspiration of a sapodilla seed. Initial evaluations, including a chest X-ray, were unremarkable. She received multiple antibiotic courses without improvement. Physical examination revealed decreased breath sounds over the right hemithorax. Given the strong suspicion of bronchial foreign body, the patient underwent emergency rigid bronchoscopy under general anesthesia. A large sapodilla seed was identified in the right lower bronchus and removed using rigid forceps. Minor bronchial wall trauma was controlled with topical adrenaline, cool physiological saline, and lidocaine. Postoperatively, her symptoms resolved completely, and oxygen saturation improved to 96% on room air. She was discharged the following day and remained asymptomatic at 1-week follow-up.
Conclusion:FBA should be considered in elderly patients with unexplained, persistent respiratory symptoms, even in the absence of radiographic evidence. Rigid bronchoscopy remains a safe and effective intervention for removing large or impacted bronchial foreign bodies. Early intervention can prevent complications and avoid the need for surgical removal.

Keywords:Rigid bronchoscopy, Foreign body aspiration, Sapodilla seed, Elderly; Bronchial obstruction

Citation:

Menghak Heng, Removal of a Sapodilla Seed From the Bronchus in an Elderly Patient by Rigid Bronchoscopy at Calmette Hospital, Cambodia. Journal of Respiratory Medicine and Research 2025.