A 69-year-old woman with hypothyroidism, hypertension, multiple previous strokes, and partial gastrectomy had been taking daily ferrous sulfate tablets. She remembered aspirating an iron pill when she experienced choking, wheezing, and cough. Chest radiograph was normal. Two months later she was hospitalized with pneumonia and required assisted ventilation. Bronchoscopy at that time revealed extensive inflammation of the truncus intermedius (TI) and left lower lobe bronchus (LLLB). No foreign body was detected but the TI was lined with greenish brown necrotic material (Fig. 1).Since she remained symptomatic, repeat bronchoscopy was performed 3 months later, revealing 90% and 70% stenosis of the TI and LLLB respectively. Near-total patency of the bronchi was established by balloon bronchoplasty followed by an endobronchial injection of submucosal DepoMedrol.
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