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To the Editor.—We have seen several patients with an unusual type of expectoration. Seven patients related a history of a cough varying in duration between a few weeks and ten years. Six of these patients had hemoptysis that varied in amount from spotting to hemorrhage of lifethreatening proportions. The offending item in two patients was a bullet fragment and shrapnel, respectively. In three patients the expectorated item had been left behind at the time of previous thoracic surgery. These were "weck clips," a sponge, and a wax pack. The two remaining patients expectorated a broncholith and a tumor cast. In each of these patients symptom relief or improvement was obtained with expectoration of the unusual offending item—sponge, bullet fragment, shrapnel, "weck clips" (six), broncholith, tumor cast, and wax pack.
DIETER RA. Unusual Expectoration Due to a Foreign Body. Arch Surg. 1974;108(1):123. doi:10.1001/archsurg.1974.01350250109029