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April 13, 1984

Migration of Schrapnel From Lung to Bronchus

Author Affiliations

From the Veterans Administration Medical Center, Salisbury, NC.

JAMA. 1984;251(14):1862-1863. doi:10.1001/jama.1984.03340380044021

MORE than 60 years ago, the pioneer endoscopist Chevalier Jackson described his experience with foreign bodies of the lung.

Metallic foreign bodies cause little specific reaction. A very smooth, dense, insoluble, inorganic substance causes no trauma and little reaction for a long time, if drainage and aeration are not interfered with. On the other hand, a sharp, ragged fragment of such form as to cause continued trauma may be followed by such serious consequences as to make the prognosis grave if the intruder is not removed within a few weeks.1

The literature is filled with many interesting reports of foreign bodies in the lung.2 However, the reported instances of erosion of a foreign body into a bronchus are rare.

Report of a Case  One month before the Armistice was signed in World War I, a 23-year-old soldier was struck in the left side of his chest by a piece

Jackson C:  Prognosis of foreign body in the lung .  JAMA 1921;77:1178-1182.Crossref
Sommer GNJ Jr, McCulloch CS:  Surgical problems of retained intrathoracic foreign bodies .  Am Surg 1949;77:314-328.Crossref
Kovnat DM, Anderson W, Roth GS:  Hemoptysis secondary to retained transpulmonary foreign body .  Am Rev Respir Dis 1974;109:279-282.
Kelly WA, James EC:  Retained intrapulmonary bullet presenting with bronchial obstruction .  J Trauma 1976;16:153-154.Crossref
Vogt-Maykopf I, Kremhoor D:  Treatment in intrapulmonary skull fragments .  Surg Gynecol Obstet 1966;123:1233-1236.
Choh JH, Adler RH:  Penetrating bullet wound of chest with bronchoscopic removal of bullet .  J Thorac Cardiovasc Surg 1981;82:150-153.