Office removal of a subglottic bread clip

Plastic bread clip impacted in gastrointestinal tract: a case report and review of the literature

A 79-year-old initially presented to her general practitioner for a 6-week history of nausea, intermittent abdominal pain and altered bowel habits. Colonoscopy was performed to investigate her symptoms and revealed a bread clip that was adherent to the sigmoid colon mucosa, unable to be retrieved. A CT scan was performed to exclude any associated complication, which showed no evidence of perforation or collection. A repeat colonoscopy by a more experienced endoscopist again failed to retrieve the bread clip. Eventually, the bread clip had to be removed through a laparotomy and colotomy. We performed a thorough literature review, which revealed 26 studies (totalling 38 cases) of bread clip ingestion. Many of the reported cases presented with abdominal pain, bowel obstruction, or perforation and carried a small mortality risk.

A rare case report of tracheal leech infestation in a 40-year-old woman

Leeches are the very rare types of airway foreign body. Here we report a rare case of a 40-year-old woman with tracheal leech infestation. A 40-year-old woman presented 2-month history of dyspnea, occasional haemoptysis. There were foreign body sensation in throat, cough and hoarseness. Computed Tomography (CT) revealed some soft tissue shadow in the upper trachea. Eventually a 5 cm long living leech was smoothly removed from trachea by rigid bronchoscopy under sevoflurane general anesthesia. The airway leech infestation should be kept in mind especially in patients presenting with unexplained haemoptysis, dyspnea, hoarseness and a foreign body sensation in the throat and a history of drinking infested water from streams, pools and spring. General anesthesia might be necessary for the removal of the leech.