Dental Floss Pick Impacted in the Windpipe for 8 years

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dental floss pick
A 7-cm dental floss pick recovered from bronchus

Doctors find a lost dental floss pick 8 years later from the patient’s windpipe. This happened when he presented with an acute episode of coughing up blood.

A 32-year-old, otherwise healthy male with no known comorbid, presented to the emergency department with complaints of bright red blood during acute coughing over the past 3 hours. This happened after an episode of sneezing. The blood was approximately 300 ml in quantity. After a series of investigations, the doctors found an impacted dental floss in the windpipe.

History revealed that the patient was a non-alcoholic, non-smoker, and had no history of upper airway diseases, chest trauma, or medication use including aspirin or non-steroidal anti-inflammatory drugs. Moreover, he denied any similar previous episodes or other pulmonary symptoms. Neither he nor his family had any history of haemoptysis, chest diseases, or bleeding disorders.

On examination in the ER, his body temperature was 36.8°C, pulse was 88/minute, respiratory rate was 18/minute, and blood pressure was 128/88 mmHg. Oxygen saturation on room air was 98%. The rest of the physical examination was unremarkable.

Serological investigations revealed normal complete blood count, urea and nitrogen, creatinine, liver function tests, and coagulation profiles. Also, urinalysis was also normal.

Imaging revealed a foreign body!

The doctors advised a plain radiograph of the chest which showed an ill-defined opacity around the left hilum.

Computed tomography scan of the chest revealed a soft-tissue opacity within the left main bronchus. Also, it revealed a needle-shaped object protruding from the bronchus.

Panel A: Chest radiograph PA view showing an ill-defined opacity (arrowheads).
Panel B and C: CT scan showing soft tissue density (arrowheads) within the left mainstem bronchus with a needle-shaped object (arrow) protruding from it.

With the above findings, the doctors strongly suspected retained tracheobronchial foreign body. They performed flexible fiberoptic bronchoscopy which showed an impacted dental floss pick in the left main bronchus. Moreover, it also showed granulation tissue formation and clotted blood over it.

The impacted dental floss pick was successfully removed using biopsy forceps. The procedure had no complications. After the removal of the object, the patient recalled ingesting a dental floss pick accidentally around 8 years back. However, never had he ever experienced any symptoms during the past 8 years.

He admitted continued use of dental floss to clean his teeth daily.

Post-procedure, the patient did not have another episode of hemoptysis. Therefore, he was discharged from the hospital after a few hours.

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Dr. Arsia Parekh
Dr. Arsia Hanif has been a meritorious Healthcare professional with a proven track record throughout her academic life securing first position in her MCAT examination and then, in 2017, she successfully completed her Bachelors of Medicine and Surgery from Dow University of Health Sciences. She has had the opportunity to apply her theoretical knowledge to the real-life scenarios, as a House Officer (HO) serving at Civil Hospital. Whilst working at the Civil Hospital, she discovered that nothing satisfies her more than helping other humans in need and since then has made a commitment to implement her expertise in the field of medicine to cure the sick and regain the state of health and well-being. Being a Doctor is exactly what you’d think it’s like. She is the colleague at work that everyone wants to know but nobody wants to be. If you want to get something done, you approach her – everyone knows that! She is currently studying with Medical Council of Canada and aspires to be a leading Neurologist someday. Alongside, she has taken up medical writing to exercise her skills of delivering comprehensible version of the otherwise difficult medical literature. Her breaks comprise either of swimming, volunteering services at a Medical Camp or spending time with family.

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