Hyderabad doctors remove lodged vitamin tablet from COPD patient’s airway in rare bronchoscopy procedure

A 75-year-old man with chronic obstructive pulmonary disease (COPD) from Hyderabad received life-saving treatment after doctors at STAR Hospitals, Nanakramguda, discovered and removed a vitamin B-complex tablet with its cover lodged in his right main bronchus. The foreign body, measuring 14 × 8 mm, was causing air trapping in his right lung and worsening his respiratory symptoms.

The patient initially presented with persistent shortness of breath, chest discomfort, and cough with sputum. He had been treated elsewhere for what was believed to be an acute exacerbation of COPD, but his symptoms continued despite treatment. This prompted a referral to Dr. Peddi Srikanth, a Clinical and Interventional Pulmonology specialist at STAR Hospitals.

The case

Dr. Srikanth ordered a chest CT scan, which revealed the foreign body in the right main bronchus, one of the major air passages leading to the lung. The obstruction extended towards the right upper lobe bronchus and was causing air trapping in the right lung. The patient was diagnosed with an acute exacerbation of COPD with low oxygen levels. Additionally, his sputum culture showed Enterobacter cloacae, indicating an associated respiratory infection.

The patient was initially stabilised with antibiotics, nebulisation, and supportive treatment. Once his condition was suitable for intervention, Dr. Srikanth and his team performed a bronchoscopy under general anaesthesia. This procedure allows doctors to look directly into the breathing passages and remove obstructions.

The bronchoscopy revealed the foreign body in the right main bronchus. It was a B-complex tablet with its cover, which had inadvertently entered the airway and remained lodged there. The foreign body was successfully removed, and samples were collected for microbiological evaluation. As the patient’s condition improved during his hospital stay, he was discharged.

Key facts about the case

Why this matters for Hyderabad residents

Foreign body aspiration is more common in children and elderly individuals, especially those with underlying lung conditions like COPD. This case highlights the importance of thorough diagnostic evaluation when standard treatment for COPD exacerbation does not produce expected results. For Hyderabad residents, especially those caring for elderly family members with chronic respiratory conditions, this case underscores the need to be aware of unusual causes of worsening symptoms.

COPD affects a significant number of older adults in Hyderabad, particularly those with a history of smoking or exposure to air pollution. Symptoms such as persistent breathlessness, cough, and chest discomfort that do not respond to standard treatment should prompt further investigation, including imaging studies.

The role of bronchoscopy

Bronchoscopy is a minimally invasive procedure that allows pulmonologists to examine the airways and remove foreign bodies, collect tissue samples, or treat certain conditions. In this case, it was the key intervention that resolved the patient’s airway obstruction and allowed him to recover fully. The procedure is performed under anaesthesia and typically involves a flexible tube with a camera passed through the mouth or nose into the lungs.

For Hyderabad residents, access to advanced interventional pulmonology services at hospitals like STAR Hospitals means that such procedures are available locally, reducing the need to travel to other cities for specialist care.

Preventive measures

While this case involved an accidental aspiration of a tablet, there are steps that can reduce the risk of similar incidents. Elderly individuals, especially those with swallowing difficulties or neurological conditions, should take medications with care. Tablets should be taken one at a time with sufficient water, and the person should be sitting upright. For those with significant swallowing problems, alternative formulations such as liquids or dissolvable tablets may be considered.

Caregivers and family members should be alert to signs of aspiration, including sudden coughing, choking, or difficulty breathing after taking medication. If symptoms persist, medical evaluation is warranted.

Source: Telangana Today – Hyderabad doctors remove vitamin B-complex tablet lodged in COPD patient’s airway