• bronchoscopy
• cryotherapy
• pediatric pulmonary diseases

• pediatric bronchoscopy
• advanced diagnostic bronchoscopy
• interventional bronchoscopy
• pediatric pulmonology fellowship training

• Humans
• Bronchoscopy/methods
• Pediatrics

• KL2 TR004421 NCATS NIH HHS
• UL1 TR004419 NCATS NIH HHS

• ECMO
• cryoextraction
• cryotherapy
• flexible bronchoscopy
• pediatric

• Humans
• Child
• Bronchoscopy/methods
• Critical Illness
• Treatment Outcome
• Bronchitis/etiology
• Airway Obstruction/etiology
• Airway Obstruction/surgery
• Retrospective Studies
• Plastics
• Cytomegalovirus Infections/etiology

• foreign body
• granuloma
• paediatrics

• Complications
• Cryotherapy
• Dilatation
• Electrocautery
• Recurrence
• Tracheobronchial stenosis

• ciprodex
• granulation tissue
• intranasal
• otic
• pediatrics
• safety
• steroids

Pseudobronchial crista-like change is an unusual type of inflammatory granulation tissue hyperplasia in the endobronchial membrane caused by chronic retention of bronchial foreign bodies. Here, we report a case of pseudobronchial crista-like change in a 4-year-old boy who required admission for intermittent cough for >10 days and wheezing for 2 days. The main manifestation was persistent and non-healing lobar pneumonia. Initial electronic bronchoscopy showed cristae at the distal left main bronchus, which was misdiagnosed as bronchial opening stenosis. Repeat electronic bronchoscopy was performed after standard antibiotic treatment proved ineffective. Foreign bodies were observed at the opening of the basal branch of the left lower lobe. The left main bronchial cristae were clamped. The cristae appeared to be a pseudobronchial crista-like change caused by long-term retention of bronchial foreign bodies. After CT-confirmation of no abnormal blood supply at the cristae, the bronchial foreign bodies were removed, and the distal cristae of the left main bronchus were cut-off by laser, followed by balloon dilatation. To our knowledge, no similar cases have been reported so far in our review of domestic and foreign literature. Insufficient clinical understanding of Pseudobronchial Crista-like Change increase the risk of misdiagnosis and missed diagnosis. Detailed exploration and careful identification under bronchoscopy are helpful for the timely diagnosis and treatment of Pseudobronchial Crista-like Change.

We report a case of a nine-year-old boy with clinical evidence of foreign body (FB) aspiration with 3 months of delay in diagnosis. The bronchoscopy found soft tissue FB with surrounding inflamed granulation tissue at the entrance to the lateral segmental bronchus. Repeated attempts to remove the FB with flexible forceps were unsuccessful due to friable FB and granulation tissue. Ablation of the granulation tissue using nitrous oxide cryotherapy was then successfully performed and the distal and organic FB was extracted. Early diagnosis is important for minimizing granulation tissue development which complicates FB removal. Cryotherapy with a flexible bronchoscope is an option if organic FB cannot be removed using conventional bronchoscopic instrumentation.

Foreign body aspiration mainly occurs in children, which can cause a severe concurrent syndrome and even death without timely treatment. As a rare foreign body, aspiration of lime is seldom reported, and most cases involve a small amount of hydrated lime. Although the symptoms are usually severe, the prognosis is good after suitable treatment. Experience of treatment for lime aspiration is lacking, and this report provides novel evidence for treatment of mass burnt lime aspiration using bronchoscopy.

We report an adult with a large amount of burnt lime aspiration. Because of delay in clearance of the inhaled lime in the trachea and bronchus at the local hospital, he suffered several severe complications, including complete occlusion of the right primary bronchus, aeropleura, aerodermectasia, pneumomediastinum, secondary infection and hypoxemia at 4 d after injury. After transferring to our department, bronchoscopy was immediately carried out to clear the lime in the major airway, using foreign body forceps, biopsy forceps, puncture needle, and hairbrush. The patient’s condition recovered rapidly and at 3-months’ follow-up, he demonstrated good recovery of the bronchus and lung parenchyma.

After mass lime aspiration, flexible fiberoptic bronchoscopy is suggested as early as possible, using clamping, flushing or cryotherapy.

• Burnt lime
• Aspiration
• Bronchial obstruction
• Flexible fiberoptic bronchoscopy
• Computed tomography
• Case report