All that glitters is not gold: A case of lanthanum carbonate aspiration

Autor: Suchitra Paranji, Neethi Paranji, Adam S Weltz
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: SAGE Open Medical Case Reports, Vol 5 (2017)
Druh dokumentu: article
ISSN: 2050-313X
2050313X
DOI: 10.1177/2050313X17712642
Popis: Introduction: Foreign body aspiration is a significant cause of morbidity and mortality in elderly hospitalized patients. These are typically small items that patients have access to, including small coins. Case presentation: This is a case report of a 75-year-old man recently bedridden from a large hemispheric stroke with sudden onset of hoarseness, cough and dysphagia. A chest X-ray was obtained which showed a radiopaque coin-shaped foreign body, presumably a coin in his aerodigestive tract. He was promptly taken to the endoscopy suite for upper endoscopy. During endoscopy, it was determined that the foreign body was a radiopaque medication that he had been given. It was easily and safely able to be crushed and lavaged down into his stomach and later determined to be lanthanum carbonate, a commonly used phosphate binder. Following endoscopy, the patient’s cough, hoarseness and dysphagia resolved with no long-term complications. Discussion: Lanthanum carbonate is a phosphate-binding medication used in the management and treatment of hyperphosphatemia commonly seen in patients with end-stage renal disease, which is radiopaque. There are few published reports and images of radiopaque fragments of medication in the gastrointestinal tract but none causing aspiration by masquerading as a coin-like density in the aerodigestive tract as we present here.
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