Plastic Bullet as a Foreign Body in the Bronchus

Otolaryngologists have recently had a chance meeting with patients suffering from foreign body problems due to ingestion of plastic goods, for examples, plastic imitation lipsticks and doll bottle caps or the like which would normally be put in or near the mouth. Of current note here are light, slippery, plastic, imtation bullets which are physically easy to ingest. Three patients, aged 5, 7 and 8 with ingested plastic bullets were successfully treated with endoscopic procedure in our clinic during January of 1973. Diagnosis of ingesting those foreign bodies in the bronchus was easily obtained thanks not only to radiographic examination in conjunction with careful physical examination but also to very clear history of aspiration. Extraction of the plastic bullet, however, was not so easy because clear detection of the ingested bullet under ventilation bronchoscope was difficult due to its pinkish color, and because the bronchus was easily and completely obstructed by the bullet due to its funnel-like shape. In this paper, our successful cases were reported and discussed mainly from the viewpoint of some devices or ideas how to find endoscopically such a plastic, pinkish and funnel-like shaped bullet.