Toothpick Aspiration Induces Massive Hemoptysis: a Case Report

Background: Massive hemoptysis refers to bleeding from the sputum exceeding 100 ml/day. This condition is known to have a poor prognosis. Although foreign body aspiration is not as common as other risk factors, it may result in massive hemoptysis. In the current study, we presented a case of massive hemoptysis due to the aspiration of a toothpick. Case Presentation: The patient was a 49-year-old woman who was primarily suspected of having tuberculosis. After observing blood in the sputum, interventions, including chest computed tomography (CT) scan and conservative management, were performed. The CT scan showed no malignancy, and paraclinical investigations were negative. However, hemoptysis was progressing into an acute phase; therefore, a surgical intervention was performed for the patient. After the surgery, the cause of the lesion was found to be a toothpick. The patient was under intensive care after surgery and was discharged from the hospital in a good general condition. The morphological evaluation of the lesion showed a bronchial wall with ulceration, besides granulation tissue formation, hematoma, and fibrinoid necrosis due to foreign body aspiration into the lung, resulting in inflammatory reactions. Conclusion: In this case report, foreign body aspiration resulted in massive hemoptysis. Our primary attempts to diagnose the cause of lesion were unsuccessful, and surgery was performed due to the life-threatening condition of the patient. Overall, unexplained hemoptysis may occur following a serious accident due to foreign body aspiration.