A 6cm Metal Crack Pipe Aspirated

A 56 year-old male, schizophrenic, was admitted for respiratory distress while, according to the patient, he was doing do-it-yourself (DIY) work. The chest X-ray revealed a metallic elongated foreign body in the right main bronchus (RMB) (Fig. 1), confirmed by the chest computerized tomography (CT) a turbine for air circulation in its interior (Fig. 2). Subsequently, rigid bronchoscopy was performed and a shiny object with smooth edges was visualized (Fig. 3) with a large rigid crocodile forceps was extracted in bloc (Fig. 4). The patient recovered without complication. The length was 6 cm (Fig. 5), at its most enlarged end had, rounded holes of 2 mm, a filter inside its tappered end and one of its side showed signs of probable combustion (Fig. 6). All of these characteristics, compared to Internet, made us think that it could be a crack pipe.

Fig. 1.

Posterior–anterior radiograph with metallic foreign body in the right bronchial tree.

Fig. 2.

Metallic foreign body with turbin inside the right main bronchus on chest computerized tomography.

Fig. 3.

Endobronchial view with its rounded edge of crak pipe in the right main bronchus.

Fig. 4.

Grip with rigid forceps through the rigid bronchoscope.

Fig. 5.

Crack pipe's measurement.

Fig. 6.

Burned side of the crack pipe.

Bronchial aspiration of accessories for the inhaled consumption of crack or even the drug itself has been published. There are one with a glass crack pipe located in the left main bronchus simulating an endobronchial prothesis on CT¹ and another very serious one while fleeing from the police he aspirated the plastic bag with wrapped drug and it is caused complete obstruction of the trachea with recovered cardiorespiratory arrest.²

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