Turban Pin: An Unusual Cause of Foreign Body Aspiration in Young Islamic Adult

Foreign body aspiration (FBA) is a common problem among children or infants. Nearly 85% of all FB aspiration occurs in childhood. Common organic aspirated materials include nuts and seeds while inorganic materials include plastic pieces or parts of toys (1). In adults, most of FBAs are seen in the 6th or 7th decade of life when the airway protection mechanism is impaired due to central nervous system dysfunction, intubation or facial trauma (2). Infants are more vulnerable because of immature swallowing coordination and lack of adequate dentition and they like to put objects into their mouths (3). Recently a new cause of FBA associated with traditional or social habits has been described. Turban pin aspirations have been reported in women wearing traditional headscarves in Islamic countries which we try to decribe in this letter. A 17-year-old-woman was referred to our emergency department with turban pin aspiration. Patient had aspirated a turban pin with beads when she tried to talk with the pin in her mouth while fixing the headscarf. She was coughing on admission. Vital signs were normal. No significant abnormality was detected in physical examination. Radioopaque foreign material was visualized with posteroanterior and lateral chest x-rays (Figure 1 A and B). Thoracic surgery department was consulted for urgent bronchoscopy and patient was admitted for further management. The turban pin was extracted with rigid bronchoscopy and forceps under general anesthesia in the operating room. The pin was located in the right main bronchus, about 1 to 2 cm from carina and was impacted in the transverse position. The spherical head of the pin was in the right upper lobe bronchus and the pin was grasped at the middle part and removed by forceps. Repeat chest X-Ray appeared normal and the patient was discharged after 24 hours of observation. There was no complaint or complication during the follow-up. Figure 1. A. PA; B. right lateral Chest X-ray of the Patient Revealing a Radiopaque Foreign Material