日気食会報，73（3），202225） Tonan M, Hashimoto S, Kimura A, et al：Success-ful treatment of severe asthma-associated plastic bronchitis with extracorporeal membrane oxy-gene. J Anesthesia 26：265─268, 2012.26） 木村拓也，米倉竹夫，山内勝治・他：10歳女児に発症したplastic bronchitisの1例．小児外科45：353─358, 2013.27） 齋藤圭一，前林祐樹，齋藤朋洋・他：気管支異物A Case of Plastic Bronchitis Presenting Difficulty in Differentiation with J. Jpn. Bronchoesophagol. Soc., 73 : 237─244, 2022Tracheal foreign bodies are a common emergency situation in the field of otolaryngology, but bronchial mucus embolism is rarely experienced. Here, we report one such case experienced in our institution. The case was a 4-year-old boy who was healthy and had no history of allergic dis-ease. He contracted streptococcal infection in August of a certain year, followed by bronchiolitis with human metapneumovirus in September. In October, he ran a fever again and was hospital-ized with a diagnosis of pneumonia. His symptoms failed to improve, however, and imaging exami-nation revealed a foreign body in the respiratory tract. A nut was suspected. The patient was transferred to our institution and underwent bronchoscopy, resulting in a diagnosis of bronchial mucus embolism, i.e. plastic bronchitis（PB）．PB was first reported in 1902. In Japan, prior to our case a total of 37 cases of pediatric PB had been reported from 1992 to 2020, all of which were di-agnosed and treated using a bronchoscope. We investigated all 38 cases. In 10 cases, the mucous plug could not be completely treated by the first bronchoscopic treatment alone. One patient died, and two patients had residual encephalopathy after cardiopulmonary arrest. Bronchoscopy is use-ful for the diagnosis and treatment of PB, but careful observation of respiratory status is required not only during bronchoscopy but postoperatively as well.bronchoscopyKey words : emergency, plastic bronchitis, bronchial mucus embolism, tracheal foreign body, との鑑別を要したPlastic Bronchitisの1例．山梨県立中央病院報39：93─96, 2013.28） 世良武大，濱本隆夫，谷 博雄・他：気管支異物との鑑別を要した鋳型気管支炎の1例．日気食会報69：255─260, 2018.29）Kirito Y, Matsubayashi T, Ohsugi K：Three cases caused by influenza B virus Yamagata lineage. Pediatrics International 61：421─423, 2019.244Tracheobronchial Foreign Body1）Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, 2）Department of Head and Neck, Esophageal Medical Oncology, Kumamoto University, Kumamoto and National Cancer Center Hospital, TokyoMai Itoyama, M.D.1）, 2）, Satoru Miyamaru, M.D., Ph.D.1）, and Yorihisa Orita, M.D., Ph.D.1）
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