TY - JOUR T1 - Management of video capsule bronchial aspiration JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P3584 AU - Matthieu Buscot AU - Stéphanie Martinez AU - Jérôme Filippi AU - Céline Sanfiorenzo AU - Xavier Hebuterne AU - Charles-Hugo Marquette Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P3584.abstract N2 - A 74-year old patient with of occult gastrointestinal bleeding was referred for a small bowel exploration using video capsule endoscopy. Medical history revealed left hemiparesis and swallowing disorders as sequels of stroke. A video capsule endoscopy was scheduled after the advice of the ENT specialist.Within minutes after the capsule ingestion, the patient developed a typical chocking episode. Real-time visualization of the video-endoscopic “bronchial tree” images by the gastroenterologist quickly assisted by the pulmonologist enabled locating the capsule at the level of the main carina / left main bronchus.Immediate bronchoscopy under general anesthesia allowed the pulmonologist to gently catch the video capsule and to readily place it within the gastro-intestinal tract (stomach). Small bowel exploration could then be perfomed “as scheduled” and revealed duodenal and jejunal angiomas as the source of the bleeding.Pictures as well as short video sequences of the chocking episode and of the gastro-intestinal placement of the capsule with the bronchoscope are presented.Based on this experience and on the litterature (about 9 reported cases of tracheo-bronchial video capsule aspiration) two recommendation can be made§ caution should be taken in patients with swallowing disorders§ immediate tracking by of the capsule initial path is recommendedThe present case also shows that a combined approach (gastroenterologist + pulmonologist) permits to replace the video capsule in the right way during the same procedure. ER -