P088

YH. Zhang*a (Prof)

a The First People's Hospital of Yunnan Province, Kunming, CHINA

* yunhuizhang3188@126.com

BackgroundThe tracheal leech infestation is a relatively rare cause of hemoptysis. The extraction of the leech attached to the respiratory tract is not always easy , not olny because of its slippery body surface which can easily be ruptured, but also due to its important link power. According to previous literature reports, the leech should be removed by rigid bronchoscopy under general anesthesia. Our case shows that the leech can be safely removed by the flexible bronchoscope under local anesthesia if cryotherapy was used.

Case Report:A 74-year-old man presented to our hospital with complaints of haemoptysis, cough and pharyngeal discomfort for 45 days. The patients came from rural area and had a history of drinking unboiled water from streams.On examination, there were no abnormal findings. Routine haematological and coagulation analysis were normal. Chest computed tomography revealed soft tissue shadow in the upper trachea. The flexible bronchoscopy was performed under local anesthesia. It revealed a brown worm-like moving foreign body attaching to the upper trachea approximately 2 cm below the glottis. The worm was removed safely in one piece via cryotherapy by flexible bronchoscope. It was identified as a leech, measured about 4 cm and was mobile. Repeat bronchoscopy revealed no bleeding and blood clots in the trachea. The symptoms were improved obviously after removal of the leech. One week after discharge, by telephone follow-up, the patient did not complain of discomfort.

Conclusion: Intrabronchial cryotherapy by bronchoscope might be the best way of extraction of leeches,and it can be performed under local anesthesia.

Disclosure of funding source(s): none