Woman placed betel nut in cheek at night for cough relief

Lung function impaired, leading to cough, breathlessness, and fever

Timely detection and removal in two pieces by Kamineni doctors

A 57-year-old woman from Hyderabad, Vijeta (name changed), narrowly escaped a fatal emergency after a betel nut she placed in her cheek at night to control persistent cough accidentally slipped into her airway while she was asleep. This led to severe respiratory distress.

Consultant Pulmonologists Dr. E. Ravinder Reddy and Dr. Bharath Janapati from Kamineni Hospitals, LB Nagar, explained the case. The patient had been suffering from chronic cough aggravated when lying down, disturbing her sleep. To ease the discomfort, she kept a betel nut in her cheek. However, she unknowingly swallowed it during sleep, resulting in violent coughing, shortness of breath, and severe discomfort. She was rushed to the Emergency Department of Kamineni Hospitals.

Senior Consultant Pulmonologist Dr. Ravinder Reddy examined her and, noting critical breathing difficulty, placed her on a ventilator and admitted her to the ICU. A chest X-ray and HRCT scan revealed a complete blockage in the left bronchus, causing her left lung to collapse.

Once her condition stabilized, Consultant Interventional Pulmonologist Dr. Bharath Janapati performed a bronchoscopy. The procedure revealed the bronchus obstructed by a foreign body. Considering her history of hypertension, thyroid disease, and previous angioplasty, the intervention required special care. With support from the anesthesia team, a flexible bronchoscopy was performed in the operating theatre. Using a specialized device (Rat Tooth Forceps), the betel nut—wedged tightly in two pieces—was successfully removed without causing harm.

A follow-up chest X-ray confirmed full expansion of the left lung, and her breathing improved significantly. She was discharged the next day in stable condition.

Commenting on the case, Dr. Bharath Janapati “Foreign body aspiration into the airway and lungs is commonly seen in children and in patients with neurological problems. However, even healthy adults who keep betel nuts or areca leaves in the mouth while sleeping are at risk of such dangerous incidents. In these situations, bronchoscopy remains the most effective and safe treatment option.”