Broken safety pin in bronchus - Anaesthetic considerations

Area of Science:

• Pediatric Pulmonology
• Pediatric Otolaryngology
• Pediatric Anesthesiology

Background:

• Metallic foreign bodies (FB) are a significant cause of pediatric airway obstruction.
• Safety pins represent a small but challenging subset of metallic FBs in the tracheobronchial tree.
• Infant airway foreign body aspiration presents unique anesthetic challenges.

Purpose of the Study:

• To report a case of a retained safety pin in an infant's airway.
• To discuss the challenges associated with removing impacted metallic FBs in infants.
• To highlight the limitations of rigid bronchoscopy in specific cases.

Main Methods:

• A case report of an infant with an inhaled foreign body.
• Management involved repeated attempts at rigid bronchoscopy.
• Anesthetic management for a challenging pediatric airway foreign body removal.

Main Results:

• A broken safety pin was impacted in the right bronchus.
• Repeated rigid bronchoscopy attempts failed to dislodge the foreign body.
• The case underscores the potential for impaction and procedural failure.

Conclusions:

• Impacted metallic foreign bodies, such as safety pins, pose significant removal challenges in infants.
• Failure to remove via bronchoscopy may necessitate alternative surgical interventions.
• Careful anesthetic planning is crucial for infants with airway foreign bodies.