Sewing machine needle retrieval from distal airways using flexible bronchoscope under fluoroscopy

Area of Science:

• Pulmonology
• Medical Imaging
• Interventional Endoscopy

Background:

• Foreign body aspiration into the tracheobronchial tree is a potentially life-threatening event.
• Airway foreign bodies can present with varied symptoms, sometimes subtle, leading to diagnostic challenges.
• Prompt and accurate diagnosis and retrieval are crucial to prevent complications such as pneumonia or airway damage.

Observation:

• An 18-year-old female presented after aspirating a sewing machine needle.
• Initial examination revealed normal vital signs and oxygen saturation, with diminished breath sounds on the right.
• Chest radiography confirmed the needle's location in the right lower lobe, but it was not initially visualized during bronchoscopy.

Findings:

• Flexible bronchoscopy with fluoroscopic guidance enabled visualization and retrieval of the needle.
• The foreign body was successfully removed from the posterior basal sub-segment of the right lower lobe.
• The retrieval was performed using alligator biopsy forceps without any immediate complications.

Implications:

• Flexible bronchoscopy is an effective tool for diagnosing and treating airway foreign bodies, even when initially difficult to locate.
• Fluoroscopic guidance enhances the safety and success rate of endoscopic foreign body removal.
• Timely intervention in cases of foreign body aspiration can prevent serious respiratory complications and improve patient outcomes.