[Treatment of patients with rare bronchial foreign body - spruce branch]

Spruce branch is a rare radiolucent bronchial foreign body. Despite modern imaging tests and endoscopic examination, this foreign body is often detected only intraoperatively. This study enrolled 4 patients with spruce branch aspiration. In the 4^th case, spruce branch was removed during rigid bronchoscopy that was associated with «lodging» type of foreign body. In two cases, spruce branch migrated to peripheral bronchial segments («extrusive» type) that required surgical treatment (thoracoscopy with resection of the right basal pyramid segments and wedge resection of the right lower lobe). The 3^rd case was the most interesting. Initially, the foreign body was «underlying», but it migrated after partial endoscopic removal that finally required right-sided lower lobectomy. This report describes the peculiarities of clinical course and management of patients with a rare type of radiolucent bronchial foreign body - spruce branch.