A Stitch in Time Saves Nine.

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Medical Device Technology

Background:

• Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard diagnostic tool for mediastinal lymph nodes.
• Needle fracture during EBUS-TBNA is an infrequent but significant procedural complication.

Purpose of the Study:

• To report a case of successful retrieval of a fractured EBUS-TBNA needle.
• To outline management strategies for needle breakage during EBUS-TBNA, particularly in resource-limited settings.

Main Methods:

• A fiberoptic bronchoscope was used to visualize the fractured needle fragment.
• A retrieval snare was passed through the bronchoscope to grasp and remove the broken needle piece.
• The procedure was performed after EBUS-TBNA from a subcarinal lymph node.

Main Results:

• Successful retrieval of the broken EBUS-TBNA needle fragment was achieved using a bronchoscope and snare.
• The patient's management involved a calm, systematic approach utilizing available instruments and team expertise.

Conclusions:

• Fractured EBUS-TBNA needles can be successfully retrieved using bronchoscopic techniques.
• Effective management of such emergencies relies on maintaining composure, judicious instrument use, and leveraging team expertise, even in resource-constrained environments.