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A Stitch in Time Saves Nine.

Harsh Yadav¹, Kranti Garg², Vishal Chopra³

¹Senior Resident, Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India.

The Journal of the Association of Physicians of India

|March 15, 2025

Summary

Needle breakage during Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is rare. This report details the successful retrieval of a fractured EBUS-TBNA needle using a bronchoscope and snare, highlighting emergency management strategies.

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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.