Endoscopic management of scarf pin aspiration with flexible bronchoscopy

An early adolescent girl was referred to our centre following accidental aspiration of a scarf pin while adjusting her headscarf. She had momentarily placed the pin between her lips while speaking. Initial upper gastrointestinal endoscopy at a local facility failed to detect the foreign body in the oesophagus. However, a chest X-ray revealed a radio-opaque object in the mid-mediastinum. Three days later, she presented to us clinically stable and asymptomatic. A CT scan of the chest confirmed a foreign body in the left main bronchus. Flexible bronchoscopy under general anaesthesia, using a supraglottic airway, was performed. The scarf pin was successfully extracted using radial jaw endoscopic forceps, typically used for gastroscopic biopsies. A follow-up chest radiograph showed no complications. This case highlights the importance of clinical suspicion and imaging for occult foreign body aspiration, and the role of flexible bronchoscopy with appropriate tools as a safe and effective treatment method.