Intrapleural Migration of an Endobronchial Watanabe Spigot: Persistent Air Leak and Surgical Retrieval

Bronchial occlusion with an endobronchial Watanabe spigot (EWS) is an effective intervention for managing persistent air leak. Severe complications associated with EWS are uncommon. We highlight a rare case of EWS migration into the pleural cavity following bronchial occlusion for persistent air leak in a patient with acute respiratory distress syndrome secondary to influenza pneumonia after blunt chest trauma. The patient underwent successful video-assisted thoracoscopic surgery for EWS retrieval and pulmonary fistula repair, resulting in an uneventful recovery without recurrence of pneumothorax. This case underscores the importance of appropriate spigot selection, anatomic assessment, and vigilant monitoring in structurally compromised lungs.