Anesthetic Management for Headscarf Pin Tracheobronchial Foreign Body Removal in a Pediatric Patient

Foreign bodies in the airways are relatively common in preschool- and school-aged children. We report a rare case of the successful removal of a sharp metallic foreign body from the bronchus of a 12-year-old boy under combined inhalational and intravenous anesthesia without tracheal intubation. This report emphasizes the perioperative anesthetic strategies for foreign object removal. The patient presented with sudden-onset choking and hemoptysis. Chest computed tomography revealed a linear metallic foreign body measuring approximately 5 cm long in the left main bronchus. The foreign body was removed via rigid bronchoscopy under deep sedation maintained by a combination of inhalational and intravenous anesthesia while preserving spontaneous respiration. Intraoperative ventilation was controlled intermittently to ensure adequate oxygenation. Based on recent studies, we discuss key anesthetic considerations and risk-mitigation strategies for managing sharp bronchial foreign bodies in pediatric patients. This case highlights the importance of maintaining spontaneous respiration during bronchoscopy and tailoring anesthetic approaches to ensure safe outcomes, despite limited access to advanced airway technologies.