A Two-Step Strategy Utilising Fluoroscopy for Resolving Peripheral Airway Impaction by an Aspirated Capsule...

Area of Science:

• Pulmonology
• Gastroenterology
• Medical Devices

Background:

• Capsule endoscopy (CE) aspiration is a rare but life-threatening complication.
• The unique physical properties of CE make bronchoscopic removal challenging, especially in peripheral airways.

Purpose of the Study:

• To describe a novel technique for retrieving a peripherally impacted capsule endoscope.
• To present a case of successful removal of a deeply impacted CE using a two-step fluoroscopic-guided strategy.

Main Methods:

• A two-step approach was employed: disimpaction with a balloon catheter under fluoroscopy, followed by retrieval with a net.
• Conventional forceps manipulation was attempted but failed due to complete impaction and limited visibility.

Main Results:

• The fluoroscopy-assisted two-step strategy successfully disimpacted and retrieved the CE from the right basal segmental bronchus.
• This method overcame the challenges posed by the capsule's size, smooth surface, and deep peripheral impaction.

Conclusions:

• A fluoroscopy-assisted two-step strategy is a safe and effective method for retrieving structurally challenging foreign bodies, such as impacted capsule endoscopes, from peripheral airways.
• This technique offers a reliable solution when standard bronchoscopic removal methods are unsuccessful.