Removal of a Fishhook-Shaped Foreign Body in the Bronchus and Literature Review

Foreign body aspiration, particularly involving complex metallic objects with sharp projections like fishhooks, presents a formidable therapeutic challenge, often leading to complications such as mucosal impaction and obstructive pneumonia. We report a challenging case of a metallic fishhook-shaped foreign body deeply embedded within the distal bronchial wall, where initial attempts at retrieval using standard biopsy and foreign body forceps via flexible bronchoscopy were unsuccessful due to significant mucosal oedema and impaction. The successful management involved a novel, multi-modal endoscopic strategy that sequentially integrated the stability of a rigid bronchoscope, the precise navigation of an ultrathin bronchoscope for direct visualisation of the embedded tip and the controlled dissection using a high-frequency electrocautery knife to safely release the object, followed by its retrieval. This case demonstrates a reproducible, stepwise surgical strategy for the safe extraction of similarly complex, impacted sharp foreign bodies, thereby minimising the risk of iatrogenic injury.