Fogarty balloon-assisted extraction of an impacted friable foreign body causing complete left main bronchus...

Foreign body aspiration (FBA) in adults is uncommon but can lead to significant morbidity due to delayed or atypical presentation. Flexible bronchoscopy is the preferred diagnostic and therapeutic modality, although extraction may be challenging depending on the foreign body's characteristics. We report a case of severe airway obstruction caused by a soft organic foreign body successfully managed using a Fogarty balloon catheter technique. A 73-year-old man with schizophrenia presented with severe hypoxemia and complete left lung atelectasis. Imaging demonstrated complete obstruction of the left main bronchus by an ovoid foreign body. Following endotracheal intubation, flexible bronchoscopy revealed a whole grape tightly impacted in the bronchus. Conventional forceps extraction attempts failed because of the grape's smooth and friable surface. A longitudinal channel was created through the grape, enabling insertion of a 5-French Fogarty balloon catheter. Balloon inflation and gentle traction allowed successful removal. This technique may represent an effective rescue strategy for extracting large, soft organic airway foreign bodies.