02/01/2025
16 years - Not just a number but my journey with asthma !
29 year male , no comorbidities
Treated as an asthmatic since age of 15 years
History of recurrent lower respiratory tract infections and asthma exacerbations since childhood
Evaluated in a tertiary care centre outside - 1 month back
Bronchoscopy done :
Stenosis of left lower lobe bronchus with granulation tissue
Impacted foreign body distal to stenosis with active pus drainage
On probing: History of foreign body aspiration -- Pen cap 16 years back
Foreign body retrieval attempted for more than 2 hours with rigid and flexible bronchoscopic instruments - Couldn't be retrieved
Stenosis dilation done
Referred for evaluation and management from 1500 kms away
Procedure: Bronchoscopic retrieval of pen cap with rat tooth forceps + Cryoextraction of granulation tissue + Balloon dislodgement
After 2 hours - Foreign body retrieved intoto
Post procedure : Complete recanalization of left lower lobe bronchus
Plan : Surveillance bronchoscopy
Patient discharged same day !
Technical Challenges in the case
1. Severe stenosis with granulation tissue of left lower bronchial ostium - Cryoextraction of granulation done prior to retrieval
2. The hour glass shape of foreign body - Difficulty in retrieval - impaction of distal portion - Dormia, balloon failed
3. Combined traction with balloon and rat tooth forceps applied to dislodge the foreign body
4. Rat tooth gastro forceps were used for better grip to retrieve the foreign body
Department of Interventional Pulmonology
Yashoda Hospitals , Somajiguda, Hyderabad
