P111

Open safety pin removal by rigid bronchoscopy in a 19 year old boy

JK. Patra*a (Dr), AK. Sahoob (Dr), M. Pattnaikc (Prof)

a DEPARTMENT OF PULMONARY MEDICINE, SCBMCH, Cuttack, INDIA ; b DEPARTMENT OF ANAESTHESIOLOGY, SCBMCH, Cuttack, INDIA ; c DEPARTMENT OF CTVS, SCBMCH, Cuttack, INDIA

* jeetendrakumarpatra@gmail.com

Background: Rigid bronchoscopy has proved its utility and superiority far beyond imagination for removal of foreign body from lungs. It is very rare to find open safety pin aspirated into right main bronchus and bronchus intermedius. We report a case of rigid bronchoscopic removal of open safety pin from right main bronchus and bronchus intermedius.

Case Report: 19 year old boy presented to emergency with history of aspiration of safety pin 5 days back. Clinical examination was normal. Chest - Xray revealed a open safety pin seen in right bronchus intermedius and extending downwards and was further confirmed by right lateral view chest x-ray. After written informed consent , rigid bronchoscopy under general anaesthesia was done and open safety pin was seen in right bronchus intermedius. With help of optical grasping forceps , the sharp end was tried to grasp. Multiple attempts to grasp the sharp end failed as it was embedded with granulation tissue. Then the blunt end was grasped by optical grasping forceps and then retrieved into the rigid barrel. The entire assembly of rigid bronchoscopy barrel and open safety pin grasped by optical grasping forceps was removed and patient was reintubated with a 8” flexible endo-tracheal tube. A check fibre-optic bronchoscopy was done. Then patient was extubated after reversal of anaesthesia and was shifted to observation room.

Conclusion: A sharp metal foreign body in lungs is always a big challenge. Rigid bronchoscopy with optical grasping forceps under general anaesthesia is very helpful for removal of sharp foreign like open safety pin from the airways.

References:

  1. Broken safety pin in bronchus- Anaesthetic considerations- NCBI, Indian journal of anaesthesia. Aditya Agarwal, Roona Shad
  2. Accidental aspiration of head scarf pin in left bronchus piercing the lung parenchyma: A rare case report , Lung India, Yusuf Parvez and Mohammed Ashraf Kandath

Disclosure of funding source(s): none