Endobronchial removal of the peripherally located foreign body with the ultrathin bronchoscopy and ultrathin cryoprobe guided by a manual navigating method
M. Yuana (Dr), F. Nia (Dr), Y. Xiaoa (Dr), W. Yina (Dr), Y. Hu*a (Dr)
a Central Hospital of Wuhan, Wuhan, CHINA
Background: Bronchoscope is a preferential method used to diagnose and remove airway foreign bodies, while for peripherally located foreign bodies, how to locate and remove them remains an intractable problem.
Case presentation: We herein report a chronic aspiration case with a tiny chili incarcerated in LB10ciiβ, with obvious granulation tissue. We used manual navigating method to locate the lesion. Firstly, we read his thin-section CT images and a three-dimensional CT image reconstruction. Then, we traced the bronchial branch in which the lesion was located by rolling thin-section CT images continuously, and recorded them with a bronchial opening sketch, marking the leading bronchus at every bifurcation point. Thus, a simulated image of endoscopic image was made. Therapeutic bronchoscope couldn’t preceed into the target bronchus. while ultrathin bronchoscope successfully found the foreign body. But the chili was too tender to be extracted completely by forceps, and it was even pushed further away. Then 1.1 mm ultrathin cryoprobe was used, with an activation time of 4s, and the chili was frozen and completely removed.
Conclusion: Combined use of manual navigating method, ultrathin bronchoscope and ultrathin cryoprobe, which can easily bend and extend to the distal bronchus, and harvest large specimens by the movement of freezing and pulling out the probe, could successfully extract foreign bodies lodged in the distal airways and avoid thoracic surgery.
Disclosure of funding source(s): none