Iftikhar A Jan, Farhat Mirza, Nasir Saleem, Lubna Samad, Noor A Sheikh, Anwar M, Umar M.
Fishing an unusual Tracheo-Bronchial foreign body.
J Surg Pak Jan ;7(2):39-40.

We are presenting case of 8 years old female child who inhaled a large rounded bead and developed sever respiratory distress and cyanosis. Attempts at retrieval of foreign body by rigid bronchoscopy using the alligator, peanut and biopsy forceps failed due to the smooth rounded nature of foreign body. In desperation an attempt was made to fish out the foreign body by hooking with the hypodermic needle mounted on the alligator biopsy forceps. Luckily it worked and the foreign body was retrieved easily. Although the procedure may not look very fancy but it definitely saved the life of a child.

CASE REPORT: An 8 years old female child accidently aspirated a large rounded bead and became cyanosed. At examination the child was in severe respiratory distress and deeply cyanosed. After placement of a good size IN line she was immediately rushed to the operating theatre and bronchoscopy was performed with a rigid scope. A large piece of rounded bead was found impacted in the right main bronchus that was partially occluding the left main stem bronchus. Several attempts were made to hold the foreign body by various forceps including peanut, Alligator and biopsy forceps but all failed. A hole was visible through the bead but smaller biopsy forceps were not available which could be passed through the hole. Fogarty catheter was also not available at that time. Parents had brought a bead of similar size with them. Due to the serious respiratory insufficiency it was not possible to leave the patient without removal of foreign body. In desperation an idea came to fish out the foreign body using a curved hypodermic needle. This was first attempted on the bead brought by the parents and worked. The same technique was attempted on the patient. A 24 G hypodermic needle was curved back near the end to about 165 degree and then held with the Alligator forceps. It was then guided through the hole in the bead through which it went with a little resistance. Once through the hole, it engaged the bead and was retrieved carefully along with the bead without significant resistance. The child immediately regained her tissue saturation. She had an uneventful post operative recovery and did not show any signs of neurological damage.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com