Sewing machine needle retrieval from distal airways using flexible bronchoscope under fluoroscopy

Abstract

18-year-old lady was admitted through emergency department after she accidently aspirated a long sewing machine needle into her airways. Upon examination, she was anxious with normal vital signs and without any respiratory distress with SpO2 of 98% on air. Systemic examination was normal except slightly reduced breath sounds intensity on right lower side of chest. Her chest radiograph revealed needle in right lower lobe but it was not visualized on bronchoscopic examination of airways up to sub segmental level. Using flexible bronchoscope under fluoroscope guidance, needle was retrieved successfully from posterior basal sub segment of right lower lobe utilizing alligator biopsy forceps, without any noticeable complication.

Needle in the Lung: A Difficult Case of Pulmonary Foreign Body

“…Sometimes at operation there are challenges to find the needle and palpation of the lung cannot be helpful; so, in the next step, broncheotomy is needed as in our case. There are some reports using fluoroscope guidance in fiberoptic bronchoscopy in similar cases before surgical intervention (20). However, there is no report using fluoroscope guidance at surgery in this area and as explained in case presentation it was useful in our case.…”