An unusual foreign body in tracheobronchial tree: A case report

Foreign body (FB) in tracheobronchial tree is a serious and potentially fatal condition in all age groups. Early diagnosisand removal are imperative to prevent mortality as well as complications.A 45 year old heroine (diamorphine) addict was brought to the emergency department in a gasping state, with a historyof substance abuse. The patient was intubated with Portex® cuffed endotracheal tube No. 8 and was shifted to intensivecare unit for ventilation. Follow up x-ray chest revealed a metallic wire like FB in the bronchus. In the operating room,rigid bronchoscopy under general anesthesia failed to remove FB. Fibreoptic bronchoscope revealed an intubation styletbelow carina. Subsequent attempts were unsuccessful so tracheostomy was done and the stylet was removed throughtracheal stoma under fibreoptic visualization. The ventilation strategies used being ventilating bronchoscope, intermittentmask ventilation and intubation twice