Extraction of Peripheral Endobronchial Foreign Body Using an Ultrathin Flexible Bronchoscope

A 61-year-old man was admitted to the intensive-care unit of Nagoya National Hospital after onset of symptomatic epilepsy with loss of consciousness and hypoxemia. He aspirated a dental filling when he fell into a convulsion. Chest roentgenogram and computed tomography showed the dental filling lodged in a distal branch of the right lower lobe. Removal of the dental filling was attempted using a 2.8-mm ultrathin flexible bronchoscope (channel diameter, 1.2 mm), which was considered small enough to reach the location of the dental filling and less invasive because of its lower resistance to breathing during the procedure. The dental filling lodged in the fourth-generation bronchus in the lateral basal segment of the right lower lobe was directly visualized with the ultrathin flexible bronchoscope, and it was successfully retrieved with a ureteral stone basket. From our case, it seems clear that, in selected cases, the use of an ultrathin bronchoscope with thin extraction instruments is ideal for ensuring the safe extraction of foreign bodies lodged in the peripheral bronchi.