Successful treatment of chronic retained bronchial foreign bodies and secondary bronchial stenosis with balloon bronchoplasty in young patients: A case series with review of literature.

Abstract

Abstract: Foreign body aspiration, though uncommon, remains a potentially fatal condition associated with significant morbidity and mortality. While children constitute majority of cases, a few occur in adults-particularly in the elderly. However, chronic retained foreign bodies in the young adult population are exceedingly rare, and when encountered, pose unique challenges due to chronic inflammatory changes, excessive granulation tissue, and resultant bronchial stenosis. These factors often complicate retrieval and may necessitate surgical intervention, including lobectomy. In this case series, we present two young patients with chronic retained bronchial foreign bodies (retained for 13 years and 15 years respectively) and associated bronchial stenosis, both of whom were successfully removed with balloon bronchoplasty to dilate the stenotic segment, enabling removal of the foreign body. Notably, both patients were spared lobectomy and its associated morbidity. Both the patients showed clinical and radiological improvement post procedure and are doing well on follow-up. Foreign bodies aspirated during childhood might present in the adulthood after being undetected for years due to neglected symptoms with associated chronic changes making foreign body removal complex. This case series highlights the importance of a complete trial of bronchoscopy guided foreign body removal strategy, including balloon bronchoplasty, in patients with chronic retained foreign bodies and associated bronchial stenosis before proceeding to surgical resection especially in young patients.