Proximal bronchial balloon dilation for embedded distal airway foreign bodies.

INTRODUCTION Distal embedded airway foreign bodies can be challenging to manage. Endoscopic retrieval techniques, such as the use of appropriately sized graspers or a Fogarty catheter passed distally to the foreign body and inflated to pull the foreign body proximally, are mainstay. Successful retrieval may become more difficult as foreign bodies become lodged more distally in segmental or subsegmental bronchi. Foreign bodies tend to become embedded in bronchi with their widest part facing upward, and over time can ratchet themselves more and more distally, stretching the bronchus as they do so. Ultimately, the foreign body can end up in a bronchus that in its normal state would be substantially smaller than the foreign body. Moreover, the proximal bronchus through which the foreign body has traversed may revert to its normal size, leading to a situation when the foreign body is larger than the bronchus through which it must be extracted. Hoff and Chang have described a novel technique to overcome this problem that involves dilating the proximal bronchus. We report a case of a distally embedded foreign body managed with similar proximal balloon bronchus dilation.