Removal of an impacted distal airway foreign body using a guidewire and a balloon angioplasty catheter.

Airway aspiration of foreign bodies is relatively common in young children. Visible objects are commonly removed under direct vision using grabbing forceps inserted through a rigid bronchoscope. We describe a case of aspiration of the hollow tip of a plastic pen which lodged distally in the right main bronchus of an older child. This object was located so distally that it could only be visualised using flexible fibreoptic bronchoscopy. A novel method was required for successful retrieval, which involved the passage of a guidewire through the centre of the foreign body. A balloon angioplasty catheter was then railroaded over the guidewire through the foreign body and the balloon inflated with saline. This allowed the foreign body to be pulled proximally out of the airway.