Three-Year Retained Endobronchial Push Pin in an Adolescent Causing Saccular Bronchiectasis: A Case Report and Review of the Literature

Background: Foreign body aspiration may remain undiagnosed for prolonged periods and lead to potentially irreversible pulmonary complications. The aim of this report was to present a rare case of a long-retained metallic endobronchial foreign body in an adolescent and to highlight the diagnostic and therapeutic challenges associated with delayed diagnosis. Case Presentation: A 16-year-old male was admitted with persistent cough and a three-year history of recurrent bronchitis and pneumonia treated mainly with antibiotics. Chest radiography revealed a radiopaque foreign body in the tracheobronchial tree. Computed tomography demonstrated a metallic, needle-shaped foreign body lodged in the right lower lobe bronchus, with multiple distal saccular bronchiectatic changes, some containing air–fluid levels. Following further questioning, the patient reported an episode of choking on a corkboard push pin three years earlier, which had not been disclosed at the time. Rigid bronchoscopy revealed the foreign body partially covered by granulation tissue. It was successfully removed using endoscopic forceps; however, part of the corroded metal tip fragmented during extraction. Purulent secretions distal to the obstruction were aspirated. The postoperative course was uncomplicated, although cough persisted and required further medical treatment. The patient did not attend follow-up visits and was lost to follow-up. Conclusions: Prolonged retention of an endobronchial foreign body may cause significant structural pulmonary damage, including bronchiectatic changes. Persistent cough and recurrent respiratory infections in children and adolescents should prompt consideration of an occult foreign body, even when the aspiration event is remote or initially unrecognized. Timely imaging and bronchoscopic evaluation may help limit the risk of potentially irreversible complications.