Video-Assisted Thoracoscopic Left Lower Lobectomy and Bronchial Foreign Body Removal for Treating a Rare Occult Bronchial Foreign Body in an Adult.

Occult bronchial foreign bodies are extremely rare in adults. Affected patients typically lack a clear history of aspiration, exhibit no characteristic clinical signs and present with unremarkable chest imaging, often leading to misdiagnosis or missed diagnosis. This paper reports a case of an adult patient with occult bronchial foreign body aspiration that was initially misdiagnosed as pulmonary sequestration. An enhanced chest computed tomography and bronchial arteriography performed at another hospital failed to detect the foreign body. However, contrast-enhanced chest CT at the respiratory department of our hospital revealed a suspected foreign body along with left lower lobe atelectasis. Endobronchial ultrasound thereafter confirmed complete occlusion of the left lower lobe bronchus with scar hyperplasia. Multiple retrieval attempts were unsuccessful, necessitating referral to the thoracic surgery department for thoracoscopic left lower lobectomy and bronchial foreign body removal. This case highlights the rarity of surgical intervention for occult bronchial foreign bodies complicated by recurrent pneumonia and bronchopulmonary abnormalities.