Bronchoscopic Removal of Impacted Foreign Body in an Obese Patient: A Case Report

Objective: To describe the anaesthetic management of a young obese patient undergoing bronchoscopic removal of an impacted foreign body under Non-Operating Room Anaesthesia (NORA). Case Report: A 17-year-old obese female (BMI 32.3 kg/m?) presented with hemoptysis following scarf pin ingestion. The pin was impacted in the left posterior basal bronchus. Airway assessment revealed Mallampati class III, heavy jaw, and snoring history. Anaesthesia was induced with propofol and maintained with spontaneous ventilation via a rigid bronchoscope barrel connected to Bain?s circuit. Dexmedetomidine infusion and oxygen?air?sevoflurane were used. Succinylcholine boluses facilitated retrieval. Rigid bronchoscopy initially failed; flexible bronchoscopy enabled successful removal. The 50-minute procedure was uneventful, and the patient recovered well. Conclusion: Airway management in obese patients undergoing bronchoscopy under NORA is challenging. A flexible?rigid hybrid approach improves success rates in foreign body retrieval. Early recognition, multidisciplinary teamwork, and patient education are essential.