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A 49-year-old male patient with asthma presented with what appeared to be an acute exacerbation of his condition. On closer questioning, he was admitted to 'inhaling something' that may have been caught in the mouthpiece of his inhaler and wondered whether there might be something in his chest. On examination, he had a monophonic high-pitched wheeze in his right mid-zone; chest X-ray confirmed the presence of a foreign body in his right main bronchus. As it was after normal working hours, he was referred for bronchoscopy under the cardiothoracic surgeons at St George's. He made a full recovery, and now keeps a used 5 pence coin in a jar on his mantelpiece., (2014 BMJ Publishing Group Ltd.)

We report a case of a 35-year-old man who presented with 4-week history of haemoptysis, with a history of intravenous drug use. There was no other significant medical or surgical history and no recollection of any foreign body aspiration. Chest X-ray and CT scan showed 40 mm long needle in left main bronchus, partly lying outside the bronchus into the mediastinum. Flexible and rigid bronchoscopes proved to be unsuccessful in retrieving the needle. We proceeded with left posterolateral thoracotomy and the left main bronchus was explored to take out this 21-gauge (green) injection needle. The distal half of the needle with the sharp end was lying in the mediastinum piercing through the bronchial wall. Surgery was uneventful with good postoperative recovery and the patient was discharged 4 days later.

A 48-year-old male patient presented to the emergency room with a history of chest pain and breathlessness. Chest X-ray demonstrated a large radio-opaque foreign body in relation to the proximal right bronchial tree. The patient subsequently revealed a history of a misplaced denture 4 months previously. Urgent flexible bronchoscopy (FB) examination demonstrated a large partial denture impacted in the right intermediate bronchus, which was removed successfully using a flexible bronchoscope. Although rigid bronchoscopy (RB) is the procedure of choice for large-sized and impacted airway foreign bodies, the present case highlights the utility of FB in airway foreign body removal. In clinically stable patients with foreign body inhalation, FB can be employed initially as it is an outpatient and cost-effective procedure which can obviate the need for administration of general anaesthesia.

A 70-year-old woman presented with a fracture and aspiration of her polyvinyl chloride tracheostomy tube. Her chest X-ray showed that a foreign body was lodged in the right main bronchus. She was otherwise asymptomatic. The foreign body was removed under general anaesthesia using a flexible bronchoscope. The patient developed pneumonia after the procedure and was admitted to the intensive care unit. She was discharged home 5 days after the event with no permanent complications.