UAE: Long cotton bud removed from Emirati grandmother’s bronchus in life-saving surgery

A life-saving procedure lasting four hours was performed on a critically-ill 80-year-old Emirati woman -- to remove a 10-cm long cotton bud from her bronchus.

Five years back, Al Ain resident MA had undergone a tracheostomy. She was bed ridden for years and breathing with the support of a CPAP (continuous positive airway pressure) machine. A medical team, including a doctor and nursing staff, looked after her.

In a freak incident, while the elderly patient’s home care assistant was cleaning the outer tracheostomy tube with a cotton bud, it fell into her trachea (windpipe) and moved to the right bronchus. M.A’s condition worsened as she was unable to breathe properly and was rushed to Burjeel Royal Hospital in Al Ain where a bronchoscopy was performed immediately to save her life.

“When she was brought here, her oxygen saturation levels had gone critically low. From the emergency room, she was transferred to the operation room. The endoscopy revealed the position of the cotton bud stick. The presence of the foreign substance had triggered bronchial secretions, which filled the space around the lungs. There was mild bleeding in the lungs. The oxygen saturation levels fell steeply to worsen her condition,” said Dr Ayman Helal, ENT surgeon, Burjeel Royal Hospital in Al Ain.

The process got complex because while removing the cotton bud, doctors had to detach the CPAP machine too.

“We had to keep the patient’s condition stable before removing the foreign body. That was very complicated and challenging. We could not use any materials except a flexible bronchoscope considering her condition and tracheostomy.”

While maintaining the oxygen saturation levels, the cotton bud and the tracheostomy tube were removed.

“We inserted a flexible bronchoscope from the tracheostomy tube and tried to take the bud out. When the oxygen saturation came down, we provided her with oxygen. Later, when the oxygen saturation became normal, we tried again. This approach continued for 4 hours. Finally, we were able to take the bud out without affecting her oxygen saturation. Her brain and other organs were not affected. There was no bleeding.”

Soon, the tracheostomy tube was reinserted and the patient became stable. She was discharged after spending a day under observation.

“Any delay in removing the cotton bud would have caused severe bronchial spasm, lung infection and dyspnea. It would have become a life-threatening condition.”

Dr Helal noted that it is dangerous to clean the tracheostomy tube with a cotton bud stick.

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“A catheter should be used to suck out the secretions. To clean the tracheostomy tube, one should remove it and then reinsert it again after cleaning. It should be done once in two months and performed with utmost care.”

The elderly patient and her family members thanked the medical team at the hospital.

“When we realised that a cotton bud stick had gone inside the trachea, we panicked and were clueless. Seeing her gasping, we rushed her to the hospital. Dr Ayman Helal and the medical team were very supportive. It was a tough moment for us but the medical team reassured us,” said a family member and added that the 80-year-old grandma can’t stop wishing and praising Dr Helal and the medical team.

• Abu Dhabi