A 38-year-old man from Navi Mumbai, who had been suffering from persistent breathlessness and wheezing for nearly three months, was found to have a chikoo (sapodilla) seed lodged deep inside his left main bronchus.
A team of specialists at Medicover Hospitals, Kharghar, successfully removed the foreign body through flexible bronchoscopy, providing immediate relief to the patient.
The procedure was performed by Dr Shahid Patel, Consultant Pulmonologist; Dr Tanay Sinha, Associate Consultant Pulmonologist; and Dr Shahabuddin, Anaesthetist.
How the persistent breathing problem led to further investigation
Prasad Nakhawa, a resident of Ulwe, had been experiencing breathlessness and audible wheezing for around two to three months.
His symptoms appeared intermittently, prompting him to consult multiple general physicians. Although he was prescribed medication, the relief was temporary and the symptoms continued to recur, gradually affecting his daily routine.
He later consulted another doctor, who advised a bronchoscopy for a detailed evaluation. Nakhawa subsequently visited Medicover Hospital for further investigation and treatment.
Found a chickoo seed blocking the left main bronchus
Dr Shahid Patel said the patient first consulted him in mid-June after experiencing the respiratory symptoms for nearly three months.
According to him, an HRCT scan showed narrowing of the left main bronchus, but it was initially difficult to determine whether the obstruction was caused by mucus impaction or another underlying problem, including an impacted foreign body.
During the bronchoscopy, doctors identified a chikoo seed lodged in the left main bronchus, causing almost complete airway obstruction. The area around the obstruction had also developed swelling and retained secretions.
Seed removal was technically challenging
The medical team used a mesh snare under adequate sedation to carefully remove the seed.
Dr Patel said the procedure was particularly challenging because the foreign body had remained lodged in the airway for an extended period.
The seed had become firmly attached to the airway wall, while its smooth and slippery surface made it difficult for the bronchoscopic instruments to obtain a secure grip.
The procedure lasted nearly 50 minutes, with the medical team working carefully to remove the seed without injuring the airway.
Following its removal, the airway was restored and the patient experienced significant relief in his breathing.
Choking episode recalled after procedure
After the procedure, doctors spoke in detail with the patient’s relatives, who recalled that Nakhawa had experienced a sudden choking episode while eating chikoo nearly three months earlier.
Since his symptoms initially appeared to settle, the incident was not considered significant and was not mentioned during his earlier consultations.
Dr Patel said this delayed the identification of the foreign body.
Dr Patel said foreign body aspiration in adults is relatively uncommon and can go undiagnosed when there is no clear history of choking.
Organic foreign bodies such as seeds can remain in the airway for months and may resemble other respiratory conditions, including mucus impaction or airway malignancies, on imaging.
He said the case highlights the need to consider foreign body aspiration when patients experience unexplained wheezing, persistent respiratory symptoms or airway obstruction that does not improve with routine treatment.
If left untreated, the obstruction could have resulted in serious infections, recurrent pneumonia and collapse of the left lung.
The patient was discharged around two hours after the procedure and recovered without complications.
Doctors advise caution while eating
Dr Tanay Sinha said people should avoid talking, laughing or rushing while eating, as these behaviours can increase the risk of food particles or seeds accidentally entering the airway.
He said parents and caregivers should be particularly cautious with children and elderly people.
Anyone who develops persistent coughing, wheezing or breathing difficulty following a choking episode should seek medical attention without delay, he advised.
According to Dr Sinha, bronchoscopy remains the gold standard for identifying and removing foreign bodies from the airways, while early intervention and access to experienced specialists can improve outcomes.
Hospital focuses on specialist care
Neeraj Lal, Regional Director for Maharashtra and Karnataka at Medicover Hospitals, said the hospital focuses on providing patients access to experienced specialists, advanced technology and comprehensive care for accurate diagnosis and treatment, including in rare and challenging cases.
Sandip Joshi, Centre Head, Medicover Hospitals, Navi Mumbai, said every patient presents different clinical challenges and that the hospital aims to provide timely and patient-focused care across specialties.