05 May 2026
: Case report 
Rigid-Flexible Bronchoscopy With Holmium Laser Cauterization for Pine Nut Shell Removal and Balloon Dilation for Subsequent Bronchial Stenosis in a 16-Month-Old Girl
Unusual clinical course, Management of emergency care
Danli Wang E 1,2, Feizhou Zhang AB 1,2,3, Nan Zhang CD 2,4, Fang Jin AF 1,2,3, Hujun Wu BC 1,2,3, Xiaofen Tao BD 1,2,3, Lei Wu EF 1,2,3*DOI: 10.12659/AJCR.951890
Am J Case Rep 2026; 27:e951890
Figure 2 Bronchoscopic findings.(A) Initial flexible bronchoscopy confirmed a foreign body, but retrieval attempts with a basket, forceps, and biopsy failed. (B) Intraoperative holmium laser cauterization, combined with rigid and flexible bronchoscopy, successfully extracted the foreign body. (C) On post-removal day 1, bedside flexible bronchoscopy under local anesthesia cleared the bronchial lumen using a foreign body basket. (D) One-month follow-up revealed marked mucosal congestion, edema, and erosive necrosis in the dorsal segment of the right lower lobe. (E) At 2 months, bronchoscopy showed stenosis at the B9 and B10 bronchial openings in the basilar segment of the right lower lobe, leading to balloon dilation.