New Delhi: For more than two weeks, a 77-year-old man’s worsening breathlessness was blamed on advanced lung disease. But when treatment failed and his oxygen levels plunged to 65%, doctors discovered an unexpected cause: a pea stuck deep inside his airway.The elderly patient, a known case of chronic obstructive pulmonary disease (COPD) for the past four years and hypertension, had been experiencing worsening breathlessness for nearly 15 days. He consulted doctors and received treatment for a “COPD-related respiratory problem”. However, his symptoms continued to worsen.He was eventually rushed to Medanta, Noida, with severe breathlessness, wheezing and respiratory failure. His condition was serious enough to require continuous non-invasive ventilation support.Given his medical history, doctors suspected a severe COPD exacerbation, a common and potentially life-threatening complication among patients with chronic lung disease. However, the breakthrough came when doctors revisited his earlier CT scans and noticed a suspicious abnormality in the right main bronchus. A repeat scan confirmed the finding, prompting doctors to perform a bronchoscopy.What they found surprised even the treating team: a pea lodged inside the right main bronchus, blocking airflow and triggering symptoms almost identical to a severe COPD attack.“Foreign body aspiration is often overlooked in adults, particularly elderly patients with pre-existing lung conditions,” said Dr Manu Madan, senior consultant of respiratory and sleep medicine at Medanta, Noida. “In this case, the patient’s symptoms closely mimicked a severe COPD exacerbation, making diagnosis challenging. His lack of improvement despite standard treatment prompted us to investigate further.”Removing the obstruction was not without risk. The patient remained dependent on ventilatory support and any intervention carried the possibility of worsening his condition. After obtaining high-risk consent from the family, doctors performed therapeutic bronchoscopy using advanced cryoextraction technology.The procedure involved using a cryoprobe to freeze and securely attach to the foreign body before removing it in one piece. Doctors said the technique allowed safe extraction of the object from the airway.The effect was immediate. The patient’s breathing improved significantly following removal of the pea. He was gradually taken off respiratory support, no longer requires oxygen therapy and continues to recover well on follow-up visits.While inhaled food particles are more commonly seen in children, specialists say they can occasionally occur in elderly patients and mimic serious respiratory disorders, making them difficult to diagnose and potentially life-threatening, if missed.
