Retrieval of Dental Foreign Bodies via Bronchoscopy During Extracorporeal Membrane Oxygenation in a 9-Year-Old Boy.

BACKGROUND Extracorporeal membrane oxygenation (ECMO) serves as a life-sustaining intervention for pediatric patients with severe, reversible respiratory or circulatory failure refractory to conventional therapies, providing temporary cardiopulmonary support to maintain oxygenation, perfusion, and hemodynamic stability. CASE REPORT Following a family argument, a 9-year-old boy fell from the seventh floor, with partial obstruction by a canopy. He presented with immediate loss of consciousness, absent voluntary motor activity, Kussmaul respirations, otorrhagia, and epistaxis. Initial computed tomography (CT) revealed high-attenuation nodules in the right main bronchus, right lower lobe bronchus. Despite endotracheal intubation and supportive measures, oxygenation remained refractory to correction, prompting interhospital transfer. On admission to our unit, imaging revealed high-attenuation opacities in the right middle bronchus and left lower lung. Multidisciplinary consultation was conducted. Under ECMO support, flexible bronchoscopy enabled retrieval of tooth fragments from the right upper lobe and an entire left maxillary first permanent molar from the left lower lobe. Postoperatively, ECMO was successfully discontinued, with the patient exhibiting stable vital signs, and subsequent management was continued. CONCLUSIONS The successful retrieval of dental fragments and an entire tooth via flexible bronchoscopy, facilitated by ECMO support, underscores the critical role of ECMO as a stabilizing platform enabling otherwise high-risk airway interventions in hemodynamically compromised pediatric trauma patients. This case illustrates the strategic implementation of venoarterial ECMO as a salvage therapy in the context of refractory hypoxemia and cardiopulmonary instability, rather than as a routine adjunct to flexible bronchoscopy procedures.