Nine Months With a Pin: Thoracotomy After Repeated Bronchoscopic Failures in a 16-Year-Old With Hijab Syndrome

Inhaled sharp foreign bodies, such as pins, are commonly managed through bronchoscopic retrieval. However, challenges arise when such efforts fail, requiring escalation to surgery. We report a rare case of a 16-year-old female who presented nine months after inhaling a pin. During this period, multiple bronchoscopic removal attempts were unsuccessful. Imaging localized the foreign body to the middle lobe of the right lung. Given the chronicity of the case and endoscopic failure, the patient underwent thoracotomy, through which the pin was retrieved. The postoperative course was uneventful, and she was discharged without complications. This case underscores the importance of recognizing the limitations of bronchoscopy and the need for timely transition to surgery. Establishing clear criteria for escalation to thoracotomy is essential to optimize outcomes and ensure effective communication with patients and families.