title: Pulmonary migration of a fragment of plastic coating sheared from a stylet.
abstract: BACKGROUND
  In trauma patients, particularly with head immobilization, tracheal intubation without the use of a stylet may be impossible.
  
  
  OBJECTIVE
  To report a very rare but potentially fatal complication that may happen in any Emergency Department: fracture of the plastic sheath of an intubation stylet, reported only twice before in the literature.
  
  
  METHODS
  Two large plastic fragments detached from a stylet while intubating a trauma patient. One piece was removed from the endotracheal tube a few hours later in the operating room. The second fragment migrated asymptomatically into the pulmonary airway. It was successfully retrieved from the right bronchus 24 h later.
  
  
  CONCLUSIONS
  This potentially life-threatening event may go unnoticed after intubation if the endotracheal tube is not obstructed by the fragment. Gentle withdrawal of the stylet from the tube is essential to avoid stylet fracture. Careful examination of the stylet after intubation may suggest a stylet fracture.
authors: Saint Joseph University Medical School, Hotel-Dieu de France Hospital, Naccach Boulevard, Beirut, Lebanon.
authors: Viviane
authors: V
authors: Chalhoub
authors: Freda
authors: F
authors: Richa
authors: Issam
authors: I
authors: El-Rassi
authors: Christine
authors: C
authors: Dagher
authors: Patricia
authors: P
authors: Yazbeck
mesh_terms: D000328:Adult; D001980:Bronchi / Q000601:surgery*; D001995:Bronchography; D001999:Bronchoscopy; D004636:Emergency Service, Hospital; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation*; D008297:Male