Foreign body (FB) aspiration is commonly seen in children and less commonly in the elderly. However, due to some social and cultural factors, a distinct group of tracheobronchial FB aspiration is increasingly recognized. We sought to assess our experience with such entity. A retrospective review of all cases with veil pin tracheobronchial FB aspiration in a single center over a 13-year period was carried out. There were 35 cases of headscarf tracheobronchial FB aspiration. All were females with mean age of 14 years. All patients experienced coughing and all had positive chest radiography findings. Commonest anatomical location was right main bronchus (32%) followed by left main bronchus (23%). Tracheal pins occurred in 17%. Rigid bronchoscopy was used more often than flexible bronchoscopy (83% vs. 17%, respectively). Repeat bronchoscopy was required in two cases (6%). Thoracotomy was required in one patient (3%). There were no complications or hospital deaths. Headscarf pin aspiration is seen in middle-aged women who inappropriately place the pins between their lips prior to securing their veils. Bronchoscopy is the treatment modality of choice and surgery is rarely required. Preventative educational strategies should be implemented to reduce such an avoidable risk.

Tracheo-innominate fistula (TIF) is a rare complication following percutaneous dilatational tracheostomy (PDT), occurring in < or =1% of cases. It usually develops three days to six weeks after the procedure and is fatal in the majority of cases, even after successful initial repair. We present a successfully treated case of TIF using a Goretex graft to replace the severely destroyed segment of the innominate artery.

Bronchial injuries are rare (1.0%-2.8% of all trauma cases) but potentially fatal, with 80% of patients dying before reaching a medical facility. They occur after penetrating or blunt chest trauma. Bronchial injuries require careful evaluation and meticulous operative repair. Adequate diagnosis is missed initially in up to 68% of cases, particularly in the presence of other organ injuries. An early correct diagnosis and prompt surgical management are mandatory to prevent mortality and morbidity.

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