Right mainstem obstruction because of erosion of a retained surgical pledget

Airway foreign bodies may be discovered after aspiration, or less commonly, after erosion into the airway. Surgical pledgets may erode into neighboring anatomic structures, often many years after the original surgery. In this case, we describe a patient who developed chronic symptoms of dyspnea and cough and then developed an acute pneumonia because of obstruction of her right mainstem bronchus from a pledget placed 7 years earlier to control a bleeding mediastinal arteriovenous malformation. She was treated successfully with antibiotics followed by bronchoscopic removal of the pledget.