In a remarkable and life-saving intervention, the Interventional Pulmonology team at Aster Whitefield Hospital, led by Dr. Srivatsa Lokeshwaran,Lead Consultant and Head of Department – Interventional Pulmonology and Lung Transplant, Aster Whitefield,successfully removed a fragmented betel nut that had been lodged in the lung of a 72-year-old farmer from a village in Karnataka for nearly five years. The patient had aspirated the betel nut while chewing, mistaking it for being swallowed after a violent coughing episode. Like many in similar situations, he did not seek immediate medical attention.
“The challenge in this case was immense,” said Dr. Srivatsa Lokeshwaran, Senior Consultant – Interventional Pulmonology, Aster Whitefield Hospital. “The foreign body had been lodged for almost five years. Over time, the fragments had eroded the lining of the airway and become embedded beneath it, forming sinuses. One fragment was lying dangerously close to the left chamber of the heart, which made the procedure particularly complex.”
The farmer, unaware of the aspiration, endured persistent fever, chronic cough, breathlessness, and repeated antibiotic courses for years. At one point, he was even evaluated for tuberculosis, but his symptoms persisted. A CT scan eventually revealed a collapsed lung segment, and he was referred to Dr. Srivatsa for advanced care.
Upon bronchoscopy, the team discovered multiple stone-like fragments of the betel nut obstructing the right lung’s airway branches, causing chronic infection and obstructive pneumonia. The removal was technically demanding, requiring advanced tools such as snares, cryoprobes, and Fogarty balloons—to carefully extract the pieces one by one. The team had to manage bleeding, maintain ventilation, and prevent fragments from blocking the patient’s only airway, all within a few centimetres of space.
“This procedure required extraordinary coordination,” Dr. Srivatsa added. “While one team member ventilated the patient, another managed secretions and bleeding, while I focused on removing the foreign body. It truly takes a village to perform such high-risk interventions.”
The rigid bronchoscopy took about one and a half hours; we were supported by anaesthesiologists Dr. Ramachandra K,Lead Consultant – Anesthesiology, Dr. Krishna,Sr. Consultant Anaesthesia& Critical Care, Dr. Ajay,Consultant – Medical Gastroenterology, bronchoscopy technician Nandaraj, and the medical team. The patient was in a precarious financial situation prior to his admission; he received a huge amount of support, including discounts on his care, assistance from a Christian missionary, and guaranteed access to this essential procedure.
The surgery was a resounding success. Large volumes of pus, caused by years of obstructed infection, were drained during the operation. The farmer was discharged in good health the following day, free from the debilitating symptoms that had troubled him for years.