Severe hypoxia following video capsule endoscopy

Video capsule endoscopy is generally associated with gastrointestinal complications, but there have been few instances of asymptomatic aspiration. We present a 74-year-old male being evaluated for gastrointestinal bleed. A video capsule was deployed with no acute respiratory symptoms. However, after airway intubation for emergent gastrointestinal surgery, he developed profound hypoxia. The video capsule was found to be completely occluding his left main stem bronchus. Due to a significantly surgically altered airway secondary to previous head and neck carcinoma and the capsule’s difficult size and shape, the capsule was dislodged only through the use of a Fogarty catheter with eventual removal from the oropharynx using forceps.