Late Migration of a Polymer Clip After Sleeve Left Upper Lobectomy: A Rare Delayed Complication

Polymer vascular clips are commonly used in thoracic surgery to ensure secure ligation of pulmonary vessels and are generally considered safe. Clip migration is well described in various abdominal procedures but is extremely uncommon after pulmonary resections. We report the case of a 35-year-old man who underwent sleeve left upper lobectomy for a malignant epithelial tumor and remained disease-free for more than four years. The patient unexpectedly expectorated a foreign body following a mild coughing episode, which was identified as the polymer clip originally used to ligate the lingular artery. Computed tomography revealed no fistula, tract formation, or erosion, and bronchoscopy demonstrated completely normal airway anatomy without inflammatory or erosive changes. This case represents an unusual example of very late, entirely asymptomatic migration of a polymer vascular clip without any radiologic or endoscopic abnormality. Clip migration should be considered in the differential diagnosis of unexpected foreign-body expectoration, even years after thoracic surgery.