Dalvi Aditi, Save Maitreyee, Kothari Paras
Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai 400022, Maharashtra, India.
Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai 400022, Maharashtra, India.
Int J Surg Case Rep. 2024 Sep;122:110061. doi: 10.1016/j.ijscr.2024.110061. Epub 2024 Jul 22.
Foreign body aspiration is a common occurrence, with severe outcomes seen in all age groups. It can present like any chronic respiratory disease with a wide spectrum of misleading symptoms, resulting in misdiagnosis and delays in appropriate treatment.
Here we present a case of a 11 year boy diagnosed with occult foreign body aspiration, chronically impacted in the left secondary bronchus, presented with bronchiectasis and multiple failed attempts at bronchoscopic retrieval.
Surgically managed by a left lower lobe lobectomy via a mini thoracotomy, reinforced with a pedicled latissimus dorsi flap. Upfront surgery will reduce the bronchoscopic morbidity incurred in repeated attempts needing pot-op ventilatory support due to edema and repeated general anaesthesia risks.
A high degree of suspicion is a key to diagnosis. There should be a low threshold for surgical management in chronic impactions.
异物吸入很常见,各年龄组都会出现严重后果。它可能表现得像任何慢性呼吸道疾病,伴有一系列具有误导性的症状,导致误诊和适当治疗的延误。
在此,我们报告一例11岁男孩,诊断为隐匿性异物吸入,长期嵌顿于左肺叶支气管,出现支气管扩张,多次支气管镜取出尝试均失败。
通过小切口开胸行左下叶肺叶切除术进行手术治疗,并用带蒂背阔肌皮瓣加固。早期手术将减少因水肿和反复全身麻醉风险而需要术后通气支持的反复尝试所导致的支气管镜检查并发症。
高度怀疑是诊断的关键。对于慢性嵌顿,手术治疗的阈值应较低。