An Unusual Iatrogenic Foreign Body (Surgical Gauze) in the Trachea

Abstract

We report the case of a 60-year-old male with history of surgery for tracheal stenosis 21 years prior to the onset of difficult asthma-like symptoms. Upon exploring the tracheobronchial tree using the fiberoptic bronchoscope, a surgical gauze was found. The foreign body migrated transluminally from the mediastinum into the trachea and its removal was possible with rigid bronchoscopy leading to a rapid recovery of his symptoms.

Unexpected autoptic finding in a sudden death: Gossypiboma

“…Trans-luminal migration through the tracheo-bronchial wall is exceptionally rare [4]; in fact, few cases of retained sponges after cervical surgery have been reported, with only two cases reported after thyroid surgery [10], and two cases were due to migration from mediastinum to tracheo-bronchial tree, with resolution of the symptoms after removal of the sponge [4,11]. Moreover, a case of sudden suffocation in a 70-year-old man caused by a retained surgical sponge after 23-year-old thoracic surgery has been described [12] (Table 1).…”

“…Migration of retained surgical sponge is a very unusual sequelae, with most of the cases being reported after intra-abdominal surgery [3]. However, trans-luminal migration through the tracheo-bronchial wall is an extraordinary phenomenon [4]. Foreign body retention in surgical procedures results from human error [2] and it is a preventable and avoidable complication.…”

Capsule Endoscopy Removal through Flexible Bronchoscopy

“…The success rate of flexible bronchoscopy in removing foreign bodies has been reported to be >90% [14,15,16]. Therefore, we recommend consideration of removal of foreign bodies with flexible bronchoscopy by an experienced team with the availability of rigid bronchoscopy.…”