Chirurgie des corps étrangers intrabronchiques

Inhalation of foreign body: "Avoidable lobectomy. A case report''

“…The reasons for endoscopic failure noted in the literature are: unsuitable instruments, distal migration of the foreign body, hemorrhagic granuloma and foreign body not visualized [9] Other indications for surgery include sharp and pointed foreign bodies with risk of migration and damage to surrounding structures, old foreign bodies with irreversible respiratory damage [9][10][11] In our case, the surgery was motivated both by the failure of endoscopic extraction and by how long the foreign body was in place.This surgery was preceded by a chest CT scan to better ensure the final seat of the foreign body and secondary bronchopulmonary destruction, which allowed us to consider the actions to be taken. Other authors also suggest that the intervention be immediately preceded by the thoracic scanner to properly locate the foreign body due to its mobility [7,9,11,15]. Irreversible parenchymal damage requires sometimes extensive excision [15] .…”

“…D8PO, drain removed, pulmonary expansion noticed them in the mouth, but girls are also concerned, in particular veiled girls [3][4][5][6][7] .The nature of the inhaled foreign body varies greatly depending on the socio-cultural and regional conditions, the eating and educational habits of the populations as well as the religious context. They can be organic or inorganic [8][9][10] These foreign bodies are usually located on the right side in 52.8% of cases. However, left side or bilateral localization is possible [11,12] .In the event of acute respiratory distress in children, it is necessary to systematically think of a bronchopulmonary foreign body.…”

“…It confirms the presence of a foreign body in the bronchus and specifies the evolutionary stage [10] .Any foreign body having penetrated by the natural ways can be extracted by the same ways provided that it has not migrated through the perforated wall of these ways [5,6,13] . There should be no delay in endoscopic extraction [7][8][9][10][11][12][13][14][15] . Surgery is reserved for endoscopic extraction failures.…”

“…An early extraction period limited to the first 72 hours after inhalation of foreign bodies is an important condition for an uncomplicated course [11,13] . Since bronchopulmonary foreign body surgery must be conservative, it is limited as much as possible to bronchotomy or extraction pneumotomy after detection and manual blocking of the foreign body in order to avoid its migration [9,10] . But, faced with a situation of irreversible parenchymal destruction, pulmonary resection procedures must be performed and depend on the extent of these lesions [9,10] In our situation, this surgery was made difficult especially by the absence of selective intubation in anesthetic practice.The post-operative events are mostly simple.…”

“…But, faced with a situation of irreversible parenchymal destruction, pulmonary resection procedures must be performed and depend on the extent of these lesions [9,10] In our situation, this surgery was made difficult especially by the absence of selective intubation in anesthetic practice.The post-operative events are mostly simple. Operative mortality varies between 0.05 and 0.5% in the literature [9,10]. Morbidity is dominated by heart rhythm disturbances, bronchial fistula, pulmonary edema and post-pneumonectomy syndrome [10,11] 4 CONCLUSION: Broncho-pulmonary foreign bodies are observed especially in young children.…”