Bronchotomy for removal of foreign body bronchus in an infan
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Foreign body aspiration into the bronchus is a frequent accident in childhood. Flexible and rigid bronchoscopy is the mainstay of treatment for removal of the foreign body bronchus. However, surgical removal of the foreign body bronchus via thoracotomy and bronchotomy is required in <2% of cases when bronchoscopy fails. Anaesthesia for bronchotomy in the paediatric population is as challenging as anaesthesia for bronchoscopic removal. A 3 months old infant weighing 4 kg presented with a history of having ingested an iron nail. The 4 cm long nail was pushed down the oral cavity by her elder sibling. Pulse oximetry on room air was 96% and chest X-ray posteroanterior view showed a nail lengthwise in the right main bronchus with emphysematous air trapping in the right lung and a mediastinal shift to the left.An awake flexible fibreoptic bronchoscopy with paediatric fibreoptic bronchoscope was performed. The head of the nail was visualized completely occluding the right main bronchus with mucosal oedema around the head of the nail...

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