Thoracoscopic Retrieval of Unusual Iatrogenic Foreign Bodies
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Case

A 21-day-old girl presented with cough for 15 days, rapid breathing and high grade fever for 2 days. Clinical examination and chest X-ray revealed the presence of right sided pyopneumothorax. Supportive treatment for management of septic shock started and urgent ICD tube insertion using a Malecot’s catheter were tried. When manipulating for insertion, a part of the Malecot’s catheter broke and got retained inside the pleural cavity. Another Malecot’s catheter was inserted for drainage of pyopneumothorax. Thoracoscopic removal of foreign body was planned after hemodynamic stabilization of patient.

After three days, when the infant recovered from septic shock and her lungs expanded significantly, she was operated upon. Surgery was performed under general anaesthesia in left lateral thoracotomy position. The foreign body was localized thoracoscopically. But as patient was not maintaining oxygen saturation with carbon dioxide pneumothorax required for procedure to continue, further port placement was abandoned. The ICD site incision was enlarged to about 5 cm and foreign body extracted under direct vision. Localization of foreign body using thoracoscopy helped in its extraction with a smaller than usual incision. Pleural cavity was lavaged and cleaned thoroughly. An ICD was placed again. The infant recovered well and was discharged....

http://www.indianpediatrics.net/apr2016/apr-341-342.htm
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