PNEUMONOTOMY FOR REMOVAL OF SHARP FOREIGN BODY IN LUNG- A CASE REPORT

Foreign body aspiration in paediatrics is a common surgical emergency. However, instances of chronic lodgement of sharp metallic pointed objects like needles or pins into the lung parenchyma are rare. Diagnosis of these cases is a challenging task in itself as the symptoms are variable, ranging from prolonged mild illness to acute attacks of respiratory distress. Careful evaluation to locate the site and status of impaction helps decide on the prospective plan of management. Our case is of a 10 year old male who presented with an alleged history of foreign body aspiration 3 months back , followed by an asymptomatic period till date. On investigations we found a sharp metallic pin residing in the right lower lobe lung parenchyma. Posterolateral thoracotomy was performed to palpate the lung tissue and guide safe removal of the pin. Bronchoscopic removal is the best method of management for centrally located objects, present freely in the bronchi. Thoracoscopy is upcoming as the minimally invasive modality of choice for peripherally situated foreign bodies in the thorax. Certain rare cases like our patient, require formal thoracotomy followed by pneumonotomy for safe removal of sharp metallic pin impacted at a depth into the lung parenchyma. These modalities are potentially life saving in children , preventing multitude of complications that may result due to the grave nature of sharp foreign body associated with its chronicity. Hence knowledge of this entity is extremely useful to provide urgent and appropriate management in children.