Abstract

This patient is a 24-year-old student by profession and from a non-consanguineous marriage, 2nd of a sibship of 4, originally and resident in Marrakech of low socioeconomic level, having as antecedent an inhalation of a neglected metallic foreign body at the age of 2 years, which presents itself for chronic bronchorrhea which has been evolving for 5 years and of recurrent pulmonary infection with the notion of a false route during swallowing which appeared 6 months ago, in who underwent pleuropulmonary examination noted the presence of right basithoracic snoring rattles, thoracic CT and bronchial fibroscopy demonstrated a metallic foreign body at the level of the right bronchus strain with dilatation of the cylindrical type sequential bronchi interesting the associated middle lobe to an oesotracheal fistula of supraciliary topography. preoperative preparation with antibiotic therapy and bronchial drainage respiratory physiotherapy and a decision on thoracic surgical intervention with left selective intubation was taken and right posterolateral thoracotomy was performed with spotting and extraction of the foreign body by bronchotomy with dissection and liberation of the margins fistula and padding of the orotracheal fistula, the postoperative follow-up was simple and the course in the course, medium and long term was marked by a good clinical, biological and radiological improvement with a decline of 14 months.

Highlights

  • Oeso-tracheal fistula (OTF) is an abnormal communication between the trachea and the oesophagus, it is usually secondary to a congenital malformation but rarely due to a foreign body

  • In this study we report a case of oesotracheal fistula due to the inhalation of a neglected foreign object for 22 years

  • Bronchial fibroscopy revealed an oesotracheal fistula located 2 cm above the carina with a quadrangular metal-like foreign body embedded in the mucosa of the right bronchus, the

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Summary

INTRODUCTION

Oeso-tracheal fistula (OTF) is an abnormal communication between the trachea and the oesophagus, it is usually secondary to a congenital malformation but rarely due to a foreign body. Who consults for chronic bronchorrhea evolving for 5 years and of repeated pulmonary infection with notion of false route during swallowing appeared 6 months ago and having as antecedent inhalation of a neglected metal foreign body at the age of 2 years, it is the brake of the belt of a manual watch of the father of the patient, the general clinical examination of the patient is without particularity, the pleuropulmonary examination notes of the right basithoracic ronflants, At the radiological assessment one note the presence of a foreign body at the level of the right bronchus with dilatation of the bronchi of the cylindrical type interesting the middle lobe associated with an oesotracheal fistula of suscarinary topography to the thoracic CT scan[fig 1-4].

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