[Foreign bodies in the body following vascular surgery (11 cases)]

Eleven cases of foreign body (F.B.) (3 autochthonous and 8 of other sources) demonstrate the rarity but also the persistent reality of these accidents. Incidence between 1970 and 1985 was close to one F.B. per 3,000 vascular procedures. In 4 cases the F.B. followed surgical non-reconstructive surgery and in the other 7 cases revascularization procedure, material involved being most often textile, sponges in 7 cases and towel in one case. Circumstances leading to let F.B., without disculpating the surgeon, included long and difficult operations conducted as emergencies or requiring one or more recovery operations. Clinical findings of the F.B. were of post-operative sepsis (10 cases) of varied clinical expression. General (4 cases of septicemia) and local (3 thrombosis, 1 anastomotic hemorrhage) consequences were serious. Prognosis in patients with F.B. closely follows that of vascular sepsis, with maximum seriousness after bifurcated prosthetic shunt. An essential prognostic factor is early diagnosis of F.B.: it is dependent on a series of clinical and paraclinical etiologic arguments, particularly results of radiography of the operated zone, fistulography and echography. Surgical intervention is a function of initial operation and is that proposed for all cases of vascular sepsis, with the common denominator of the total revision of the operated zone and removal of foreign bodies. Prophylaxis of F.B. in vascular surgery follows the rules for general surgery; these have been enounced for the last 50 years but have failed to prevent the postoperative F.B. This rare but always possible accident justifies its knowledge by even the most serious, experienced vascular surgeon.