Navigating Intraoperative Dislodgement: Anaesthetic Management in Foreign Body Retrieval with Bronchotomy and...

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Pulmonology

Background:

• Foreign body aspiration into the lower airway poses significant anesthetic challenges.
• Dislodgement during surgical manipulation complicates retrieval efforts.

Purpose of the Study:

• To report a complex case of foreign body retrieval from the lung.
• To highlight a successful multimodal anesthetic and surgical strategy for a dislodged airway foreign body.

Main Methods:

• Case report of a 21-year-old male with an iron nail in the left lower lobe.
• Initial failed attempts with flexible and rigid bronchoscopy.
• Left thoracotomy followed by dislodgement into the tracheal wall.
• Multimodal retrieval using fiber-optic bronchoscopy and bronchotomy.
• Anesthetic management with spontaneous ventilation and total intravenous anesthesia (TIVA).

Main Results:

• Successful retrieval of a dislodged iron nail from the tracheal wall.
• Effective management of a complex airway foreign body scenario.
• Demonstration of successful coordination between anesthetic and surgical teams.

Conclusions:

• Complex airway foreign body retrieval requires a coordinated multimodal approach.
• Total intravenous anesthesia (TIVA) and spontaneous ventilation can be key components of the anesthetic strategy.
• This case underscores the importance of adaptability in managing dislodged foreign bodies during thoracic procedures.