title: Ingested ring-pull causing bronchoesophageal fistula and transection of the left main bronchus: successful salvage of the left lung and esophagus five years after injury.
abstract: A 6-year-old girl with a history of ingestion of a ring-pull of a can and a transient episode of stridor had been asymptomatic 3 years before admission when left lung atelectasis with severe respiratory distress developed. Fluoroscopy and 3-dimensional computed tomography scan showed bronchoesophageal fistula and the ring-pull around the left main bronchus. At operation, the ring-pull, which transected the left main bronchus, was extracted. The left main bronchus was reconstructed by end-to-end anastomosis in spite of insufficient inflation of the collapsed left lung. The esophageal defect was repaired. The patient's respiratory distress gradually disappeared, and the x-ray films 3 months after operation showed complete expansion of the left lung. This case shows the risk of the long-term retained esophageal foreign body and the possibility of pulmonary salvage after long-term total atelectasis of the lung.
authors.affiliation: Department of Surgery, Kobe Children's Hospital and Hyogo Medical Center, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Satoh
authors.forename: C
authors.initials: C
authors.lastname: Tsugawa
authors.forename: N
authors.initials: N
authors.lastname: Tsubota
authors.forename: E
authors.initials: E
authors.lastname: Nishijima
authors.forename: T
authors.initials: T
authors.lastname: Muraji
mesh_terms: D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D001980:Bronchi / Q000293:injuries*; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002648:Child; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D004947:Esophagus / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D011859:Radiography; D016879:Salvage Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome