title: Migration of surgical clips through a right lobectomy stump mimicking an asthmatic syndrome.
abstract: The mechanical stapler is routinely used in thoracic surgery practice to attend resection of bronchus and vessels. Herein, we reported a very rare complication as the migration of a titanium surgical clip through a right lobectomy stump. One year after the procedure, the patient complained of persistent cough. A misdiagnosis of asthma was made and she treated for 6 months with bronchodilators, corticosteroid and antihistaminic without success. Thus, patient re-referred of our unit. No clinical signs of infection as fewer, productive cough, dyspnea were present. The laboratory exams were within normal value including white cells. CT scan revealed no abnormalities. Bronchoscopy demonstrated a healed upper bronchus stump without evidence of an actual, open bronchopleural fistula but with clips apparently working their way into the airway, with approximately half of the clip visible within the lumen. The side of the clips that would be open before closure by the surgeon formed the leading edge of the clips visible in the lumen. The clips were successfully removed during flexible bronchoscopy with a forceps usually used for biopsy. After the procedure, the cough disappeared. The endoscopy check after 3 months showed a normal bronchial stump without evidence of fistula.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Crescenzo
authors.forename: Paolo
authors.initials: P
authors.lastname: Laperuta
authors.forename: Filomena
authors.initials: F
authors.lastname: Napolitano
authors.forename: Chiara
authors.initials: C
authors.lastname: Carlomagno
authors.forename: Michele
authors.initials: M
authors.lastname: Danzi
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.forename: Alfredo
authors.initials: A
authors.lastname: Garzi
authors.forename: Mario
authors.initials: M
authors.lastname: Vitale
mesh_terms: D000368:Aged; D001249:Asthma / Q000175:diagnosis*; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008168:Lung / Q000601:surgery*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery; D013537:Sutures; D013577:Syndrome