A Large Board Pin in the Right Main Bronchus: A Case Report With Review of Literature.

Foreign body (FB) aspiration is one of the most common emergency scenarios in cardiothoracic surgery and ENT unit consultations. We present the case of a 16-year-old male student who inadvertently ingested board pins while enjoying leftover savory. Despite the initial shock, he promptly sought evaluation at the local primary care facility. Remarkably, he remained largely asymptomatic. A subsequent chest radiograph revealed a radiopaque FB lodged in the right main bronchus. Employing a rigid bronchoscope, we successfully extracted the FB, obviating the need for open surgical intervention. What sets this case apart is the unusual combination of a large FB aspiration with minimal symptoms and the absence of internal injury during retrieval.

Mitral valve repair in chronic severe mitral regurgitation: short-term results and analysis of mortality predictors.

INTRODUCTION: Mitral valve repair is the accepted treatment for mitral regurgitation (MR) but lack of resources and socioeconomic concerns delay surgical referral and intervention in developing countries. We evaluated immediate and short-term results of mitral valve repair for non-ischemic MR at our centre and aimed to identify the predictors of in-hospital and follow-up mortality. MATERIALS AND METHODS: The study was conducted at a tertiary-level hospital in South India. All patients >18 years with severe non-ischemic MR who underwent mitral valve repair over a period of 6 years were included. Perioperative data was collected from hospital records and follow-up data was obtained by prospective methods. RESULTS: There were 244 patients (170 males). Most of the patients were in the age group 31-60 years (76.6%). Aetiology of MR was degenerative (n = 159; 65.2%), rheumatic (n = 34; 13.9%), structural (n = 42; 17.2%), or miscellaneous (n = 9; 3.7%). All patients underwent ring annuloplasty with various valve repair techniques. One hundred patients (44.7%) underwent additional cardiac procedures. At discharge, MR was moderate in 4 patients; the rest had no or mild MR. The mean hospital stay of survivors was 7.1 days (SD 2.52, range 5-25 days). There were 9 in-hospital deaths (3.68%) and 10 deaths during follow-up (4.2%). The mean follow-up period was 1.39 years, complete for 87.6%. Pre-operative left ventricle ejection fraction (LVEF) <60% (p = 0.04) was found to be significantly associated with immediate mortality. Logistic regression analysis detected age (p = 0.019), female sex (p = 0.015), and left ventricular (LV) dysfunction at discharge (p = 0.025) to be significantly associated with follow-up mortality. CONCLUSION: Pre-operative LV dysfunction was identified as a significant risk factor for in-hospital mortality. Female sex, age greater than 45 years, and LV dysfunction at discharge were found to be significantly associated with follow-up mortality. Hence, it is important to perform mitral valve repair in severe regurgitation patients before significant LV dysfunction sets in for a better outcome.

Inflammatory myofibroblastic lung tumor with dysphagia in a 4-year-old child.

Inflammatory myofibroblastic tumors of the lung are rare in adults but common among pediatric lung tumors. A 4-year-old girl was evaluated for respiratory symptoms, dysphagia, and weight loss. Radiology revealed a right hilar mass that persisted despite antibiotic treatment. On exploration, a hilar mass involving the pulmonary vasculature, diaphragm and gastroesophageal junction was found. Aggressive surgical excision including a right pneumonectomy was performed. Histopathology confirmed an inflammatory myofibroblastic tumor with no features of malignancy. At the 2-year follow-up, the child was clinically stable with no recurrence. Dysphagia is a very rare presentation of such tumors.

Late presentation of esophageal rupture following blunt thoracic trauma.

Esophageal rupture following blunt thoracic trauma is extremely rare. A 30-year-old man sustained a road traffic accident causing blunt thoracic trauma that resulted in lower esophageal rupture. He presented 24 h after the initial trauma and was managed with primary repair and aggressive lavage with a drainage procedure. Early identification and repair of esophageal rupture is vital for preventing mediastinitis, but an aggressive surgical and postoperative management strategy can prevent mortality even in late presentations.