The foreign body in the respiratory tract and its transthoracic penetration through empyemes necessitans in the chest wall

Aspired foreign bodies continue to present a challenge to otorhinolaryngologists, pulmonologists and thoracic surgeons, where you can find a quick diagnosis, speed, and safe respiratory service of foreign bodies. Tracheobronchial foreign bodies are most common in the age group of 1-3 years and are most commonly of plant origin. The most common signs and symptoms from foreign bodies in the tracheobronchial trunk are coughing, difficulty breathing, and decreased airflow to the affected side. Bronchoscopy is recommended in all cases with a history of sudden cough, vague acute respiratory distress, or chronic lung infection. In our clinical case, an unusual flow occurs after penetration of the foreign plant body into the right tracheobronchial trunk of the 5-year-old child and the inflammatory and physical effects on deep structures of the right lung, the creation of bronchocutaneous fistula, and the penetration of the foreign body into the the external environment through the empiema necessitans drained to the chest wall. Empyema necessitans is a long-term complication of a poor or uncontrolled thorax empyema characterized by pus penetration into soft tissues and the skin of the thoracic wall. In our case the same is a direct consequence of the penetration - aspiration of the foreign plant body, part of the plant of the family Poaceae and the species Festuca rubra with body building and propensity for one-way penetration in different structures. The child is admitted to the Regional Hospital of Gjilan / Gnjilane, able to cough with a sudden onset, then persistent as well as respiratory problems, where he is treated as persistent right pleuropneumonia. The child is transferred to the Pediatric Surgery Clinic in Prishtina to accompany the condition with abdominal obstruction. After excluding the possibility of acute surgical disease, the child is transferred to the Pediatric Clinic where he is treated as a right pleuropneumonia until the appearance of a chest wall change and transfer to the Thoracic Surgery Clinic, where he is treated as empyema necessitans and drainage of pus contents. together with aspiring foreign troops