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PubMed2004

Anesthesia for removal of inhaled foreign bodies in children.

BACKGROUND: Foreign body aspiration may be a life-threatening emergency in children requiring immediate bronchoscopy under general anesthesia. Both controlled and spontaneous ventilation techniques have been used during anesthesia for bronchoscopic foreign body removal. There is no prospective study in the literature comparing these two techniques. This prospective randomized clinical trial was undertaken to compare spontaneous and controlled ventilation during anesthesia for removal of inhaled foreign bodies in children. METHODS: Thirty-six children posted for rigid bronchoscopy for removal of airway foreign bodies over a period of 2 years and 2 months in our institution were studied. After induction with sleep dose of thiopentone or halothane, they were randomly allocated to one of the two groups. In group I, 17 children were ventilated after obtaining paralysis with suxamethonium. In group II, 19 children were breathing halothane spontaneously in 100% oxygen. RESULTS: All the patients in the spontaneous ventilation group had to be converted to assisted ventilation because of either desaturation or inadequate depth of anesthesia. There was a significantly higher incidence of coughing and bucking in the spontaneous ventilation group compared with the controlled ventilation group (P = 0.0012). CONCLUSION: Use of controlled ventilation with muscle relaxants and inhalation anesthesia provides an even and adequate depth of anesthesia for rigid bronchoscopy.

Anesthesia, General↗
PubMed2005

Magnetic nasal foreign bodies in a 9-year-old male: opposites attract when it comes to nasal foreign bodies.

We report the case of a 9-year-old male who developed nasal ulcerations from magnets which were placed in his nose, and became attracted to each other across the nasal septum. The magnets came from a non-penetrating earring. Normally harmless, but when attracted to each other magnets can cause ulcerations and possibly perforation of the nasal septum and should be removed urgently whenever encountered.

Child↗
PubMed2005

The role of osteopontin in foreign body giant cell formation.

Foreign body giant cells (FBGCs) are a hallmark of the foreign body reaction caused by biomaterial implantation and are thought to contribute to biomaterial degradation and the duration of the response. Osteopontin (OPN) is a secreted, acidic matricellular protein with multiple phosphorylation sites that is highly expressed at sites of inflammation. OPN wildtype and knockout mice were implanted with poly(vinyl alcohol) sponges and explanted at 14 days. OPN knockout mice had more foreign body giant cells but fewer macrophages surrounding the implants than their wildtype counterparts. In an in vitro human FBGC assay, addition of soluble OPN was found to reduce macrophage fusion to giant cells. These are the first studies to show a direct inhibitory role of OPN in FBGC formation in response to implantation.

Animals↗
PubMed2000

'A parent's kiss': evaluating an unusual method for removing nasal foreign bodies in children.

Nasal foreign bodies are a common problem in children. Various techniques have been described for removing the offending articles. Positive pressure techniques have long been described, and have many potential advantages, but are not yet in widespread use. The aim of this study was to evaluate the efficacy, safety and acceptability of a technique of mouth-to-mouth blowing. Of 19 children with intranasal foreign bodies, the technique was successful in 15 (79 per cent). The procedure caused little or no distress to the child, and no complications were encountered. All parents found the technique acceptable. This technique for nasal foreign body removal is, as far as we are aware, the first to be subjected to any prospective evaluation of effectiveness. We suggest that it should be used as the first line management for removing nasal foreign bodies in young children.

Child, Preschool↗
PubMed2003

Retained rectal foreign bodies.

BACKGROUND: Retained rectal foreign bodies have been encountered more frequently and present a dilemma for management. Most of the reports on these cases were documented in the form of case report and from Western countries. The present study was a review on the authors' experiences in such cases. METHODS: Data from January 1979 to January 2000 were extracted from a computerized database of Taipei Veterans General Hospital. The clinical features, treatment strategies and outcomes were analyzed. RESULTS: Ten male patients (mean age: 57.0 years) with 12 presentations of retained rectal foreign bodies were collected. Glass bottles and vibrators were the most common objects encountered, while anal eroticism was reported as the reason for insertion in 50% of the cases. The majority of the objects were extracted by non-surgical methods through either anoscope (n = 4), rigid sigmoidoscope (n = 2) or colonoscope (n = 1). Obstetric forceps was utilized to remove an incarcerated bowling bottle. Emergent laparotomies were performed in cases with overt peritonitis (n = 2), pelvic sepsis (n = 1) and an impacted high-lying glass bottle. Minor complications, such as mucosal abrasion or superficial tear, were found in 62.5% of the non-surgically treated cases. Delayed bleeding was found in 2 of them. There was no mortality in our series. CONCLUSIONS: Despite its rarity, the retained rectal foreign body had varying clinical features. Most of the uncomplicated rectal foreign bodies could be simply extracted transanally under adequate anesthesia. Fiberoptic colonoscopic extraction provided an alternative choice. Open surgery should be reserved only for those patients with overt peritonitis or pelvic sepsis.

Adult↗
PubMed2001

Radiological features of unusual ingested foreign bodies.

For patients who ingest foreign bodies, pre-operative radiography is an invaluable tool that allows the surgeon to confirm the presence of the foreign body, preempt potential difficulties and plan the best method for foreign body removal. This is particularly important when a foreign body is of usual shape and size. We present a series of radiographs and pictures of some of the retrieved foreign bodies of five patients who swallowed unusual foreign bodies.

Child, Preschool↗
PubMed1996

[Foreign-body aspiration].

Aspiration of foreign bodies is a common accident during childhood. In its diagnosis, both an accurate clinical history and a high degree of suspicion must be taken into account. Without an early diagnosis and its correct treatment, it remains a major cause of morbidity and mortality in children. The objective was to analyze the incidence, diagnosis and therapy of foreign bodies in the airways in pediatric patients. We have conducted a retrospective study of sixty-four patients admitted to our Pediatric Intensive Care Unit during the last eight years with a suspected diagnosis of a foreign body in the airways. Accordingly, we have evaluated the clinical and epidemiological data, as well as the diagnostic and therapeutic methods used. Half of the patients were under two years of age. Cough was a constant finding in all cases. Most of the cases showed air-trapping in chest X-rays, and in almost all cases a bronchoscopy was needed to remove the foreign body. The aspirated material found was mostly frequently found was a piece of food and it was most commonly placed in the main right bronchus. We underline the importance of prevention to avoid this problem by leaving out of the child's reach dry fruits and other small objects that can be easily introduced into their mouths.

Adolescent↗
PubMed1995

Esophagotomy for incarcerated esophageal foreign bodies.

Less than 1% of esophageal foreign bodies are irretrievable by endoscopic techniques. Incarcerated esophageal foreign bodies require esophagotomy for removal. A retrospective study was conducted to determine the incidence, predisposing factors, and optimal treatment of incarcerated esophageal foreign bodies. Four of 815 patients (0.5%) with esophageal foreign bodies required esophagotomy for foreign body removal. Two predisposing factors for incarceration were identified, and these factors were related to patient age. Two infants had neglected esophageal foreign bodies that partially migrated through the esophageal wall. In two adults, foreign body size and sharpness were responsible for incarceration. One cervical and three thoracic esophagotomies were done. One thoracic esophagotomy suture line dehiscence occurred. Occult foreign body pressure necrosis may be a factor in esophagotomy suture line leakage. Care is required in esophagotomy closure. Principles established for repair of esophageal perforations are also applicable to esophagotomy closure.

Adult↗
PubMed1977

Corneal foreign bodies of coconut origin.

Corneal foreign bodies of varied nature have been reported, however, vegetable foreign bodies in the cornea have seldom been described. A case is reported of a male from the Marshall Islands in the Pacific who retained a number of deep corneal foreign bodies after being struck in the eye by a piece of a coconut shell. The foreign bodies caused considerable inflammation which ceased after they were exposed and removed by means of a centrally based lamellar corneal flap. The patient's eye has remained quiet for 4 months following removal of the foreign bodies.

Adult↗
PubMed1992

Magnetic resonance imaging and computed tomography in the detection and localization of intraocular foreign bodies.

In this experimental study, various foreign bodies were inserted into fresh bovine eyes, in different localizations. Twenty-one magnetic and non-magnetic foreign bodies, dimensions of which varied from 1.5 x 1.5 x 2 mm to 3.5 x 6 x 7 mm, were tried to detect by computed tomography (CT) and magnetic resonance imaging (MRI) scanning. In addition, further dissections were applied to check the ocular damage attributable to movement of the foreign bodies. Ferromagnetic foreign bodies have been shown to move in the eye and the risk of torsional forces being applied to the ferromagnetic foreign body seemed to cause intraocular complications during MRI scanning. All of the foreign bodies that were implanted in bovine eyes were recognized on CT scanning, except intraocular lenses. As a general rule, metallic foreign bodies produced beam-hardening artifacts, but these artifacts did not cause any problem in detecting the localizations of foreign bodies.

Animals↗
PubMedDate not supplied

A missing tongue stud: an unusual appendicular foreign body.

Appendicitis caused by foreign bodies after body piercing is rare. Previous reports have described a variety of foreign bodies that were either found incidentally in the appendix or were felt to be responsible for appendicitis. We report a case where a patient known to have previously ingested a "tongue stud" after a tongue piercing presented with chronic right iliac fossa pain. The missing "tongue stud" had impacted in the appendix and was successfully removed by laparoscopic appendicectomy with resolution of patient's symptoms. We review the literature covering the clinical management of patients presenting with foreign bodies in the appendix.

Adolescent↗
PubMed2000

[Radiological study of orbital foreign body].

OBJECTIVE: To study the factors influencing of foreign body. METHODS: 527 cases of orbital foreign body was analysed and the relationship between foreign body and projection position or projection angle was retrospectively reviewed. RESULTS: Foreign body in 13 cases was found in the lateral radiogram(No foreign body in the posteroanterior radiogram). In 12 cases foreign body was found in the Belot's radiogram(No foreign body in P. A. and lateral radiognam). In ten cases foreign body was found in the Vogts radiogram (No foreign body in P. A., lateral, Belot's radiogram). In the first radiogram, one case was found to have foreign body in the Lateral but P. A. In the second radiogram, just the reverse of above. CONCLUSION: The image of foreign body was influenced by projection position and projection angle between foreign body and X-ray. The patients must take Belot's or Vogt's radiogram except routine P. A. and Lateral radiogram. Sometimes the patients should be taken more radiogram after moving the eye ball direction in order to find the small and flact foreign body.

Adolescent↗
PubMedDate not supplied

The relationship between time of admittance and complications in paediatric tracheobronchial foreign body aspiration.

PURPOSE: Majority of tracheobronchial foreign body aspirations occur in paediatric age group and may constitute a life hazard. We examined the relationship between the time of admittance and complications in children with tracheobronchial foreign body aspiration. MATERIAL AND METHODS: Sex, age, time of admittance, presenting symptoms, radiological findings, and the nature of the foreign body were reviewed retrospectively in patients aged 16 and under follow-up for tracheobronchial foreign body aspiration between January 1990 and January 2005. Cases were randomly assigned into 6 groups based on admittance times. RESULTS: Within 15-year period, 263 children under the age of 16 were followed-up for tracheobronchial aspiration of foreign body. The most commonly aspirated foreign bodies included sunflower seed, peanut, hazelnut, walnut. While the pathology could be detected radiographically in 80.3% (n : 211) of the cases, in 19.7% (n : 52) radiology was normal. All cases had rigid bronchoscopy under general anaesthesia. In 220 cases foreign body was detected and could successfully be removed in 209 cases. The remaining 11 cases required bronchotomy or pneumotomy to remove the foreign body. Among 679 cases operated for bronchiectasis during the same period, 22 cases (3.2%) had foreign body as the aetiology. No complications were observed when the patients presented to the hospital within the first 24 hours after the aspiration while fever, purulent sputum, haemoptysis and bronchiectasis were noted in those presented later. Most of the complications were medically treated. CONCLUSION: Paying medical attention within the first 24 hours after the aspiration of foreign bodies is critical in order to accomplish a complication-free course. Organic foreign bodies and retention period of 30 days and over, constitute major risk factors in the development of bronchiectasis. It is advisable to perform bronchoscopy in the early stages of all suspected cases to avoid serious complications such as bronchiectasis.

Adolescent↗
PubMedDate not supplied

Comparison of the clinical presentations of ingested foreign bodies requiring operative and nonoperative management.

Foreign body ingestion is commonly seen in emergency departments. Although most cases have a clear history, foreign bodies in the gastrointestinal tract can be an unexpected finding after operations for other conditions. This study compares the clinical presentations and outcomes for patients requiring or not requiring operations. Between January 1998 and December 2001, 80 patients with foreign body ingestion were included and divided into two groups. Specifically, group 1 patients were managed nonoperatively, and group 2 patients were managed operatively. The patient demographics, symptoms, foreign body ingestion mechanisms, type of diagnostic studies and management, and outcomes were compared between the two groups. Group 1 contained 44 patients, and group 2 contained 36 patients. Group 1 patients were significantly younger, but the incidence of underlying disease and the proportion of patients who ingested foreign bodies intentionally or incidentally was similar in groups 1 and 2. Most of the ingested foreign bodies in group 1 were in the esophagus and stomach, but for group 2 patients they were mostly in the small bowel. Moreover, most of group 1 patients were asymptomatic, which was not the case in group 2. Most group 2 patients had no known history of foreign body ingestion, and diagnoses generally were established during surgery. Neither group of patients displayed any mortality. Nonoperative management of foreign body ingestion usually can succeed in asymptomatic patients with a clear history; however, ingested foreign bodies can cause serious problems for those patients without a clear history of foreign body ingestion.

Adolescent↗
PubMed1997

Fragment of a catheter as a foreign body in the kidney.

Foreign bodies in the kidney are unusual. A review of the literature disclosed few reports of renal foreign body from nontraumatic causes. In this article, we report a case of gross hematuria due to iatrogenic foreign body in the kidney from ureteral endoscopy. The catheter fragment eluded diagnosis for 18 months until it was discovered and retrieved by means of a flexible ureteroscope. To our knowledge, this is the first report of this complication and presentation following endoscopic manipulation of the upper ureteral tract.

Adult↗
PubMed1985

Stenosis and fistulae with neglected vaginal foreign bodies. A case report.

Foreign bodies present in the vagina for long periods of time are infrequent but potentially serious findings in adult women. Significant injury can occur to bowel, bladder or other pelvic structures. Repair of fistulae is delayed following removal of the foreign bodies until the chronic inflammation produced by the objects has resolved. Coexisting psychiatric illness or physical abuse may complicate the evaluation and treatment of some women with long-standing vaginal foreign bodies.

Adult↗