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PubMed1976

[Misdiagnosis of intraocular iron foreign bodies (author's transl)].

Out of 393 intraocular foreign bodies (1961-1975) 361 were magnetically removed and 32 non-magnetically (copper 7,brass,2,lead 5, glass 10, stone 3, wood 4 and plastic 1).60% of the foreign bodies were caused by hammer and chisel injuries.73 foreign bodies were diagnosed too late, in 71 cases no x-ray was made. The incidence of complications (infection, siderosis, retinal detachment was considerably increased where the foreign bodies were removed late. From the 73 foreign bodies (18.5%) the patient did not consult a doctor in 37 cases because of "insignificance". 4 times the family doctor was consulted, who treated the patient symptomatically. In 4 cases occurring in the weekend no eye-specialist could be ostensibly found. In 26 cases the ophthalmologist performed no x-ray control, and small foreign bodies were twice described as "x-ray plate artefacts" from the roentgen specialist. It must be an absolute rule in the eye-doctor's practice that every injury received while working with metals necessitates an x-ray control!

Accidents, Home↗
PubMed1995

Sensitivity and specificity of ultrasound in the diagnosis of foreign bodies in the hand.

High-resolution ultrasound is capable of detecting foreign bodies of practically any composition. The purpose of this study was to determine in a controlled manner the sensitivity and specificity of ultrasound in the diagnosis of foreign bodies in the hand. Each of 15 fresh-frozen cadaver hands was divided into 21 standardized sites for potential foreign body insertion. Foreign bodies consisted of two sizes of three different materials (wood, glass, and metal). Foreign bodies were randomly assigned to 50% of the available sites. The empty sites served as controls. All hands were scanned by a single radiologist using high-resolution ultrasound at a frequency of 10 MHz. The radiologist was unaware of which specimens contained foreign bodies. Of the 166 foreign bodies inserted in total, 156 were detected by ultrasound. Ten sites were falsely analyzed as negative, for a sensitivity of 94%. There was one false positive result and 148 true negatives. The specificity was therefore 99%. The high specificity of ultrasound allows foreign body presence to be confirmed given a positive result. A combination of ultrasound and x-ray films should allow for diagnosis and localization of virtually all foreign bodies in the hand.

Cadaver↗
PubMed2004

Chronic esophageal foreign bodies in pediatric patients: a retrospective review.

OBJECTIVE: Chronic esophageal foreign bodies (CEFB) are associated with a high incidence of morbidity and mortality in adults. However, the presentation, management and outcome of chronic esophageal foreign bodies in children are not well described. METHODS: We performed a retrospective chart review of children with chronic esophageal foreign bodies admitted to the Children's Hospital Medical Center, Cincinnati, OH, between May 1990 and January 2002. A chronic esophageal foreign body was defined as a foreign body estimated to have been present for over 1 week. RESULTS: Over the inclusion period, 522 children were admitted with esophageal foreign bodies, 41 (8%) of which were chronic. The most common foreign bodies were coins. Seventy-six percent of patients presented with a primary complaint of respiratory symptoms, with respiratory distress being the most common followed by asthmatic symptoms and cough. Twenty-two percent of patients had primarily gastrointestinal symptoms including nausea/vomiting and dysphagia. One patient was asymptomatic on presentation. A perforated esophagus was identified in 18 patients, with 17 of these being a technically perforated esophagus and one case being a classic esophageal perforation. There were no deaths or permanent morbidity in this series. CONCLUSIONS: Respiratory symptoms are more common than gastrointestinal symptoms in pediatric patients with chronic esophageal foreign bodies. Removal by rigid esophagoscopy is recommended. A small proportion of cases require open removal of the foreign body. Conservative management is appropriate for the technically perforated esophagus. A good outcome should be anticipated for the majority of cases.

Adolescent↗
PubMed1989

Localisation of intraocular and intraorbital foreign bodies using computed tomography.

Accurate localisation of foreign bodies in the region of the orbit is vital for correct management. Fifteen patients with such foreign bodies are described. Computed tomography (CT) of the orbits proved accurate in differentiating extraocular and intraocular foreign bodies, and in localisation within the globe. If a foreign body is visible on a plain radiograph, axial 6 mm thick CT sections will demonstrate it in all cases. If plain radiographs are negative or equivocal, 3 mm thick CT sections are necessary. Coronal scans are of limited usefulness.

Adolescent↗
PubMed2000

[Laryngeal foreign bodies: management in children in Senegal].

UNLABELLED: Inhalation of foreign bodies is a frequent accident in children. It remains severe in the case of laryngeal foreign bodies. PATIENTS AND METHODS: Retrospectively, for a 16-year period, 65 laryngeal foreign bodies have been treated (44.8%), among 145 cases of airway foreign bodies, in the ENT department of Dakar University hospital. Etiological, clinical and therapeutic aspects were reviewed. RESULTS: Average age was 36 months, with a sex-ratio of 2.42 in favour of males. The time lag (time between the accident and admission to the department) was particularly long; 73.33% of the children were admitted more than 24 hours after the event. Eighty-three percent of the patients presented greater or lesser laryngeal dyspnea. Tracheostomy was performed in 55.4% of the patients. Average duration for abiation of the canula was ten days. Three cases of death were recorded (4.16%). DISCUSSION: The frequency of 44.8% for laryngeal localization of foreign bodies appears to be the highest in the literature. If the appropriate treatment for foreign bodies in the respiratory tract is endoscopic removal, the tracheostomy nevertheless occupies a central place in the management of the disease. This procedure may be recommended to all ENT specialists working in similar conditions. In spite of its inherent complications, tracheostomy allows reduction of mortality in relation to laryngeal foreign bodies. Improvement of prognosis requires prevention based on widespread public information and improving technical infrastructures.

Adolescent↗
PubMed1995

[Extraction of intravascular foreign bodies].

OBJECTIVE: Loss or displacement of foreign material within the cardiovascular system is not an uncommon event. Foreign bodies include fragments of diagnosis equipment, ruptured catheters or malpositioned or displaced intravascular prostheses. The incidence has increased with the development of endovascular catheterism and raises the problem of extraction. METHODS: We report our experience with percutaneous extraction of intravascular foreign bodies. RESULTS: There were 56 cases. Percutaneous extraction was successful in 53. In 11 cases, the procedure was carried out during a catheterism procedure and in the others the initial event had occurred earlier. The delay to extraction varied from a few hours to several years. CONCLUSION: Percutaneous extraction of intravascular foreign bodies should be attempted before surgical removal, an often difficult high-risk procedure. The literature does not provide data on the frequency of intravascular foreign bodies.

Adolescent↗
PubMed1997

Pearls and perils in the management of prolonged, peculiar, penetrating esophageal foreign bodies in children.

BACKGROUND/PURPOSE: Most retained esophageal foreign bodies (FB) are identified soon after ingestion and are easily extracted. A minority of FB ingestions are not identified for weeks to years and present significant problems for retrieval. The purpose of this study was to describe the diagnostic and therapeutic strategies needed to care for children who have chronic esophageal FBs. METHODS: Five children were identified as having retained esophageal FBs 2 months to 2 years after ingestion. During the same 3-year period, 100 children who had acute FBs were identified and had their foreign bodies removed endoscopically. The average age of the children was 3 years (range, 2.4 to 3.5). RESULTS: The average age of the five children identified in this study was 3 years. The items ingested included coins, a heart pendant, a clothespin spring, and a toy soldier. Complications from chronically retained foreign bodies were bronchoesophageal fistula, mediastinitis, esophageal diverticulum, and lobar atelectasis. One patient died from an aortoesophageal fistula. In all children, endoscopic removal was attempted. Barium esophagram was then performed, and foreign bodies were eventually removed via right thoracotomy. CONCLUSIONS: Long-retained esophageal FBs are extremely morbid and life threatening. History most often identifies excess salivation, new onset asthma, and/or recurrent upper respiratory infections. Three diagnostic adjuncts are helpful in identifying the presence of a long retained FB: (1) Chest x-ray (PA and lateral), (2) barium swallow, and (3) esophagoscopy. Indications for thoracotomy for removal of foreign body include (1) Poor endoscopic visualization of FB because of inflammatory tissue and (2) Herald bleeding during endoscopy.

Aorta, Thoracic↗
PubMed1977

Detection of orbital and intraocular foreign bodies by computerized tomography.

Localization of intraocular and orbital foreign bodies with computerized tomography (CT) was evaluated in eight patients and an experimental model. CT examination was particularly helpful in cases with multiple similar foreign bodies and in identifying foreign bodies too radiolucent to be seen by standard skull x-rays. Limitations of CT technique included insufficient resolution to localize a foreign body immediately adjacent to the sclera as either intraocular or extraocular, and obscuration of a small foreign body by artifacts from an adjacent, larger foreign body.

Adolescent↗
PubMed1981

Colorectal foreign bodies and perforation.

Although most rectal foreign bodies can be removed safely in the emergency room, some require removal in the operating room. Good results can be achieved if basic principles in the management of colorectal injuries in general are applied to colorectal perforations by foreign bodies. Although rectal foreign bodies and colorectal perforations from non-medical rectal instrumentation have been a medical curiosity for many years, especially in metropolitan general hospitals, there can be little doubt that the frequency of such problems is increasing. We expect that community hospitals, will see more of these problems in years to come, if they are not already.

Adolescent↗
PubMed1996

Two unusual cases of a foreign body in the oral cavity caused by eating raw squid.

Foreign bodies are often encountered by otolaryngologists, but the oral cavity is considered a place where foreign bodies are rare because of its structural and functional features. We here present 2 cases with a foreign body in the oral cavity resulting from eating raw squid. In one of these 2 cases endoscopic examination revealed a gastric foreign body. The foreign bodies in the oral cavity were removed using forceps, together with surrounding mucous membrane. These foreign bodies were identified as sperm bulbs and discharging tube of sogittated calamary (Todarodes pacificus Steenstrup). Larva migrans of anisakiasis are to be differentiated from sperm bulbs; it is important to distinguish between the shape and size of the foreign body in our cases. If sperm bulbs are stuck in the oral cavity, it is necessary to remove them completely to ensure that inflammation is prevented. We stress the importance of checking not only anisakiasis but also sperm bulbs in humans who like eating raw squid.

Animals↗
PubMed2003

Endoscopic basket extraction of a urethral foreign body.

The presence of a foreign body in the genitourinary tract represents a urologic challenge that often requires prompt intervention. We describe an endoscopic approach that was used for removal of a foreign body located in the prostatic urethra of a schizophrenic man. A nitinol stone basket was used as an effective means for extraction of a large metal screw from the urethra of this patient.

Endoscopy↗
PubMed2004

Nasal foreign bodies in the African children.

Nasal foreign bodies are very common in daily clinical practice. Their simplicity in pathology and diagnosis often gives the wrong impression of little or no risk of complications. A 5-year (1998 - 2002) prospective study of 106 patients with nasal foreign bodies was done to evaluate and present the patterns, possible challenges and complications or problems in the management of this condition in the Nigerian Africans. The male to female ratio was 1:1.26 (M 47; F 59) and with an average age of 3 years. The duration of symptoms ranged from degrees hour to 4 years with 74 (69.8%) presenting within 24 hours and 27 (25.5%) presenting after 24 hours. The most common nasal foreign bodies were seeds 34 (32.1%), polyurethane foams 12 (11.3%), stones 11 (10.4%), plastic 10 (9.4%), beads 6 (5.7%) and erasers 6 (5.7%). The objects were found in the right nasal cavity in 63 (59.4%) cases while 43 (40.6%) in the left nasal cavity. The various clinical presentations were history of insertion of foreign bodies 91 (85.8%), 15(14.2%) with no history of insertion, mucopurulent nasal discharge 25 (23.6%), foul nasal odour 10 (9.4%), epistaxis 6 (5.7%), nasal obstruction and mouth breathing 3 (2.8%) and 2 (1.9%) cases respectively. The main complications were nasal infections (23.6%), epistaxis (5.7%), and purulent maxillary sinusitis (1.9%) seen in this study. These are preventable complications if the patients present early to the hospital. The absence of enough E.N.T. specialists however still plagues developing countries like Nigeria. A call is therefore made for more specialists in this area for early detections and care of these cases.

Child↗
PubMed1987

Esophageal foreign bodies.

Over 80 per cent of ingested foreign bodies pass through the gastrointestinal tract without incident. Sharp (bones, pins, needles, wire) or long (greater than 6.5 cm) foreign bodies are most commonly implicated in perforation. Food boluses are most common in obstruction seen in adult patients and associated esophageal pathology is common in patients aged 60 years and older. Adults with nonfood foreign bodies have a high incidence of psychiatric, social, or chemical derangements. Pediatric patients most commonly ingest coins. Ingestions tend to occur during nonschool months or in high-risk situations, and repeat ingestions are not uncommon. Fatalities and other major complications are linked to type of foreign body, location, and duration of the impaction. Deaths have also occurred with endoscopic and enzymatic modalities of treatment. Glucagon and Foley catheter removal are safe techniques in selected patients, provided resuscitative skill and equipment are available. Based on these data, an algorithmic approach to the management of esophageal foreign bodies by the emergency physician is recommended (Table 5).

Adult↗
PubMed2000

Complications of foreign bodies in the esophagus.

Major complications of foreign bodies in the esophagus carry significant morbidity and mortality risks. A retrospective case control study was performed to assess the factors associated with major complications. In total, 273 patients seen within a 7-year period were divided into 2 groups; 253 had no or minor complications, and 20 had major complications. Age, sex, duration of the foreign body, total white cell count (TWC), and nature and site of the foreign body were analyzed in the 2 groups. The major complication rate was 7.3%. Duration of the foreign body and TWC were the only statistically significant factors associated with major complications. Six patients required open neck exploration, 1 had an open thoracotomy, and 13 were treated by endoscopic removal. There were 2 deaths. Given the significant morbidity and mortality risks, we conclude that patients with a prolonged history of a foreign body in the esophagus and a raised TWC should be treated urgently.

Adult↗
PubMed2000

Frequency of tracheobronchial foreign bodies in children and adolescents.

OBJECTIVE: The problem of foreign body aspiration in the community has been studied and compared with other reports. METHODS: We have retrospectively studied patients who had bronchoscopy for suspected foreign bodies in the tracheobronchial tree, attending or referred to Al-Noor Specialist Hospital, Makkah over a period of 3 years from May 1996 to May 1999. RESULTS: The total number of patients was 94 (62 male and 32 female). Ages ranged from 4 months to 45 years(mean age 3.77 years), 85% of children being under the age of 5 years. One hundred bronchoscopies (6 repeat bronchoscopies) and one thoracotomy were carried out. Foreign bodies were removed from 60 patients (64%). Six (10%) did not have any definite history, while 15 patients (21%) with definite history of foreign body aspiration had negative bronchoscopy. An aspirated Fis-Fis (Alfalfa, Lucerne) seed accounted for more than one-third of all foreign bodies. The most frequent symptoms, signs, radiological findings and site of foreign body lodgement in the tracheobronchial tree are discussed. CONCLUSION: We conclude that a negative history, clinical examination and chest x-ray do not necessarily exclude aspirated foreign body material. Bronchoscopy is the most effective diagnostic and therapeutic modality to prevent complications related to neglected foreign body aspiration. In addition to children, teenagers and adolescents are also not immune to this problem. We recommend early referral to an appropriate hospital on suspicion or if symptoms persist. However, preventive measures, remain the best means of protecting these children.

Adolescent↗
PubMed1993

[Unusual history of a foreign body of the oropharynx].

The foreign bodies of oropharynx rarely make difficulties, whether diagnostic or treatment is concerned. However we considered interesting to report the following observation: an unusual or even anecdotal case. The matter is plantlife foreign body, which penetrated in oropharynx and only made exit four weeks later ... through the Meatus acusticus externus (external auditive duct).

Child, Preschool↗
PubMed2002

Foreign body aspiration: clinical utility of flexible bronchoscopy.

Foreign body aspiration is a worldwide health problem which often results in life threatening complications. More than two thirds of foreign body aspirations occur among children younger than 3 years. Organic materials such as nuts, seeds, and bones are most commonly aspirated. There is a wide range of clinical presentation, and often there is not a reliable witness to supply the clinical history, especially in children. Maintaining a high index of suspicion is therefore necessary for the diagnosis. None of the imaging methods employed in such cases are diagnostic, and bronchoscopy is frequently necessary for the diagnosis as well as the treatment. In adults, removal of the foreign body can be attempted during diagnostic examination with a fibreoptic bronchoscope under local anaesthesia, which may help to avoid any further invasive procedures with more complications. When diagnosis is delayed, complications of a retained foreign body such as unresolving pneumonia, lung abscess, recurrent haemoptysis, and bronchiectasis may necessitate a surgical resection. However, some of the late complications may resolve completely after the retrieval of the foreign body, therefore, a preoperative flexible bronchoscopy should always be considered in suitable cases.

Adolescent↗
PubMed1978

Migratory traumatic cardiovascular foreign bodies.

Six cases of cardiovascular foreign bodies secondary to trauma are presented. The various modes of entry and travel within the vascular are reviewed. Routine radiographic examination and angiography are shown to be the most useful techniques in defining the location and subsequent course of the foreign body in the vascular system.

Adult↗