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PubMed2004

Bronchial foreign bodies.

Foreign body aspiration is an extremely serious problem in childhood with varied clinical presentation demanding high degree of suspicion on the part of clinician. Surgical emphysema of the neck and chest often complicates tracheostomy and sharp penetrating injuries to the neck perforating viscera of the aerodigestive tract. Rarely if follows chest injuries. But emphysema due to the neck of foreign bodies in the bronchus is quite rare. The authors hereby report four cases of surgical emphysema following foreign body aspiration into the tracheobronchial tree.

Bronchi↗
PubMed2001

The combined use of a Fogarty balloon with extraction forceps for the controlled retrieval of an endobronchial foreign body.

Foreign body aspiration is a common problem in children necessitating prompt recognition and early treatment to minimize the potentially serious and sometimes even fatal consequences. We report the case of a 7 year old girl with a peanut lodged in her right main bronchus. Bronchoscopy identified the foreign body which was then removed by the combined use of a Fogarty balloon catheter and extraction forceps. This case differs from previous reports, in that the foreign body and forceps were removed separately from the balloon catheter, which theoretically should minimize the risks associated with this procedure.

Bronchi↗
PubMed1991

The two-headed stethoscope: its use for ruling out airway foreign bodies.

Foreign body aspiration is a common concern for physicians and surgeons who care for children. Evaluating infants and toddlers to rule out this possible diagnosis is often fraught with difficulties. Specifically, the standard stethoscope is of limited use unless unilateral asymmetry of breath sounds can be appreciated. Inspiratory and expiratory chest X-rays in children often appear to show a very similar diaphragmatic excursion and, unless the object is radiodense, the determination of foreign body aspiration is frequently not possible. Other procedures, such as flexible or rigid endoscopy, are more invasive and are reserved for children with positive findings or a less acute but more perplexing scenario. We present the use of the two-headed stethoscope as an option for evaluation of children to rule out foreign body aspiration. Our experience with this instrument over the past 10 years has consistently allowed us to non-invasively differentiate the presence or absence of objects in the airway.

Airway Obstruction↗
PubMed1992

Ingestion and aspiration of foreign bodies.

Foreign bodies may be swallowed as well as aspirated, but patients and their relatives may not understand the distinction. Fortunately, swallowing occurs more often than aspiration. Dental prostheses present specific problems in this regard. Their configuration impedes easy gliding through the esophagus and makes their extraction difficult. Swallowing of foreign bodies in elder patients is often explained by a decrease in psychological or neurological function, which undoubtedly may occur. The loss of tactile sense of the hard and soft palate as a result of complete denture use is another reason for frequent occurrence of this problem in elder patients.

Bronchoscopy↗
PubMed1998

Pediatric airway foreign bodies.

Foreign body aspiration (FBA) is a leading cause of accidental death in children less than one year old and is the cause of death in 7% of children less than four. Food items, especially peanuts, are the most common items aspirated in infants and toddlers, whereas older children are more likely to aspirate non-food items such as pen caps, pins, and paper clips. A high degree of suspicion is required to diagnose FBA. A history of a witnessed choking episode is most important in early diagnosis. An asymptomatic period is common after aspiration and contributes to a delay in diagnosis of greater than one week in 12% to 26% of patients. This delay in diagnosis causes increased morbidity from bronchial inflammation, obstruction, and pneumonia which is resistant to treatment. Prompt endoscopic removal of the foreign body with an open rigid bronchoscope under general anesthesia is the mainstay of therapy.

Airway Obstruction↗
PubMed1996

Aortoesophageal conduit due to a foreign body.

Foreign body-induced aortoesophageal conduit is a rare but frequently fatal condition. In children, ingestion of small objects can lead to such a problem, and care in eliminating small parts from the environment can lower the risk of this serious condition. This is a case report of a child who ingested a sharp, small foreign body that impacted in the esophagus and perforated the esophagus and aorta. With a hollow cylindrical shape, the foreign body provided a conduit between the aorta and esophagus, resulting in fatal massive bleeding.

Aortic Diseases↗
PubMedDate not supplied

Application of 3D computer-assisted techniques to sinonasal pathology--case report: war wounds of paranasal sinuses caused by metallic foreign bodies.

Foreign bodies in paranasal sinuses are found quite infrequently. They are usually detected after various types of head trauma and most commonly occur as a consequence of improper handling of firearms or explosives. In countries at war, eg, during the war in Croatia, adults and children were almost equally exposed to these injuries. The diagnosis should be based on results from precise computer tomography (CT) scanning in axial and coronal sections, and, using these data, tissues of different densities at these anatomical locations can be differentiated. The possibility of exact preoperative, noninvasive visualization of the spatial relationships of anatomic and pathologic structures with 3-dimensional (3D) computer-assisted diagnosis and intraoperative navigational techniques allows the surgeon to achieve a considerable advantage in the preoperative examination of the patient and to reduce the risk of intraoperative complications, all by the use of virtual surgery (VS) or virtual diagnosis. The expected contribution of the mentioned computer-assisted surgical technique manifests itself in defining the most appropriate mode of CT scanning of the head to design the 3D operating field model, and the possibility of active and dynamic 3D visualization of the desired anatomical regions is realized. 3D reconstruction of anatomic units becomes a routine preoperative procedure, providing a highly useful and informative visualization of the regions of interest, and, thus, advancing the definition of geometric information on anatomical contours of the 3D model by the transfer of so-called image pixel to contour pixel.

Child↗
PubMedDate not supplied

Analysis of cutaneous foreign bodies.

Foreign materials from exogenous sources pose a constant challenge to the diagnostic skills of practicing dermatologists. Depending upon circumstances, radiologic, histologic, and ultrastructural techniques can be of assistance in ascertaining the presence and nature of the substance in question. With technologic advancements, identification of small-sized particles is no longer limited to morphologic study alone. Ultrastructural analytic techniques now permit identification of minute particles or quantities of material in tissues with relative ease. No doubt, further application of currently available and newly evolving analytic systems will expand our limits of detection and enhance our scientific knowledge.

Foreign Bodies↗
PubMed1999

Eyelid foreign body mimics an intraocular foreign body on plain orbital radiography.

Localization of a foreign body detected on plain orbital radiography may be achieved by comparing radiographs taken with the eyes in upgaze and downgaze. Movement of the foreign body with ocular rotation is considered to indicate localization either within the globe itself or within the soft tissues of the orbit closely related to the globe. A case is reported that demonstrates that this radiologic feature may also occur when a foreign body is located within an eyelid because the position of the eyelids also changes on vertical eye movements. An eyelid foreign body may therefore mimic an intraocular foreign body on plain orbital radiography.

Adult↗
PubMed1992

The improbable intravesical foreign body.

Foreign objects in the urinary bladder can occasionally pose perplexing diagnostic problems, especially in the face of a seemingly incredible history. This case illustrates the importance of investigating such claims. Occasionally, alternate diagnostic methods such as fluoroscopy or ultrasonography may assist in noninvasive diagnosis and management.

Adult↗
PubMedDate not supplied

[Localization and removal of metallic foreign bodies using LIT-2 foreign body locator].

The paper analyzes the advantages and disadvantages of devices used in medical practice to localize and remove foreign metallic bodies. To enhance the accuracy of detection and localization of foreign bodies and the efficiency of medical application of whirl-current locators, a LIT-2 model foreign body locator is presented. Cases of mutual orientation of the device transducer and foreign metallic bodies, the specific features of whirl-current diagnosis with procedures for preoperative and intraoperative localization.

Equipment and Supplies↗
PubMed1990

Radiographic screening for glass foreign bodies--what does a "negative" foreign body series really mean?

This study was designed to provide percentages of radiographic detection of small glass foreign bodies and to compare the detection rates (sensitivity) of two-view posteroanterior and lateral with those of four-view posteroanterior, lateral, and right and left obliques screening radiographs. Three sizes (0.5, 1.0, and 2.0 mm, maximum dimension) of beer bottle glass fragments were inserted into chicken legs and radiographed. Three staff radiologists reviewed the films independently. With two-view radiography, the 2.0-, 1.0-, and 0.5-mm glass fragments exhibited 99%, 83%, and 61% average detection rates, respectively. An analysis of variance and a Tukey's range test demonstrated that the variation in the average detection rate with respect to size was statistically significant (P less than .01). X2 Analysis failed to demonstrate a statistically significant (P greater than .05) increase in average detection rates with four-view radiography. The results of this study indicate that the size of the glass foreign body is often the limiting factor for radiographic detection and that 0.5- to 2.0-mm fragments represent a "limited detection" size range. Furthermore, two-view radiography is appropriate and more cost-effective than four-view radiography for screening purposes.

Analysis of Variance↗
PubMed1997

[Detection of orbital foreign bodies by CT: are plain radiographs of foreign bodies still useful?].

PURPOSE: To prove the visualisation of orbital foreign bodies by CT. MATERIALS AND METHODS: In vitro we examined defined small objects of various materials (metal, wood, glass, stone) which are common as orbital foreign bodies, Density and minimum detectable size were studied. The findings of 27 patients with suspected orbital foreign bodies were compared with the results of plain radiographs, Comberg radiographs, sonography, and surgery. RESULTS: For iron, the minimum detectable size was 0.02 mm3. A differentiation of various materials by CT was not always possible, especially in small objects. There were wide differences in density of wood (-600 HU to +130 HU) according to hardness and water content. The CT scans correctly showed number and location of foreign bodies. Other methods were inferior in detection of foreign bodies. CONCLUSION: In diagnosis of foreign body injuries of the orbit, CT is the imaging method of choice.

Adolescent↗
PubMed1999

[Foreign body ingestion].

Foreign body ingestion is not infrequent in infants and children. The diagnosis of radiopaque foreign body ingestion does not pose a major problem. It is crucial to take an X-ray from the pharynx to the level of the pylorus. If a foreign body that might get stuck at the ileocoecal valve is ingested, it is necessary to perform a radiograph of the whole abdomen. Foreign bodies that do not pass the cardia must be extracted endoscopically. In the case of foreign bodies with a smooth contour that have passed the pylorus, parents are advised to check the child's stool or collect it and bring it for X-raying. If after a week there is no definite evidence that the foreign body has been excreted a follow-up radiograph is carried out. If the foreign body is still in the stomach or duodenum, endoscopy is necessary. The detection of nonopaque foreign bodies can be facilitated by giving oral contrast medium, making the depiction of the foreign body as a filling defect possible. As a complication, perforation can occur, the diagnosis of which may entail the use of sonography, conventional radiography and, to a lesser extent, CT.

Child↗
PubMed1995

Selective management of pediatric esophageal foreign bodies.

Esophageal foreign body is a relatively common consultation from the Pediatric Emergency Room. This study evaluates optimal selective management of esophageal foreign bodies in the pediatric patient. Eighty-six children have been referred for esophageal foreign body. Fifteen had been symptomatic for 48 or more hours before being seen. In eight, there was a known history of previous repair for esophageal atresia. In 88%, the foreign body was opaque, most frequently a coin. The most common nonopaque foreign body was retained food. Upon diagnosis, 72 children were taken to radiology, where balloon extraction under fluoroscopic control was attempted. Fourteen children went directly to the operating room for endoscopy and foreign body removal. Balloon extraction was successful in 62 cases (86%), and the children were discharged directly from the Emergency Department. The foreign body was successfully removed at esophagoscopy in the 10 cases that failed attempts at balloon extraction. Since 1990, successful extraction has been accomplished in 100% of cases (29/29). Neither balloon extraction nor endoscopy was associated with morbidity or mortality. Endoscopy was, however, associated with total hospital charges approximately 400% higher than balloon extraction. Fluoroscopically guided balloon extraction of appropriate esophageal foreign bodies is a safe and cost-effective alternative to endoscopy. Failure of nonoperative management does not complicate subsequent endoscopic removal. Patients with symptoms > 48 hours, a history of prior esophageal atresia, and/or nonopaque esophageal foreign bodies do not preclude attempt at balloon extraction.

Catheterization↗