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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↗
PubMedDate not supplied

An unusual rhino-pharyngeal foreign body.

BACKGROUND: Foreign bodies of the upper aerodigestive tract are commonly seen in the paediatric population; however adult patients with nasal foreign bodies in particular are much less common and when sharp foreign bodies are present there is a great risk of developing complications. STUDY DESIGN: This is a case report of a 20-year-old male magician with impacted rhino-pharyngeal foreign body. He intentionally inserted two long sewing needles into the right nasal cavity during a magical act. RESULTS: The impacted foreign bodies were located in his nose/pharynx and removal was achieved per orally under general anaesthesia. Only a minimal evidence of retropharyngeal abscess was noted despite the prolonged stay of the foreign bodies. CONCLUSION: This case highlights the fact that both a deliberate and an accidental foreign body in an adult nasal cavity can get impacted as well as the significance for its early removal.

Adult↗
PubMed2001

[Orbital foreign bodies].

Orbital foreign bodies are found in a variety of instances according to the foreign body, its volume, its nature and its location. Clinical cases are variable. In an emergency, the suspicion of an orbital foreign body in case of an orbital wound is studied as well as the surgical indications for extraction of this foreign body. Later, a misdiagnosed orbital foreign body can lead to infectious complications such as cellulitis, orbital abscess, fistula, or cerebral abscess with possible mortality. The different cases are presented with their surgical indications.

Emergencies↗
PubMed1987

Laryngotracheal foreign bodies in children. A comparison with bronchial foreign bodies.

Twenty cases of laryngotracheal foreign bodies were reviewed over an 11-year period to determine features that differentiate these from bronchial foreign bodies. A history of choking or aspiration was obtained in 18 patients (90%). The most common presenting symptoms were stridor, wheezing, sternal retractions, and cough. The chest roentgenogram was most often normal (58% [11/19]). Posteroanterior and lateral neck roentgenograms suggested the diagnosis in 92% (12/13) of the patients. The correct diagnosis was made within the first 24 hours of presentation in 11 patients (55%); 19 patients (95%) were correctly diagnosed within one week. The incidence of major complications was 45% (9/20); however, in patients with a delay in diagnosis of over 24 hours the complication rate was 67% (6/9). For this reason, in children with a diagnosis of croup or reactive airway disease who respond poorly or whose condition deteriorates despite appropriate medical therapy, early endoscopy should be considered.

Adolescent↗
PubMed1999

Diagnostic and therapeutic approach to migrating foreign bodies.

Ingested foreign bodies are the commonest otolaryngological emergency in Singapore and other parts of Southeast Asia. One of the uncommon complications of ingested foreign bodies is migration, which has the potential to cause morbidity and mortality. A retrospective study of 24 patients presenting from 1990 to 1996 at Singapore General Hospital was done to evaluate the presentation, investigation, and diagnosis of migrated foreign bodies. Of interest, most patients had ingested foreign bodies within 24 hours. All the migrated foreign bodies were linear, sharp fish bones. Migration is said to have occurred in the presence of positive neck radiography and negative rigid esophagoscopy. Computed tomography is the investigation of choice to confirm migration. All patients had neck exploration, and factors for successful outcome are discussed. This is the largest series in the literature to date.

Adult↗
PubMed1980

[Juvenile urologic foreign body extraction].

Foreign bodies are rarely found in the urethra and bladder of children. Generally, they are first observed at the start of puberty. Severe complications may occur, even involving the upper urinary tract. Therefore, foreign bodies should be removed as early as possible. Even in infancy it is possible to extract foreign bodies by transurethral approach. When such an extraction is carried out, injuries to the urethra, especially in male children, must be avoided. When difficulties arise during the transurethral procedure suprapubic removal should be preferred. Urinary tract infections which nearly always accompany the presence of foreign bodies in the urinary tract should be treated with antimicrobials.

Adolescent↗
PubMed1991

The radiolucent wooden foreign body.

Wooden foreign bodies in the extremities are frequently not suspected at initial presentation. Most often, these foreign bodies are not visualized radiographically. Xeroradiography, ultrasound, computed tomography, and MRI have been described as useful adjuncts in foreign body detection and localization. In our case, a truly radiolucent wooden foreign body was well visualized on plain radiographs. The atypical appearance resulted in misinterpretation, and proper diagnosis and treatment were delayed.

Child↗
PubMed1992

Dangerous pencils and a new technique for removal of foreign bodies.

Aspirated foreign bodies are important problems during childhood. Some instances may be fatal. Most of the foreign bodies are removed with use of classic instruments like rigid bronchoscopes and foreign body forceps. But sometimes we fail to remove them, particularly aspirated beads and spherical objects. In this case, a Fogarty catheter is helpful. Although we have had many experiences recently we failed to remove one aspirated foreign body which was a pencil cap. We succeeded in removing this pencil cap with a new technique that is explained in this article. We used a Storz transbronchial aspiration biopsy needle and a cotton-carrier stylet to remove the pencil cap.

Adolescent↗
PubMed1999

Use of mediastinoscopy for foreign body removal.

Foreign body removal from the aerodigestive tract can be a challenging endeavor despite improvements in technology. Rigid bronchoscopy has been demonstrated to be a safe and effective means of airway foreign body removal with appropriate training and expertise. However, potential complications exist and include extraluminal impaction of a penetrating foreign body during removal. This report details such a complication and the first known use of mediastinoscopy to remove the impacted foreign body to avoid the need for thoracotomy.

Bronchi↗
PubMedDate not supplied

Echocardiographically guided removal of an intracardiac foreign body.

BACKGROUND: Foreign bodies lodged in the heart can easily be missed during surgical repair of penetrating cardiac wounds. SUMMARY: We report the use of intraoperative echocardiography to identify and accurately locate a small cardiac foreign body. Our patient had a fragment of a drill bit lodged in his left atrium as the result of an industrial accident. He initially underwent emergency median sternotomy because of acute tamponade, but the foreign body was not found, and he subsequently required a second procedure to remove it. Intraoperative transesophageal and epicardial echocardiography during the second procedure confirmed the position of the metallic fragment, excluded the possibility of other lodged foreign particles, and ruled out other types of penetrating injury to the heart. CONCLUSIONS: Intraoperative echocardiography should be standard procedure in the removal of intracardiac foreign bodies.

Adult↗
PubMed1983

[Foreign bodies in the biliary tract. II. Unusual foreign bodies in the biliary tract. Review of the literature].

The authors have collated 21 cases of unusual foreign bodies, other than parasites, in the biliary tract. The collection includes 6 penetrating bodies, 4 ingested by patients who had undergone previous bilio-digestive anastomosis or a sphincterotomy, and 11 foreign bodies ingested by patients who had never had previous surgical treatment. They consider that the real frequency is certainly greater than might be expected from a review of the literature. They discuss the different ways of penetrating the biliary tract and stress the interest of wide biliodigestive anastomosis and large Y loops, as recommended by Roux, to prevent lithiasis forming on food residue trapped at the level of the anastomosis or upstream.

Biliary Tract↗
PubMed2001

Neglected laryngeal foreign body.

Laryngeal foreign bodies, especially in children, mostly present as an acute emergency. Few cases of long-standing laryngeal foreign bodies have been reported in the literature. This case illustrates one of the sequelae of a neglected laryngeal foreign body, resulting in significant granulation tissue formation in the larynx, and its management.

Animals↗
PubMed1976

Intestinal perforation in adults due to ingested opaque foreign bodies.

Accidental foreign body ingestion occasionally occurs in adults and is especially likely in those wearing dentures. While most foreign bodies pass readily through the gastrointestinal tract, complications such perforation, abscess, obstruction and hemorrhage occasionally occur. Radiography may be of help in detecting and localizing these foreign bodies and in determining complications caused by them.

Adult↗
PubMed2000

[An unusual complication of esophageal foreign body].

Esophageal foreign bodies must be carefully managed because they carry a high risk of potentially severe complications. A case of a sharp foreign body located in a previously unsymptomatic pharyngoesophageal diverticulum is described. The management protocol for esophageal foreign bodies is reviewed. Fiberesophagoscopy is the therapeutic technique of choice, but it may be dangerous if patients are not selected properly.

Aged↗