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PubMed2001

[Penetrating intraocular injuries caused by foreign bodies of organic origin] ].

OBJECTIVE: To demonstrate two eyes of two patients with a penetrating injury by an organic intraocular foreign body (CNT), to outline the course of treatment and to evaluate anatomical and functional results. MATERIAL AND METHODS: During the period between May and July 1999 the authors treated at their department an 11-year-old girl and a 17-year old boy with a penetrating CNT injury of organic origin. In the girl they extracted a CNT which pierced the sclera and protruded into the vitreous body. The foreign body was extracted by means of a forceps, the site of perforation was treated by a cryosurgical procedure with a radial Silastic filling. The man was shot into the OL by a grain of pepper from an air-gun. The organic body in the vitreous body caused a violent inflammatory reaction in the vitreous body and retina. Early extraction of the CNT could not be made because of an adverse corneal finding which made surgery impossible. The progressing proliferative vitreoretinopathy (PVR) led to repeated formation of epiretinal, subretinal and cyclitic membranes which caused relapsing detachment of the retina (OS). The foreign body was extracted during pars plana vitrectomy (PPV) by the transvitreal route using a forceps. Definite adherence of the retina was achieved during the third PPV, membranectomy and implantation of silicone oil (SO). Final functional success was achieved by eliminating SO and by partial perforating keratoplasty. RESULTS: The CNT in the girl was histologically and parasitologically identified as a fibre of animal origin (animal hair or human eyelash). The follow up period is six months, VOP-5/5 nat., NOT 17 torr, bulbus undisturbed. In the second patient the cultivation finding from the vitreous body was negative. Extensive PVR developed as a result of breakdown products of the organic CNT and led to relapsing OS. Three months after the last operation the bulbus is at rest, the corneal disc clear, the retina attached, VOL-3/60 s + 8.0 D steop., NOT 12 torr. CONCLUSIONS: The final results of treatment of severe devastating penetrating injuries by a CNT is determined by the preoperative condition of the ocular tissues. CNT of organic origin damage intraocular tissues by their breakdown products as well as by more frequent contamination with pathological microorganisms. Our experience provided evidence that penetrating injuries by non-infected CNT of organic origin have a favourable prognosis. But even relapsing and prolonged OS after extraction of the CNT of organic origin and endophthalmitis need not lead to loss of the eye or its function.

Adolescent↗
PubMed2002

Colonoscopic retrieval of an appendiceal foreign body: prophylaxis for appendicitis?

Management of orally ingested foreign bodies usually consists of endoscopic retrieval while the objects reside within the esophagus or stomach. Although most foreign bodies that pass through the pylorus will be excreted without incident, some may become impacted distally, resulting in obstruction or perforation. Appendiceal foreign bodies have been reported rarely, yet have resulted in the development of acute appendicitis. We report the case of a young male who swallowed a nail that became impacted in the appendiceal lumen and was retrieved colonoscopically before the development of acute appendicitis.

Adult↗
PubMed1996

Pediatric tracheobronchial foreign bodies: historical review from the Johns Hopkins Hospital.

We investigated changing trends in pediatric tracheobronchial foreign body removal and resident experience from 1939 to 1991. We retrieved the records of 234 cases of tracheobronchial foreign body removal at Johns Hopkins. The mean number of cases per year was 5.9. The most common foreign bodies removed were peanuts, accounting for 38.9%. The average yearly incidence of pediatric tracheobronchial foreign bodies remained relatively constant during the period studied. Our data suggested little change in outcome or complications with the advent of optical telescopes in the mid-1970s, despite their great value in improved visualization. Resident experience and training were evaluated by the number of cases attended by each resident during his or her training. The number varied from 1 to 8 cases, not including experience acquired at our sister institutions. Although complete data could not be obtained in many of the older medical records, our review suggests that despite the advantage offered by the optical forceps technology, proper training and experience in traditional rigid endoscopic techniques is still crucial to optimize outcome and minimize the risk of complications in pediatric tracheobronchial foreign body removal. Chevalier Jackson's recommendation that residency training include an animal laboratory course in foreign body removal still applies.

Adolescent↗
PubMed1983

[Computer tomography in the search for iatrogenic foreign bodies].

CT enables the identification and localization of foreign bodies which cannot be visualised at all or only slightly so via conventional x-ray film, iatrogenic foreign bodies not recognisable by the usual methods were identified by us by means of CT in two cases direct and in one case indirect as a "soft part finding". Basing on these three cases the article discusses the validity of CT when searching for foreign bodies.

Abdominal Injuries↗
PubMedDate not supplied

Unusual palpebral foreign bodies.

We encountered cases of palpebral foreign bodies, which were a bamboo chip that entered in a trauma, a gelatinoid material that formed an iatrogenic ulcer, and self-injected lipstick. Treatments and complications of these unusual palpebral foreign bodies are evaluated.

Adult↗
PubMed2000

[Problems in diagnosis of intraocular foreign bodies in the posterior eye segment].

BACKGROUND: To evaluate the application of the available diagnostic procedures in intraocular foreign bodies impacted in the posterior segment of the eye. MATERIALS AND METHODS: Between 1989-1993 were treated 51 patients and between 1994-1998 were treated 74 patients with intraocular foreign bodies in the posterior eye segment at the Department of Ophthalmology, Medical faculty of the Comenius University in Bratislava. It was evaluated: time of the first medical examination, cause of the injury, time of the right diagnostic and used ancillary testings. In the second period (prospective study) was evaluated also foreign body trajectory in the posterior segment of the eye. The influence on the final visual acuity was evaluated in no proper diagnosed patients. RESULTS: 50.9% of patients in the first period and 55.9% of patients in the second period were injured while at work. Foreign body was metallic in 96% and 94.7% respectively. In the first period 12 patients were injured by various explosions and in the second period 16 patients were injured by working with some circulating tools. The most common ancillary testing was plain film testing and Comberg localisation. In the second period was intraocular foreign body trajectory defined as indirect in 24 eyes (32%). The foreign body achieved its final intraocular position after simple or double contact with the retina. Foreign body was unproperly diagnosed in 14 patients. The final visual acuity was negative influenced by this fact in 8 patients. CONCLUSIONS: A history and ocular examinationare are still most important in diagnosis of the penetrating eye injury with intraocular foreign body. The basic ancilary testing is simple plain film. Ultrasonography is helpful in diagnosis of other intraocular pathological changes. In justified cases is also possible to perform computed tomography. The peroperative intraocular diagnostics is very important for treatment of the all injured intraocular structures.

Adult↗
PubMedDate not supplied

Management of foreign bodies of the upper gastrointestinal tract.

The use of flexible endoscopes had made removal of foreign bodies in the upper gastrointestinal tract easier and safer. We describe our experience of 49 cases of foreign bodies of the upper gastrointestinal tract. Majority (67%) of the patients were children and only 4 patients (8%) were above 45 years of age. The most common foreign bodies encountered were coins (25), fruit stones (4) and dentures (3). In 29 patients foreign bodies were lodged in the oesophagus and in 15 cases in the stomach. Forty one patients were considered for endoscopic removal of the foreign bodies and 40 could be managed successfully. There were no procedure related complications. We conclude that endoscopic removal of the foreign bodies of the upper gastrointestinal tract is a safe and effective technique.

Adolescent↗
PubMed1991

An unusual oronasal foreign body.

An unusual case of oronasal foreign body in a child is reported. A plain lateral X-ray of the head was carried out to show the shape and position of the foreign body; it was also useful in planning removal. Ribbon gauze impregnated with vaseline was packed around the sharp end of the metal in the nostril to protect the nasal mucosa from further trauma while removing it. We recommend this technique.

Child, Preschool↗
PubMed1996

Foreign bodies in the airway: eighteen-year retrospective study.

Sixty-four cases (male:female = 43:21) with foreign bodies in the trachea and bronchi are reviewed. They had been hospitalized in Nagoya City University Hospital between January 1976 and December 1993. Fifty-four patients (84.2%) were 2 years of age or younger. Peanuts predominated (40 cases; 62.5%) among the foreign bodies. Foreign bodies were found in the right bronchus in 26 patients (40.7%), in the left bronchus in 23, in the trachea in 8, and in multiple regions in 7.

Adult↗
PubMed1978

Spontaneous extrusion of intraocular foreign body after 11 years.

A case of spontaneous extrusion of intraocular foreign body after 11 years is presented. Despite being magnetic and containing mostly iron the foreign body could not be removed in repeated magnet trials. It was retained in the ciliary body region for a very long time without causing siderosis. The foreign body was spontaneously extruded without any signs of intraocular inflammation.

Adolescent↗
PubMed1994

[Foreign bodies in the airways and esophagus in children].

The hospital records of 99 children with foreign bodies in the airways (n = 51) or oesophagus (n = 48) were reviewed with respect to occurrence, course of disease and mortality. Childhood death records in Denmark over a ten year period due to asphyxiation by food were surveyed. A third of the patients with oesophageal foreign bodies had respiratory symptoms. Most children with airway foreign bodies were aged 1 to 3 years and generally had a positive history of choking. The dominating symptoms were cough, wheezing and cyanosis. Chest X-ray was normal in 25%. There were no complications during bronchoscopy. The most common foreign bodies extracted were nuts (29%). The estimated death rate due to airway foreign bodies is 0.9 per 100,000 children in Denmark per year. Rigid oesophagoscopy and bronchoscopy should be performed promptly on suspicion of foreign bodies located in the oesophagus or airways to ensure fast recovery. Nuts, tablets and other small items should not be within reach of small children.

Adolescent↗
PubMed2006

Surgical treatment of posttraumatic foreign bodies in the heart or great vessels.

Posttraumatic foreign bodies in the heart or great vessels is rare, which may cause cardiac tamponade, bleeding, shock, infection, embolism, arrhythmia, valve dysfunction, etc. The foreign bodies can be removed by surgery or percutaneous intervention. In this report we reviewed our experience in managing posttraumatic foreign bodies in 13 patients at our institution from 1992 to 2002.

Adolescent↗
PubMed1989

Flexible bronchoscopy for foreign body in airway.

The flexible bronchoscopy has not yet been popular in the foreign body in the airway, especially in children. We performed the flexible bronchoscopy for 27 patients with foreign bodies in the airway including 22 patients who had not been removed foreign bodies by the rigid bronchoscopy. Nineteen of 27 patients were children. The success rate of flexible bronchoscopy was 81% (22/27 cases) in all patients, 77% (17/22 cases) in patients failed by the figid bronchoscopy, and 82% (9/11 cases) in young children of 2 years old or less. For the removal of foreign bodies under the flexible bronchoscope, a biopsy forceps and a Fogarty balloon catheter were effective. The flexible bronchoscope is useful for foreign bodies in the airway, even in young children.

Adolescent↗
PubMed1998

Treatment of aural foreign bodies in children.

OBJECTIVE: To determine the proper treatment of children and adolescents with foreign bodies of the external auditory canal (EAC). DESIGN: Retrospective case series. SETTING: Specialty care referral hospital. PATIENTS: All patients younger than 18 years of age who presented in the emergency ward or office setting with a foreign body of the EAC during a 5-year period. RESULTS: One hundred ninety-one patients with aural foreign bodies were identified. Age at presentation ranged from 10 months to 17 years with 141 patients (74%) younger than 8 years old. Twenty-seven different objects were encountered with pebbles, beads, insects, and plastic toys the most common. Fifty-seven (30%) of the patients required surgical removal of the aural foreign body under general anesthesia. CONCLUSION: Adequate immobilization and proper instrumentation allow the uncomplicated removal of many EAC foreign bodies in the pediatric population. The use of general anesthesia is preferred in very young children and in children of any age with aural foreign bodies whose contour, composition, or location predispose to traumatic removal in the ambulatory setting. Criteria for otolaryngologic referral and consideration of operative microscopic removal are outlined.

Adolescent↗
PubMed1997

Esophageal 'stars': a sinister foreign body ingestion.

This paper describes an "epidemic" of foreign body ingestion in six consecutive prisoners from the same jail. The resulting esophageal perforations won all patients "temporary vacations" from prison. The nature of the ingested foreign body (hypodermic needles fashioned into a "star") guaranteed perforation of the esophagus. All six patients had emergency esophagotomy for foreign body removal. In the only case of significant morbidity, suture line disruption with mediastinitis and empyema led to esophagectomy, cervical esophagostomy, and tube gastrostomy. This patient survived and subsequently had uncomplicated esophagocoloplasty. Foreign objects of this type have not been described in the literature. Because of their specific design, they necessitate immediate and aggressive surgical management.

Adult↗
PubMed2006

[The diagnosis and treatment of special airway foreign body].

OBJECTIVE: The aim of this study was to discuss the diagnosis and treatment of special airway foreign body. METHOD: Clinical data of 69 patients with airway foreign body were analyzed,of which 45 patients underwent rigid bronchoscopy while another 24 patients underwent tracheotomy. RESULT: The operations succeeded in 43 of the 45 patients who underwent rigid bronchoscopy, while the other 2 patients died of respiratory failure because of the foreign body slipping off at the level of the glottis. All of the 24 other patients were cured, in which continuous saturation of blood oxygen below 90% occurred in 8 patients and turned normal after positive airway pressure in intensive care unit (ICU). The total cure rate reached 97.1%. CONCLUSION: Most of special foreign body in the airway can be taken out through tracheotomy under general anesthesia. If the foreign body is too big and irregularly, or the patients is too young or have the pulmonary atelectasis, it is much safer to remove foreign body by tracheotomy.

Adolescent↗
PubMed1988

Unusual gastric foreign body: a case report.

Ingestion of foreign bodies, either intentionally or accidentally, is quite common. The authors report an unusual case in which a 32-year-old man deliberately assembled a large metallic aggregate in his stomach by swallowing magnets and coins in order to relieve epigastric discomfort. The collection was retrieved by laparotomy and gastrotomy; a gastric ulcer was also found and it was oversewn. Management of this patient is discussed and the principles of treatment for ingested foreign bodies are reviewed.

Adult↗