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At least 721 records · Page 40Linked to original sources
PubMed2004

Removal of a foreign body from the upper gastrointestinal tract with a flexible endoscope: a prospective study.

BACKGROUND AND STUDY AIMS: There have so far been no prospective studies on the value of flexible endoscopy for removing foreign bodies in the upper gastrointestinal tract. This study presents a clinical analysis of accidents with foreign bodies and prospectively evaluates the effectiveness of flexible endoscopy for removing them. PATIENTS AND METHODS: A total of 105 cases of foreign-body ingestion in the upper gastrointestinal tract were evaluated, 29 (27.6 %) in children and 76 (72.4 %) in adults. Thirty patients (28.5 %) had esophageal strictures. RESULTS: Thirty-nine of the foreign bodies (37.1 %) consisted of food and 66 (62.9 %) were not food-related. The success rate of foreign-body extraction using only a conventional flexible endoscope and accessories for treatment was 98.0 %, and with only a polypectomy snare and rat-toothed forceps it was 91.2 %. Complications at the moment of foreign-body removal occurred in nine patients (8.6 %); there was only one (1 %) esophageal perforation. The incidence of complications related to the duration of foreign-body impaction was six (10.5 %) with foreign bodies impacted for up to 24 h, 13 (52.0 %) for those impacted for 24-48 h, and three (60.0 %) for those impacted for 48-72 h ( P < 0.05). CONCLUSIONS: The flexible endoscope is an effective and safe device for removing foreign bodies from the upper gastrointestinal tract, with a high success rate using only the polypectomy snare and the rat-toothed forceps as accessories. If foreign-body impaction lasts for more than 24 h, there is a significant increase in the incidence of complications.

Adult↗
PubMed1995

Intravaginal foreign body retained for a long duration.

An intravaginal foreign body of long duration can pose a diagnostic dilemma, since a number of diagnostic modalities may fail to detect its existence. We present the case of an 8-year-old girl who suffered from a bloody, malodorous vaginal discharge for over 4 years, during which time she had been evaluated by several gynecologists. A vaginal examination performed under analgesia revealed a pinpoint-sized opening 2 cm above the hymen. We inserted a cannula and injected radio-opaque contrast medium. An intravaginal filling defect was visible, which strongly suggested the presence of a foreign body. An incision through this scarred area was performed and two foreign bodies, one shaped like a plastic tube and the other a cap, were removed. We conclude that vaginography may provide an alternative diagnostic tool for this condition.

Child↗
PubMed2004

Three cases of intraocular foreign bodies as a result of walking or running along roadways.

PURPOSE: To report three cases of intraocular foreign bodies resulting from walking or running along roadways. DESIGN: Case reports. METHODS: Three separate incidents of walking or running along roadways with "traumatic events" resulting in intraocular foreign bodies. RESULTS: Each patient had pars plana vitrectomy with removal of intraocular foreign bodies. Chemical analysis was performed to give information on the potential origins of each foreign body. CONCLUSION: We hypothesize these intraocular foreign bodies were projected from the road surface with sufficient energy to penetrate the globe. Intraocular foreign bodies may result from simply walking or running along roadways.

Adult↗
PubMed1982

Tumorigenicity of sarcoma cells is enhanced by the local environment of implanted foreign body.

The local effect of an implanted foreign body (polyvinyl chloride film) on the growth of transplanted syngeneic sarcoma cells was studied. Two cell lines derived from CBA mouse sarcomas induced by subcutaneously implanted polymer films were used. Small numbers of tumour cells were subcutaneously transplanted to CBA mice in several ways (1) as a suspension into normal tissue (control group); (2) as a suspension into the capsules around previously implanted polymer films; (3) attached to the surface of polymer films, and implanted with these films. The incidence of tumours was significantly increased and the time of their appearance was decreased in groups (2) and (3) as compared with the control group (1). Removal of the film from the capsule 24 h after the transplantation of sarcoma cells did not abolish the stimulation of tumor growth. It is concluded that the local environment of the implanted foreign body promotes the growth of sarcoma cells; similar promoting effects may play some role in the course of foreign body tumorigenesis.

Animals↗
PubMed1992

Tracheobronchial foreign bodies. Experience at Red Cross Children's Hospital, 1985-1990.

Ninety-six children with suspected tracheobronchial foreign bodies were referred to the Department of Cardiothoracic Surgery at Red Cross War Memorial Children's Hospital, Cape Town, between February 1985 and February 1990. Foreign bodies were removed by rigid bronchoscopy from 63 patients, 79% of whom were under 5 years of age. The majority of patients (59%) presented more than 24 hours after aspiration of the foreign body, and this delay in definitive management was associated with an increased incidence of complications (P = 0.01). Complications occurred in 28 patients, and there was one fatality at bronchoscopy due to overwhelming aspiration of an unanticipated release of pus, following the removal of a chronically impacted foreign body. The complete classic diagnostic triad (sudden onset of coughing, wheezing and decreased air entry) was seldom present, and we recommend diagnostic bronchoscopy in children presenting with either a history of sudden choking or a witnessed aspiration of a foreign body, an unexplained acute wheeze or cough or a chronic pulmonary infection. This report also highlights the continued need for increased awareness on the part of both parents and medical practitioners of the need for early referral if a foreign body is suspected. Furthermore, public education is needed as regards the dangers of allowing young children to eat peanuts. Peanuts were the commonest foreign bodies removed.

Bronchi↗
PubMed1983

Foreign body in the airways of children.

During the years 1969-1981 57 children with inhaled foreign bodies in the tracheobronchial tree were treated at Turku University Hospital. Of the patients 91% had a history of foreign body inhalation and 25% had a radiopaque foreign body which was seen in the X-ray of the chest. In 9% of 57 patients a foreign body was found unexpectedly at bronchoscopy. The foreign body was removed by bronchoscopy from all the patients but one, who required a segmentectomy due to a fragment of a spike in the lung parenchyma. The patients presented no major complications, and they were all discharged from the hospital in good condition.

Adolescent↗
PubMed2003

Aspirated foreign bodies in children: why are they more commonly found on the left?

The objective was to present our experience in the brochoscopic removal of foreign bodies in children. This was carried out through a retrospective analysis of the medical records of 96 patients in whom endoscopic removal of an inhaled foreign body was required, at the department of paediatric otorhinolaryngology, Eramus Medical Centre, Rotterdam. The participants were all children who underwent bronchoscopy after suspected foreign body aspiration from 1990 to 2000. The main outcome measures were confirmed diagnosis of foreign body aspiration and localization of aspirated foreign body. It was seen that in children up to 3 years of age, there was no significant difference in foreign body distribution and in children aged 3 and older foreign bodies were more commonly found in the right main bronchus. It was concluded that aspirated foreign bodies are equally distributed between the left and right main bronchus in children younger than 3 years. This could be explained by the handling of choking infants by their parents.

Bronchi↗
PubMed1994

[Use of fiberoptic bronchoscopy for removal of foreign bodies from the lower respiratory tract].

One of the initial indications for therapeutic bronchoscopy was removal of an aspirated foreign body. The aim of this study was to evaluate the role of bronchofiberoscopy in removal of aspirated foreign bodies. Thirty patients were included in the study (age range 4-81 years). Endoscopy was performed under local anesthesia in two sessions. During the first a complete evaluation of the tracheobronchial tree was carried out, while during the second the actual removal was performed. In the majority of the patients (23) the foreign body was aspirated into the right lung. In the majority of the patients (13) various fragments of bones were recovered. Only in one patient a major complication was observed (hemorrhage) which compelled to change from bronchofiberoscopy to rigid endoscopy. All complaints from patients subsided during 2-4 days after removal of the foreign body. Foreign bodies were removed using a bronchofiberoscope in 21 out of the 28 patients. In two patients a calcified lymph node could not be removed during bronchoscopy and the patients were referred to the Surgical Department for thoracotomy.

Adolescent↗
PubMed2005

An unusual foreign body in the floor of the mouth presenting as a gradually growing mass.

Foreign bodies in the upper aerodigestive tract represent one of the most common ENT emergencies, but patients with foreign bodies in the floor of the mouth rarely present to the otolaryngologist. Only a very small number of these foreign bodies are embedded under normal mucosa and can result in lethal complications. In this article, we report the case of a 3-year-old girl with a gradually enlarging mass in the floor of the mouth. On physical examination at admission, there was a 2x3-cm, elastic, tender mass on the left side of the floor of the mouth, with the overlying mucosa intact and normal in color. Taking the palpable lymph nodes into consideration, a congenital lesion or a pediatric malignancy was suspected initially. A blue pen cap with a surrounding pneumatocele was found intraoperatively. After a careful reevaluation of a previous MRI, a check valve mechanism at the possible site of entry was detected, leading to a pneumatocele, thus explaining the constant growth of the mass. This is a unique case of a foreign body in the floor of the mouth, mimicking a congenital lesion or a pediatric malignancy. Thus, the possibility of a foreign body should not be underestimated when evaluating a child with swelling in the floor of the mouth.

Child, Preschool↗
PubMed1977

[Therapy of chronic bronchial foreign bodies in children (author's transl)].

During infancy bronchoscopic removal of a foreign body firmly embedded in the granulation tissue sometimes causes considerable difficulties so that surgical procedures (bronchotomy) must be envisaged. On the basis of 4 observations, the distinct influence of daily prednisolone inhalations (25 mg of prednisolone) and antibiotic therapy on the retrogression of endobronchial granulation tissue has been proved: resulting in a spontaneous expectoration of the foreign bodies or in enabling the bronchoscopic removal of the foreign bodies. If chronic foreign bodies cannot be removed immediately and especially before undertaking surgical measures, treatment by prednisolone inhalation should be tried.

Aerosols↗
PubMed1980

[Removal of foreign bodies from the upper airways and the bronchial tree of small children].

Food remnants are the foreign bodies most frequently aspirated by young children. Larger foreign objects are nearly always rejected spontaneously. In many cases, however, aspiration of foreign bodies lead to death by suffocation. From March 1975 to August 1979, 27 endoscopies removing 22 foreign bodies have been carried out by us. All children were less than 7 years old. The foreign bodies most commonly found were peanuts. Endoscopy was not only carried out when diagnosis was clear, but also if there was suspicion of foreign body aspiration. It is nowadays a treatment without risk when the following conditions are met: 1. Careful medical preparation leading to bronchial dilatation. 2. Effective collaboration with a paediatric anaesthetist. 3. Exact knowledge of the bronchial tree of children.

Bronchi↗
PubMedDate not supplied

Foreign bodies in the aerodigestive tract--a clinical study of cases in the coastal belt of South India.

PURPOSE: To investigate the cases of foreign body in the aerodigestive tract and to elucidate the characteristic problems in India. DESIGN AND SETTING: Three hundred patients presenting with a history of either aspirating or swallowing a foreign body were analyzed in a tertiary care center. Data were collected by retrospective chart review and statistically analyzed. RESULTS: Of the 300 patients studied, 90% (270 cases) did have a retained foreign body, with 233 (86.2%) cases found in the pharyngoesophagus and 37 (13.7%) cases in the tracheobronchial tree. With foreign bodies in the tracheobronchial passages, the most common sign and symptom were rhonchi (50%) and dyspnea (67%), respectively; in pharyngoesophagus, the most common symptom and sign were dysphagia (64%) and odynophagia (45%), respectively. The most common foreign body found was fish bone in 39% (106 cases) and the most common site of lodgment was the cervical esophagus 50.5% (136 cases). Rigid endoscopy with forceps removal under general anesthesia was the main treatment modality. Thirty-three (12.2%) cases had complications secondary to retained foreign body. CONCLUSION: Foreign bodies in the aerodigestive tract continue to be a common problem affecting adults and children alike. Rigid endoscopies with forceps removal under general anesthesia are the preferred management modality. From their experience, the authors recommend that no foreign body in the upper aerodigestive tract should be left alone with the hope that it will come out spontaneously. Delay in diagnosis and management can lead to life-threatening complications.

Adult↗
PubMedDate not supplied

Complications of tracheobronchial foreign body aspiration in children: report of 5 cases and review of the literature.

Foreign body aspiration (FBA) is one of leading causes of death in children, especially among those younger than 3 years of age. The inhalation of a foreign body may cause a wide variety of symptoms, and early diagnosis is highly associated with the successful removal of the inhaled foreign material. Despite the great advances in endoscopic procedures and anesthesia, a large number of difficulties and complications still result from foreign body aspiration. We describe 5 cases of serious acute complications following aspiration of foreign bodies that became lodged in the tracheobronchial tree, including pneumomediastinum, pneumothorax, total atelectasis, foreign body dislodgment, and need for thoracotomy in children admitted into our intensive care unit in 1999 and 2000; these were all situations that could have been prevented with early recognition and prompt therapeutic intervention.

Bronchi↗
PubMed1987

CT detection and location of intraorbital foreign bodies. Experiments with wood and glass.

The series comprises 27 patients examined by CT to detect, locate or exclude a foreign body. 22 of them actually had an orbital foreign body. In three cases CT was the primary method and showed the foreign body correctly, while in 18 it was first detected in plain films and CT was performed to locate it. 20 metallic foreign bodies were hyperdense in appearance. Two cases had wooden foreign bodies, one with a density of +10 HU and the other hypodense with a value of about -434 to -446 HU. The latter piece of wood was first interpreted falsely as a bubble of gas. The results proved that the detection of metal is easy, but differentiation between wood and gas is problematical. Experiments conducted to determine the CT densities of different pieces of wood gave results varying from -618 HU to +23 HU. The highest densities obtained for glass varied from +522 HU to +2000 HU. The density of a plastic lens was -105 HU.

Adolescent↗
PubMed1987

A 6 1/2-years survey of intraocular and intraorbital foreign bodies in the North-west Frontier Province, Pakistan.

A survey of 198 patients (210 eyes) with intraocular or intraorbital foreign bodies is presented. Most were males between 16 and 30 years of age, and 6.1% of cases were bilateral. The commonest cause was a flying particle while using a hand hammer, followed by fragments of bomb and mine blasts. Intraorbital foreign bodies occurred in 78 eyes and intraocular foreign bodies in 132 eyes. Irreparable damage caused 13 eyes (6.2%) to be enucleated. Ten eyes developed severe endophthalmitis or panophthalmitis requiring evisceration. One hundred and thirty-four (63.8%) foreign bodies were removed, and 76 (36.2%) foreign bodies could not be removed. The causes of non-removal, the various complications, and the pattern of foreign bodies in the eye or orbit in Pakistan are discussed and compared with those of other regions.

Adolescent↗
PubMed1975

Histochemical localization of intraocular copper foreign bodies.

Alizarin blue, rhodanine, and rubeanic acid stains cytochemically localized copper in rabbit eyes harboring intravitreal copper foreign bodies of varying copper composition. Local deposition presented in small amounts in areas adjacent to the foreign body (fibrous capsule, adjacent retina, and surrounding macrophages). The localized pattern was more frequent with the 60% copper alloy, when the foreign body was encapsulated or shiny, and when the aqueous copper concentration was normal. The generalized pattern of copper deposition revealed moderate to marked amounts of copper within the following multiple intraocular structures: (1) the posterior cortex of the lens, (2) the vitreous cavity, either in free-floating macrophages or in macrophages on the surface of the retina, (3) the retina, either within monocytic macrophages, Müller cells, or extracellularly in granular clumps, and (4) the fibrous capsule around the foreign body. Copper in several eyes was observed within macrophages that were clustered around the central retinal vessels within the optic nerve. The generalized pattern was frequent with the pure copper foreign body, when the copper foreign body was tarnished, and when copper concentration of the aqueous humor was elevated. There was a direct toxic effect of copper on the lens in the form of local opacification in the posterior cortex but no clinical or histochemical evidence of a Kayser-Fleisher ring or a sunflower cataract.

Alloys↗
PubMed1999

[Surgical policy in gastrointestinal tract foreign bodies].

66 patients (45 males and 21 females) who have swallowed 157 foreign bodies (fragments of wire, nails, needles, hafts of spoons, et were treated). If the objects were located in the stomach and the duodenum in the absence of complications endoscopic method of treatment was preferable, with the help of which 31 objects were successfully removed and the terms of treatment were significantly decreased. Conservative treatment (diet rich in fiber and protective substances, barium sulfate administration) resulted in elimination of 58 objects by vias naturals, 53 from which were not more that 8 cm long. Evacuation of the foreign bodies was carried out only during the first 3 weeks after the swallowing. Operative treatment was carried out in 21 patients, in whom 68 foreign bodies were extracted. An urgent operation in the first 6 hours in complications due to foreign bodies (perforation, incarceration, gastrointestinal bleeding) was carried out in 13 patients. An urgent operation in terms from 6 to 24 hours of hospitalization was carried out in 6 patients with large (more that 8 cm) swallowed objects, conglomerates and bunches of foreign bodies. Early removal of these objects prevented development of complications. Elective operation was carried out in failure of conservative treatment as was in 2 patients. No lethality was registered.

Adolescent↗
PubMed2004

Retrieval of intravascular foreign bodies with goose neck snare.

PURPOSE: to evaluate the efficacy and advantages of the snare systems in the retrieval of foreign bodies from vascular system. MATERIALS AND METHODS: the snare technique has been used for intravascular foreign body retrieval. We performed percutaneous extraction of intravascular foreign bodies using combination multipurpose catheters and a nitinol snare loop. In this report, we evaluated the patients who had performed endovascular device reposition or foreign body retrieval from 1998 to 2001. RESULTS: foreign body retrieval was performed in 15 patients. The foreign bodies consisted of seven fractured port catheters, one sheath fragment, one embolization coil, four wire fragments, one pace-maker transducer and one dislocated endovascular stent. In no case were surgical procedures required, and no complications were encountered. CONCLUSION: the snare technique is a useful and a safe method as an alternative procedure to surgery. This technique is highly effective with low rate complications.

Adolescent↗