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PubMed1990

Clinical and pathologic studies of twenty-six patients with penetrating foreign body injury to the joints, bursae, and tendon sheaths.

Foreign body synovitis has been neglected in the rheumatology literature. We describe 26 patients in whom arthritis, bursitis, or tenosynovitis appeared within 1 day to 7 years after an initial injury by a penetrating foreign body. Twenty-two patients presented with acute synovitis, which was followed by chronic or recurrent inflammation mimicking septic arthritis, osteomyelitis, monarticular juvenile rheumatoid arthritis, bone tumor, or apatite deposition disease. Foreign bodies were not seen in 5 inflammatory synovial fluids studied, but were seen in the synovium or periarticular tissues of 17 patients. Excisional biopsy was required in most patients for precise diagnosis and treatment.

Adolescent↗
PubMed2005

[Phototherapeutic keratectomy of diffuse corneal foreign bodies caused by gunpowder explosion].

PURPOSE: To investigate the clinical effects of phototherapeutic keratectomy (PTK) on the treatment of diffuse corneal foreign bodies caused by gunpowder explosion. METHODS: From Dec, 1999 to Dec, 2003, 39 eyes of 25 patients with diffuse foreign bodies on cornea caused by gunpowder explosion were investigated in this study. All foreign bodies located in one third of superficial cornea and conjunctiva. Besides slit-lamp biomicroscope examination and cornea thickness measurement, ultra-sound B, VEP and ERG were used to exclude the possibility of damage of posterior ocular segments. Then the PTK was performed at every 100-150 pulse-interval. In case of damaging to deep cornea, the total pulse was less than 500 and corneal thickness was measured during the operation. After operation, vision acuity, recovery of corneal epithelium, haze, intraocular pressure and ametropia were checked and the patients were followed up for 6 months. RESULTS: Compared with traditional therapies used for diffused corneal foreign bodies, PTK generally took shorter time (10 minutes). It could erase most foreign bodies on cornea and had little injury to normal corneal tissue. Commonly, the corneal epithelial layer recovered completely within one week. The vision acuity after PKT was improved notablely. The mean value of vision acuity at 10th day of post-operation is 0.6 (vs < 0.3 in all patients before operation). There were 38 eyes with gentle hyperopia and 1 eye with moderate hyperopia. The complication of PTK can be controlled during operation or after operation by drugs. CONCLUSION: PTK is a facile, effective, hypo-cost method for the treatment of diffused foreign bodies on cornea damaged by gunpowder explosion.

Adult↗
PubMed1984

Foreign body pulmonary embolism originating from a gunshot wound to the head.

Foreign body pulmonary emboli from a cranial venous sinus are unusual. Two patients are presented with gunshot wounds to the head who subsequently developed foreign body pulmonary emboli. Neither had any pulmonary complaints at presentation or during followup. Radiologists and primary care physicians should be aware of the possibility of distal missile pulmonary emboli when a foreign body enters the peripheral venous system or an intracranial venous sinus.

Adult↗
PubMed1981

Identification of a foreign body using energy dispersive x-ray analysis.

A foreign object, presumably swallowed during a dental appointment, was recovered by using an esophagoscope and thought to be a piece of dental impression material, probably alginate. It was identified as being of nondental origin by means of visible light and scanning electron microscopy (SEM), the latter coupled to an energy dispersive X-ray analyzer. Histologic examination revealed some amorphous crystalline material surrounded by parakeratin and exfoliated squamous cells. The material was essentially radiolucent. A known dental alginate impression material contained diatomaceous earth filler (siliceous shells of diatoms), but no microscopic symmetrical figures were seen in the foreign body. After dehydration, both materials were carbon-coated and observed in an SEM at 20 kV at magnifications up to 2000 X. The spectrum of secondary X-rays produced by the scanning electron beam revealed only magnesium in the foreign body and mostly silicon in the dental alginate. There are no known dental products that contain magnesium as the only inorganic ingredient and so the foreign body is believed to be not of dental origin. The patient may have had an antacid or laxative having magnesium as a major ingredient in the stomach, and this may have been refluxed from the stomach after stimulation of the normal gag reflex during the dental procedure.

Dental Materials↗
PubMedDate not supplied

Foreign bodies from the upper-aerodigestive tract of children in Puerto Rico.

The objective of this study was to investigate the incidence management, and complications of foreign bodies in the upper aerodigestive tract of children in Puerto Rico. The records of children admitted to the University Pediatric Hospital of Puerto Rico were revised from January 1, 1989 to December 31, 1994. 51 children had foreign body in their airway and 107 children had foreign body in their digestive trac (a total of 158 patients) These records were examined for age, gender, previous medical illness, clinical presentation, radiographic studies, removal technique, complications, and hospital stay. The most common age in both groups was 1 year old children. Of the 51 foreign bodies aspirations, 25 were boys and 26 were girls; and of the 107 ingestion, 67 were boys and 40 were girls. The most common times of the year were during the summer and winter months. The diagnosis of foreign body aspiration or ingestion was made in 6 hours or less in only 68 of the 158 cases. The most common signs were vomiting, coughing, and choking episode (44 cases). X-rays were positive in 146 cases (92.4%). The most common foreign body ingestion was coins and aspiration was peanuts. There were no complications on 129 cases (81.6%). The most common complication was pneumonia with 19 cases. The mean hospital stay was 3 days. In general, foreign body aspiration or ingestion are common events that can be prevented in the pediatric age. Parental education is important at this stage. If the event can't be prevented then a rapid management must be given to those patients with positive history of an adult witness of the event and a high level of suspicion for those patients with no reported event of choking or witness present.

Adolescent↗
PubMed2004

Low-dose MDCT and virtual bronchoscopy in pediatric patients with foreign body aspiration.

OBJECTIVE: The purpose of this study was to investigate the potential use of low-tube-current MDCT virtual bronchoscopy for the evaluation of children with suspected foreign body aspiration. SUBJECTS AND METHODS: Low-tube-current MDCT was performed in 23 patients (10 girls, 13 boys) with a mean age of 3.3 years (9 months-13 years) with suspicion of foreign body aspiration. Chest radiographs were obtained before CT was performed. MDCT was performed using 25- to 50-mA tube currents. MDCT virtual bronchoscopy images were obtained. Neither sedation nor IV contrast medium was used during CT scanning. All patients underwent endoscopic evaluation within 24 hr after MDCT was performed. MDCT virtual bronchoscopy findings were retrospectively compared with the results of rigid bronchoscopy. RESULTS: The mean tube current was 35 mA (range, 25-50 mA). Imaging quality was excellent in nine studies (39%), good in 12 studies (52%), and poor in two studies (9%). Motion artifacts were present on several slices in five examinations. In 15 patients, all foreign bodies detected by conventional bronchoscopy were also revealed on MDCT virtual bronchoscopy. The foreign body was in the right main bronchus in six patients, in the bronchus intermedius in one patient, and in the left main bronchus in eight patients. No discordance was found between the two techniques. MDCT revealed hyperaeration of the ipsilateral lung in five patients, atelectasis in five patients, infiltration in three patients, and infiltration and bronchiectasis in two patients; it showed infiltration in four patients and atelectasis in one of eight patients without a foreign body detected. There were no abnormal findings in three patients. CONCLUSION: Evaluation of foreign body aspiration of the airway in children can be accomplished by using a low-tube-current MDCT protocol. It may be useful both in showing the exact location of a foreign body before bronchoscopy and in ruling out a foreign body in patients with a low level of suspicion and normal or nonspecific findings on chest radiography.

Artifacts↗
PubMedDate not supplied

Comparison of extraction devices for the removal of supraglottic foreign bodies.

OBJECTIVE: By using a porcine model, the efficacy of various extraction devices for airway foreign body removal was examined. METHODS: The upper airways of euthanized swine were occluded with a rubber ball, glass marble, or grape. A Magill forceps, a spongestick forceps, and a nasal trumpet attached to suction were used by test subjects for foreign body removal. Extraction success and time were recorded for each removal attempt. Satisfaction scores were recorded for each foreign body and device combination. RESULTS: Seven paramedics, seven residents, and seven attending physicians participated. A total of 189 attempts were analyzed. Success rates for foreign body extraction with Magill and spongestick forceps were similar, with both devices superior to nasal trumpet (98% and 97% vs. 83%, respectively, p < 0.001). For successful ball removal attempts, the mean extraction time with spongestick forceps was less than those for both Magill forceps and nasal trumpet: 12.4 (95% confidence interval [CI], 10-14.7) versus 23.4 (95% CI, 16.3-30.3) and 21.2 (95% CI, 14.2-28.3) seconds, respectively. For marble removal, the mean extraction time with spongestick forceps also was less than Magill forceps and nasal trumpet: 10.8 (95% CI, 8.7-12.8) versus 18.4 (95% CI, 12.8 to 23.8) and 16.7 (95% CI, 12.6-20.8) seconds, respectively. For grape removal, the mean extraction times with both spongestick and Magill forceps were less than that of nasal trumpet: 11.8 (95% CI, 7.1 to 16.4) and 8.1 (95% CI, 6.8-9.4) versus 15.6 (95% CI 10-21.2) seconds, respectively. Subjects preferred the spongestick forceps for removal of the glass and rubber ball to the Magill forceps and nasal trumpet. CONCLUSION: In this porcine model, the SF appeared to be the most efficient and preferred device for extracting the type of airway foreign body that is associated with fatal asphyxiation.

Airway Obstruction↗
PubMed2006

Delayed trigeminocardiac reflex induced by an intraorbital foreign body. Case report.

OBJECTIVE: To emphasize the importance of the mechanism and surgical approach to trigeminocardiac reflex (TCR) developing 48 h after orbital trauma due to a foreign body. CASE REPORT: After gunshot injury of a 17-year-old male patient, computerized tomography evaluation revealed a right globe perforation and an intraorbital metallic foreign body in the right orbita adjacent to the lateral wall. The ocular perforation was repaired, but the foreign body was not removed. Constant bradycardia (45/min) developed 48 h after the operation. Since there were no cardiological findings, a temporary cardiac pacemaker was inserted and on the 6th postoperative day, the foreign body was removed through orbitolateral approach. After the removal of the foreign body, bradycardia completely recovered. CONCLUSION: In the presence of an intraorbital foreign body accompanied by globe perforation, TCR may develop 48 h after the trauma and insertion of a temporary pacemaker may be required to control the cardiac rhythm. In this paper, the delayed TCR complication presented an indication for the removal of the intraorbital foreign body.

Adolescent↗
PubMed1992

Metallic foreign bodies in the mouth or pharynx of horses: seven cases (1983-1989).

Seven horses with metallic foreign bodies in the mouth or pharynx were examined at the Colorado State University Veterinary Teaching Hospital from 1983 to 1989. The horses had variable clinical signs, such as purulent nasal discharge, swelling of the throatlatch area, and dyspnea. Most of the horses had clinical signs for more than 2 weeks, and had no or only temporary improvement with conservative medical treatment (antibiotics, nonsteroidal anti-inflammatory drugs). The definitive diagnostic test in all of the cases was radiography, which also aided in the plan for surgical removal of the foreign body. Once the foreign body was removed from each of the horses, their clinical signs resolved. Most of the foreign bodies were small pieces of wire, the sources of which could not be determined, but that may have been incorporated in baled hay.

Animals↗
PubMed1976

[Aftereffects of long-term stay of foreign bodies in the bronchi].

The author have observed 132 patients with foreign bodies in the bronchi. In 32 of them foreign bodies have been staying in the bronchi for 1 day and longer (up to 24 years). Pathological changes in the lung due to the presence of foreign bodies in the bronchi and the rational therapy are described.

Adult↗
PubMed1990

Management of foreign bodies in the upper gastrointestinal tract.

Records of 55 consecutive patients who had ingested foreign bodies were reviewed retrospectively. Foreign bodies were located in the esophagus, stomach and duodenum in 25, 27 and 3 patients respectively. Eleven of these passed through the entire gastrointestinal tract spontaneously and uneventfully. Endoscopic extraction was successful in 36 patients while 8 needed surgical removal of the ingested object. Only one death was encountered. We conclude that using simple guidelines, foreign body ingestion can be managed with a low incidence of complications and mortality.

Adolescent↗
PubMed1989

Endobronchial tuberculosis simulating foreign body aspiration.

A case of sudden onset of severe respiratory distress is reported. Appropriate clinical and roentgenologic findings suggested foreign body aspiration. The foreign body was removed by fiberoptic rigid bronchoscope. Bronchoscopic, histopathologic, and microbiologic findings revealed that the foreign body was a granulomatous mass originating from endobronchial tuberculosis.

Bronchi↗
PubMed1988

Multiple foreign bodies (fish bones) in the esophagus and rectum.

Multiple foreign bodies (fish bones) in the esophagus and rectum, seen in a 64-year-old man, are reported. This patient suffered from severe pain on swallowing after he had eaten fried fish. Five days later, he was referred to us, and underwent removal of a piece of fish bone under direct metal esophagoscopy. After surgery, fever and leukocytosis still continued, even though pain on swallowing disappeared. Periesophageal abscess was suspected; but no leakage or abnormal shadow was found by esophagography. Since the patient complained of severe anal pain five days after the endoscopic procedure, a romanoscopy was performed: a fish bone in the rectum and periproctal abscess were detected. Removal of the foreign body and incision of the periproctal abscess caused fever and leukocytosis to subside. A review of the literature revealed only a very few cases of multiple foreign bodies in the esophagus and lower digestive tract.

Endoscopy↗
PubMed2006

A glass foreign body in the knee joint mistaken for ACL avulsion: an unusual case.

Foreign body in the knee is associated with trauma to knee or deliberate self harm. We see them often in clinical practice. They come in all forms and shapes. Very rarely one can find a foreign body within a joint without obvious external scarring (e.g. needle). We have not come across anywhere in the literature of a large foreign body in the knee joint without a definitive history of injury where the external scar has healed so well to become inconspicuous. With this background it is even more difficult when the X-rays mimic anterior cruciate ligament (ACL) avulsion. This case report highlights the fact that diagnosis of a foreign body in the knee joint can sometimes be challenging and almost impossible when there is no history of any injury and when the X-ray mimics ACL avulsion.

Adult↗
PubMed2005

Factors predicting early diagnosis of foreign body aspiration in children.

OBJECTIVES: To analyze the clinical spectrum of tracheobronchial foreign bodies in children and explore the clinical features which could facilitate early diagnosis. METHODS: We retrospectively studied pediatric patients who had aspirated foreign bodies over the past 5 years from July 1998 to July 2003 in a tertiary children hospital in northern Taiwan. Patients were divided into 2 groups according to the elapsed time from aspiration to definite diagnosis as early (< or =24 hours after aspiration) and late diagnosis (>24 hours after aspiration). The 2 groups were compared for clinical features, radiological findings, and the influence of morbidity and mortality of early- and late-diagnosed foreign body aspiration (FBA). RESULTS: A total of 53 patients (27 boys, 26 girls) were recruited with a median age of 25.4 +/- 21.3 months. FBA was suspected by the parents in 59% of patients. Sudden onset of cough (72%), dyspnea (64%), and wheeze (60%) were the predominant symptoms and signs. Nuts and peanut (59%) were the most common foreign bodies aspirated. Obstructive emphysema (53%) and normal chest radiograph (34%) were the most frequent radiological findings. Parenchymal consolidation with pneumonia was predominant in the group of late diagnosis (P < 0.05). Bronchial asthma (n = 9), pneumonia (n = 8), and common cold (n = 5) were the most common mistaken diagnoses. Witnessing of choking episode was the most important historical event to pinpoint an early diagnosis of FBA in children (P = 0.002). CONCLUSIONS: In children with an unequivocal choking event while eating even with normal physical and radiographic findings, FBA requires to be excluded by thorough investigations in such instances. Similarly, in toddlers with unexplained persistent cough with refractory parenchymal infiltrates, unrecognized FBA should also be considered. A witnessed choking event is the most important historical information to make an early diagnosis of FBA.

Bronchi↗
PubMed1993

[A case of a right bronchial foreign body (rice cake)].

We had a case of a bronchial foreign body (rice cake). A 73-year-old male with severe dyspnea was taken by emergency car. His right breathing sound was very weak, but chest X-ray showed no changes. We diagnosed it as right bronchial foreign body and we could endoscopically remove the foreign body with basket-forcep successfully. We could save his life.

Aged↗
PubMed2005

Foreign body aspiration in children.

BACKGROUND: The aim was to investigate the role of physical and radiological findings before bronchoscopy in the diagnosis of foreign body aspiration (FBA). METHODS: We retrospectively reviewed the clinical records for 82 patients (mean age 26.4 +/- 21.4 months, range 9 months to 13.5 years; 49 males) with a history suggestive of foreign body aspiration. RESULTS: The presence of a foreign body in the airways was confirmed in 70 children (85.4%) (mean age 25 +/- 14.1 months, 45 boys). Of the 70 children, 63 patients (90%) were under 3 years of age, with a peak incidence during the second year. Of the 70 foreign bodies retrieved, 46 (60%) were vegetable and 35 (76%) of these were nuts. In 42% of the patients the foreign body was located in the right bronchial tree. The most frequent physical findings observed in our patients were persistent cough (75%), localized decreased breath sound (62.8%) and localized wheezing (30%). The clinical triad (concomitant cough, localized wheezing and decreased breath sound) was present in 11 patients (15.7%). All clinical findings had a high positive predictive value with poor sensitivity. In 11 patients (20%) chest X-rays were normal. Five foreign bodies (9.1%) were radiopaque. The most frequent radiological findings observed were localized air trapping (43.6%), followed by atelectasis (40%). The diagnostic sensitivity was 80% and the specificity 33% for the presence of a single positive radiological finding. CONCLUSIONS: Our study confirmed that clinical symptoms and radiological findings before bronchoscopy have a low diagnostic value in children with a history of FBA.

Adolescent↗
PubMed2005

[The cases of penetrating eye injuries with large intraocular foreign body].

AIM: Three consecutive cases of penetrating eye injuries complicated with large (size 9-12 mm) intraocular foreign body are presented as such. PATIENTS AND METHODS: The initial findings, management, surgical procedures and final anatomical and functional outcomes of each particular case are given. Corneal entrance laceration was seen in all three patients. Second scleral full-thickness eye wall laceration was found just posterior to the horizontal muscle insertions in two eyes. Full-thickness exit posterior eye wall laceration obturated with foreign body was diagnosed in one case. This metallic foreign body projected into posterior orbit. Two eyes were injured with metallic radio opaque foreign body. Glass fragment was removed from posterior segment of the eye in one patient. Following primary wound closure pars plana vitrectomy was performed to remove all posterior segment intraocular foreign bodies. RESULTS: Silicone oil was used to fill the vitreous cavity at the end of the surgery in two eyes. Gas bubble (perfluoropropane, C3F8) was injected into the vitreous space at the end of the vitrectomy in one eye. The authors observed following complications: vitreous cavity haemorrhage, traumatic cataract formation, cystoid macular oedema and peripheral stationary traction retinal detachment. CONCLUSION: Good anatomical results and restoration of good visual functions of injured eye were achieved in all patients despite some inferior initial prognostic factors.

Adult↗