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PubMed2000

Intestinal perforation by foreign bodies.

OBJECTIVE: To present our experience of patients who presented with intestinal perforation by foreign bodies to our hospital between 1980 and 1998. DESIGN: Retrospective study. SETTING: University hospital, Spain. SUBJECTS: 21 patients who presented with intestinal perforation by foreign bodies. MAIN OUTCOME MEASURES: Size of perforations, nature of foreign bodies, clinical symptoms, radiological findings, treatment and outcome. RESULTS: The most common location was the terminal ileum (n = 11), followed by the rectosigmoid junction (n = 5). The objects were mainly bone fragments and toothpicks. The diagnosis was generally made at operation, and only 4 of the 21 patients had signs of pneumoperitoneum on the preoperative abdominal film. The most common treatment was simple suture of the defect. CONCLUSIONS: Intestinal perforation by a foreign body is uncommon, and normally affects the ileocaecal and rectosigmoid regions, in which it is unusual to find pneumoperitoneum preoperatively. It must be considered in the differential diagnosis of such conditions as acute appendicitis and diverticulitis.

Adolescent↗
PubMed1979

Extraction of magnetic foreign bodies from the clear lens.

In 20 patients with magnetic foreign bodies in the clear lens, I closed the apperture in the anterior lens capsule by a fibrin cover after extraction of the foreign body. The lens remained clear in 17 patients; total cataract was formed in three. Two of these three patients had had a foreign body in the lens for a longer period of time, and at the time of the extraction the signs of lens siderosis were marked. The cause of the cataract progression in the third subject was not clear. There were no complications of operation or in the postoperative period.

Adolescent↗
PubMed2006

Turban pin aspiration: non-asphyxiating tracheobronchial foreign body in young islamic women.

BACKGROUND: Foreign body aspiration is rare in adults. However, in recent years, the aspiration of pins which are used for securing turbans (headscarves) is seen frequently in young women. The aim of this article was to review 105 patients who were admitted to our hospital for turban pin aspiration. METHODS: Chest X-rays were used for diagnosis. Various methods of treatment were performed: laryngoscopy in 6 patients, flexible fiberoptic bronchoscopy in 16, rigid bronchoscopy in 93, and thoracotomy in one patient, while in the other patient the turban pin was spontaneously expectorated. RESULTS: Localization of the pin in the right bronchial system was common (52%). In 6 patients, turban pins located in the larynx were extracted successfully by direct laryngoscopy. Turban pins were successfully removed with a flexible fiberoptic bronchoscope in 4 patients of the 16 (25%) and by rigid bronchoscope in 93 patients of 94 (99%). The average time until discharge was 18 hours and there was no mortality. CONCLUSIONS: Turban pin aspiration is common in Islamic populations and treatment usually requires bronchoscopic procedures. In order to minimize turban pin aspiration frequency, we recommend that turbans should be secured by traditional fastening methods or with an apparatus which cannot be aspirated.

Adolescent↗
PubMedDate not supplied

Ingested foreign bodies within the appendix: A 100-year review of the literature.

BACKGROUND/AIM: Appendicitis and its complications remain a common problem affecting patients of all age groups. Foreign bodies are a rare cause of appendicitis. We tried to define potentially dangerous foreign bodies that may cause appendicitis and summarize general guidelines for their clinical management. METHODS: A 100-year literature review including 256 cases of ingested foreign bodies within the appendix with emphasis on: (1) objects that are more prone to cause appendicitis or appendiceal perforation; (2) foreign bodies that are radiopaque and may be detected during follow-up with plain abdominal films, and (3) guidelines for clinical management. RESULTS: Complications usually occur with sharp, thin, stiff, pointed and long objects. The majority of these objects are radiopaque. An immediate attempt should be made to remove a risky object by gastroscopy. If this fails, clinical follow-up with serial abdominal radiographs should be obtained. If the anatomical position of the object appears not to change and, most commonly, remains in the right lower abdominal quadrant, an attempt at colonoscopic removal is indicated. If this is unsuccessful, laparoscopic exploration with fluoroscopic guidance should be carried out to localize and remove the objects either by ileotomy, colotomy, or by appendectomy. CONCLUSION: Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects get into the appendiceal lumen they have a high risk for appendicitis or perforation. These foreign bodies are almost always radiopaque.

Appendicitis↗
PubMed1992

[Fiber endoscopy in the extraction of foreign bodies from the gastrointestinal tract].

23 patients that they swallowed foreign bodies, were treated. There were 16 male and 7 female, between 3 and 85 years old; 6 children and 17 adults. Of all, 7 were psychiatric patients. 15 foreign bodies were removed by upper digestive fiberendoscopy and 2, by procto/colonoscopy, without early nor late complications. 8 foreign bodies were eliminated spontaneously through the rectum/anus. Fiberendoscopy is an excellent method for treatment in these clinical problems.

Adolescent↗
PubMed2002

[Complications of endoscopic extraction of foreign bodies and their treatment].

Endoscopic extraction of foreign bodies from the upper part of the digestive tract has become recently the method of choice. As this method can be associated with very serious complications which cannot be resolved endoscopically and which may have permanent sequelae, it is important to consider the indication of endoscopic extraction of foreign bodies from the oesophagus or stomach very carefully. Fore illustration the authors present the case of a young female patient who swallowed by mistake a fork During its extraction a serious injury of the oesophagus occurred which had to be treated surgically. In the discussion pros and cons of endoscopic extraction are considered, the main principle being primum non nocere.

Adult↗
PubMed1982

Diagnosis and treatment of retained foreign bodies in the hand.

A retrospective review was conducted of 200 consecutive patients with foreign bodies in the hand seen between 1976 and 1982. Wood, glass, and metal accounted for 95 percent of the foreign bodies seen. The duration of follow-up ranged from 1 week to 3 years (average 6 weeks). Approximately 70 percent of the foreign bodies could be removed in either the office or the emergency room. The foreign bodies were removed anywhere from the day of injury to 20 years later. In 38 percent of the patients the diagnosis was missed by the initial treating physician, in many cases because a roentgenography of the injured area was not taken. Metal was visible in all of the radiographic studies obtained, glass in 96 percent, and wood in just 15 percent.

False Negative Reactions↗
PubMed1977

A simple stereotactic method to isolate and remove foreign bodies.

For the past several years, a simple technique using an image intensifier has been employed to isolate and remove foreign bodies from the extremities. Five consecutive cases were recorded to demonstrate its accuracy and simplicity. After the foreign body was identified by an x-ray film, the wound was infiltrated with local anesthesia and the foreign body was "located" by two venipuncture needles placed with the aid of an image intensifier. A small incision was then made between the needles to locate the foreign body at their tips. In this manner, foreign bodies have been consistently removed successfully in the emergency room in a relatively short period of time.

Adolescent↗
PubMed1993

[Foreign body synovitis--a limiting factor in use of the Trevira ligament in cruciate ligament surgery?].

In a prospective clinical study on 32 patients with Trevira ligament implants arthroscopic and histological findings were used to assess the articular effects of the synthetic ligament. In group 1 of patients with intact Trevira ligament no changes associated with foreign-body reactions were seen. In group 2 with abrased or frayed synthetic ligaments generalised foreign-body reactions in the suprapatellar recess as well as perivascular, round-cell infiltrates were seen in four out of six patients; four of the six cases also showed fibrotic signs indicative of prearthrotic changes. In group 3 with ruptured Trevira ligament no diffuse foreign-body reactions in the suprapatellar recess were seen in any of the 16 cases. In the intercondylar space foreign-body reactions correlating with the age of the implant were identified (p < 0.03). In 18% of cases with ruptured Trevira ligament generalised foreign-body reactions were seen; however, these changes were not accompanied by chronic inflammatory changes. Cases with technical shortcomings associated with a gradual fraying of the synthetic ligament invariably showed diffuse foreign-body reactions as well as chronic inflammatory infiltrates. In patients with spontaneous ligament rupture due to repeated trauma foreign-body reactions were restricted to the intercondylar space. In spite of the histological evidence of foreign-body granuloma no permanent clinical articular effects could be seen in our patients population within the follow-up time of up to 60 months.

Adult↗
PubMed1992

Blood lead levels in children with foreign bodies.

To determine the risk of increased blood lead levels in children with aural, nasal, or gastrointestinal foreign bodies, the authors prospectively obtained venous blood lead and erythrocyte protoporphyrin levels from 40 study patients and two control groups without foreign bodies (65 patients presenting to a medical clinic and 40 patients presenting to an emergency department). A questionnaire was used to assess environmental and behavioral risk factors for lead poisoning in the three groups. Mean blood lead level was higher in children with foreign bodies (P less than .001), and they were more likely to have a venous blood lead value of more than 1.2 mumol/L (25 micrograms/dL, P less than .01) than patients in either control group. Seventy-eight percent of study patients had no prior lead screening by parent's report vs 64% of emergency department control subjects and 55% of medical clinic control subjects. Control patients in the emergency department had the same incidence of elevated blood lead values as patients enrolled from the medical clinic (6%). No differences in environmental risk factors were found among the three groups. Study patients more often had a history of pica or ingestion of a poison than control patients from the medical clinic. Inner-city children with foreign bodies have increased lead exposure and may have an increased risk for lead poisoning. In areas of high prevalence of lead poisoning, children with foreign bodies should be screened for lead poisoning in the emergency department. General lead screening in the emergency department may be justified for high-risk, inner-city populations.

Child, Preschool↗
PubMed1981

The treatment of retained peripheral foreign bodies in the pediatric airway.

Aspiration of foreign bodies into the pediatric airway is a common surgical emergency condition. Once impacted into the peripheral airway, repeated attempts at removal may push these objects into segmental bronchi, causing endobronchial bleeding, and prolonged anesthesia time. In addition to standard endoscopic techniques, the use of fluoroscopy, endobronchial contrast material, topical vasoactive medications, and diverse retrieval instruments in eight such cases has avoided the need for either bronchotomy or segmental pulmonary resection. By using such supportive intraoperative techniques, the morbidity and mortality from impacted airway foreign bodies can be greatly reduced.

Bronchi↗
PubMed1981

Foreign body perforation of the stomach.

A case of foreign body perforation of the stomach is reported. Complications of foreign bodies in the gastrointestinal tract and their management are discussed.

Adult↗
PubMed1996

Removal of a cranio-orbital foreign body by a supraorbital-pterion approach.

Foreign body removal in blind, penetrating craniocerebral injuries, especially those involving craniobasal localization, could entail additional brain trauma risk. Under such conditions one can use surgical approaches for tumor removal or clipping of intracranial aneurysms. In this report, we present a case of blind, penetrating craniofacial injury in which a supraorbital-pterion approach for foreign body removal was used. Craniography, carotid angiography, and computed tomography data, including three-dimensional imaging, were taken into consideration while planning the operation.

Adolescent↗
PubMed2001

Enzyme and cytokine effects on the impaired onset of the murine foreign-body reaction to dermal sheep collagen.

Subcutaneous implantation of biodegradable hexamethylenediisocyanate crosslinked dermal sheep collagen (HDSC) elicited little foreign-body reaction in mice in contrast to rats. If the factor(s) resulting in this minor foreign-body reaction are better understood, this knowledge can be used to modulate unwanted foreign-body reactions. Therefore, we investigated whether the phagocytic potential of murine macrophages and giant cells could be enhanced. Disks of HDSC were predegraded with collagenase or impregnated with tumor necrosis factor-alpha (TNF-alpha) or interferon-gamma (IFN-gamma) before implantation in 129 SVEV mice. Explantation was performed on days 7, 14, 21, and 28 and the disks were evaluated at the (immuno) light and transmission electron-microscopic levels. More giant cells were present in the predegraded disks. Cells were associated with the HDSC bundles, and the onset of phagocytosis started on day 28, in contrast to the controls and the disks impregnated with the cytokines. Expression of MHC class II was minimal in all groups. The matrix metalloproteinases MMP-2 and MMP-9 were expressed in all groups although on day 28 MMP-9 expression was higher in the predegraded disks. Thus, predegradation only slightly enhanced the onset of the foreign-body reaction to HDSC in mice, and impregnation with cytokines not at all. This suggests that lack of proteolytic enzymes or TNF-alpha or IFN-gamma is not the cause of the impaired onset of the foreign-body reaction.

Animals↗
PubMed1988

Endoscopic removal of foreign bodies using a newly developed extractor.

A newly developed extractor for the endoscopic removal of foreign bodies has already been used with success. It can be rotated through 360 degrees, so that foreign bodies can be grasped from any angle. Capture and extraction of the foreign body is accomplished with a band-like snare, the inside surface of which is provided with tiny "studs". With the aid of this extractor, foreign bodies can be captured and removed quickly, reliably, and without risk to the patient.

Endoscopes↗
PubMed1983

[Statistic study of 1,272 cases of foreign bodies in the bladder or urethra].

The foreign bodies in the bladder or urethra found in the clinical observation of the 41 cases treated between April, 1963 and October, 1982, in our Department and those of 1,231 cases so far reported in Japan, were studied statistically. The incidence was higher in males than in females, the ratio being 1.7:1. This ratio has been unchanged for the past 20 years. Of the foreign bodies removed, the cases of wax and rubber objects have been on the decrease. The urethra has come to occupy an increasingly large percentage of the introductory routes during the past 20 years. Removal through the urethra has become more common owing to the development in the transurethral appliances.

Adolescent↗
PubMed1993

Esophageal foreign bodies as child abuse. Potential fatal mechanisms.

Foreign bodies being forced into the esophagus as a form of fatal child abuse is rare. A 4.5-month-old female infant presented to clinicians with respiratory distress. Several coins were recovered from the esophagus. One month later, she was found dead in her crib. At autopsy, there were three coins in the esophagus. In addition, there were cutaneous contusions of various ages, acute and partially healed fractures of the extremities, old aspirated foreign material in the lungs, and pulmonary fat emboli. Although the fat emboli may have contributed to the death, several potentially fatal mechanisms from the esophageal foreign bodies deserve consideration. These include vagal stimulation from esophageal distention, aspiration of swallowed fluids after esophageal obstruction, compression of the trachea or the heart by the coins, and cardiac compression or airway occlusion by the introducing finger.

Cause of Death↗