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In most cases of bronchial foreign bodies removal in children rigid bronchoscopy is used. In this study three cases of bronchial foreign body removal by bronchofiberoscopy were presented. In some cases that method could be necessary for diagnosing and removal of the foreign body.
PURPOSE: To evaluate the effectiveness of pressure patching in the treatment of noninfected, noncontact lens-related traumatic corneal abrasions and abrasions secondary to removal of corneal foreign bodies. METHODS: Two hundred twenty-three patients with noninfected, noncontact lens-related traumatic or foreign body removal-related corneal abrasions were followed daily after receiving topical antibiotics and mydriatics and after being randomized to receive either a pressure patch or no patch. RESULTS: Twenty-two patients were excluded from the study. For data analysis, the remaining patients were split into two sections: those with traumatic corneal abrasions (120 patients) and those with corneal abrasions secondary to removal of corneal foreign bodies (81 patients). Patients with traumatic corneal abrasions healed significantly faster, had less pain, and had fewer reports of blurred vision" when they were not wearing a patch. The amount of photophobia, tearing, and foreign body sensation were similar between the patch and no-patch groups. Similarly, for corneal abrasions due to removal of foreign bodies, patients healed significantly faster and had less pain when they were not wearing a patch. There was no difference in the amount of photophobia, tearing, foreign body sensation, or blurred vision. Finally, there was better compliance in the no-patch group. CONCLUSIONS: Noninfected, noncontact lens-related traumatic corneal abrasions as well as abrasions secondary to foreign body removal can be treated with antibiotic ointment and mydriatics alone without the need for a pressure patch.
In a retrospective study we evaluated 49 endoscopies performed under suspicion of a foreign body in the oesophagus or upper gastrointestinal tract. In 27 cases a foreign body was easily removed. One child had to undergo a cervical oesophagotomy as a result of a chronically incarcerated foreign body. Because of the very low complication rate of endoscopy and a much higher risk of complications due to unknown foreign bodies, early endoscopic diagnosis is recommended even if the foreign body is only suspected.
AIM: To review the children who presented to Christchurch Hospital emergency department with aerodigestive tract foreign bodies during 1994. METHOD: The emergency department, and impatient notes were retrospectively reviewed for all children presenting with a complaint of an aspirated or ingested foreign body, for the period 1 January 1994 to 31 December 1994. One hundred and thirty-nine children were identified as being eligible for study. A telephone followup interview to determine outcome was also conducted. RESULTS: The 139 children had a median age of 3 years, 2 months and an even gender-distribution. The foreign bodies implicated were 47 coins, 23 sharp objects, 4 button batteries and a wide variety of blunt, noncorrosive foreign bodies. Twelve of the foreign bodies required removal (5 oesophagoscopies, 4 bronchoscopies, 2 indirect laryngoscopies and 1 laparotomy). Forty-five of 139 children had no significant symptoms at any time and these children had a total of 43 x-rays and 5 followup visits, none of which changed management. No child assessed by followup interviews had suffered complications requiring further evaluation or treatment. CONCLUSION: Children who have ingested blunt, noncorrosive foreign bodies, and who have had no significant symptoms at anytime require no investigations after exclusion of oesophageal impaction but should be reviewed if symptoms develop.
During the last 14 years, 250 patients with aspirated foreign bodies in the tracheobronchial tree were admitted to Kuwait Chest Diseases Hospital. Ninety-six per cent of the cases were under 10 years of age and 38% gave a clear history of foreign body inhalation. The rest were diagnosed either clinically, from the chest radiograph findings or because of unexplained pulmonary symptoms. In 247 cases, bronchoscopy under general anaesthesia was successful in removing the foreign bodies. In only three cases was bronchotomy needed. Seventy per cent of the foreign bodies were melon seeds. Asphyxia and cardiac arrest occurred in four cases during bronchoscopy but the patients were successfully resuscitated. In 10 cases a tracheostomy was done before bronchoscopy and the removal of the foreign body, while in five it was needed after bronchoscopy. Fifteen patients developed late complications such as recurrent pneumonia or atelectasis of the lung. Early diagnosis and adequate treatment are essential to prevent pulmonary and cardiac complications and to avoid radical lung surgery.
The authors observed 45 patients with foreign bodies in different parts of the digestive tract. In all the patients the foreign bodies were extracted with the help of endoscopes without complications. Wide introduction of diagnostic and curative endoscopy in the clinical practice in cases with foreign bodies in the digestive tract allows to avoid operations in most cases. Besides, it considerably shortens the time of staying of such patients in the hospital.
AIMS: To evaluate the clinical features as well as the visual and anatomical outcome in eyes with magnetic posterior segment foreign bodies, to identify prognostic factors after removal using an electromagnet. METHODS: The records of 40 patients with posterior segment foreign bodies were retrospectively reviewed for 6 years (1989-94). Post-traumatic cataracts and secondary retinal detachments were treated using conventional surgical techniques. Pars plana vitrectomy was used only for late complications. The mean follow up was 30 months (6-71). Clinical factors were studied using univariate analysis. RESULTS: The most common findings before treatment of these 40 eyes were lens wound, hyphaema, vitreous haemorrhage, and retinal impairment. The foreign body was in the vitreous (85%) or minimally embedded in the retina (15%). Initial visual acuity was worse or equal to 20/40 in 70% of the cases. Subsequent to surgical treatment, a cataract was reported in 60% of the patients. Postoperative complications included retinal detachment (15%) and phthysis (5%). The prognosis was worse in cases with intraocular foreign body of largest diameter > or = 3 mm, an initial visual acuity less than 20/200, or the presence of post-traumatic retinal detachment. Presence of initial intravitreous haemorrhage, hyphaema, or intraocular tissue prolapse did not appear to affect the prognosis. CONCLUSION: The long term visual acuity results indicated that wound repair associated with conventional magnet extraction in an emergency is a viable treatment for posterior segment magnetic foreign bodies in this selected group. At the time of diagnosis, size of foreign body (< 3 mm) and initial visual acuity > or = 20/200 were predictors of good visual outcome after primary magnetic extraction.
OBJECTIVE: The study was performed to evaluate detection of soft-tissue foreign bodies using conventional radiography (film-screen radiography), computed radiography printed on films (computed radiography-hard copy), and computed radiography displayed on a computer workstation (computed radiography-soft copy). SUBJECTS AND METHODS: Fifteen foreign bodies of different size, shape, and composition were implanted at different locations in a fresh cadaveric hand, and images were obtained using three radiographic techniques. Images were evaluated by four board-certified radiologists to ascertain the conspicuity of the foreign bodies with the different techniques. A subjective grade was assigned to each image in an attempt to identify the relative conspicuity of foreign bodies when imaged with the three techniques. RESULTS: Computed radiography-soft copy is the preferred imaging technique for the detection of wood and plastic foreign bodies in soft tissue regardless of the size of the wood or the plastic. No significant differences in conspicuity among the three techniques were demonstrated with glass foreign bodies. CONCLUSION: Detection of soft-tissue foreign bodies is best done using computed radiography-soft copy instead of film-screen radiography and computed radiography-hard copy imaging.
We report a particular case of a traumatically introduced foreign body in the sub-mandibular gland. A breaking object (plastic pen) penetrated, through the anterior oral floor, the submandibular gland. Such foreign bodies should be removed before suturing the wounds, as they can disturb healing and cause problems long after the accident. An adequate history, clinical and imaging studies should reveal the possibility of foreign body penetration and its localization, when it isn't previously removed. We compare the use of ultrasound detection of foreign bodies in soft tissue and conventional plain radiography, computed tomography, and magnetic resonance imaging. The usefulness of US in this kind of research does not justify TC or RM studies and allows a less invasive surgical operation.
Two cases of laryngeal foreign body (FB) are presented. The incidence of laryngeal FBs, variation in the presenting symptoms and the management are discussed.
The most important rule in treating patients with an intraocular foreign body is that the primary goal of the intervention, while typically including foreign body removal, is comprehensive anatomical reconstruction of the injured eye so that the best possible visual outcome can be achieved. If the ophthalmologist is unable to perform such surgery, the patient should be referred to a facility where the expertise and personnel are available to address all treatable tissue lesions. If the foreign body is in the posterior segment, vitrectomy is usually necessary. With appropriate management, most eyes have a good chance of regaining and maintaining useful vision.
BACKGROUND AND PURPOSE: Our purpose was to evaluate the cost-effectiveness of clinical versus radiographic screening for an orbital foreign body before MR imaging. METHODS: Costs of screening were determined on the basis of published reports, disability rating guides, and a practice survey. Base case estimates were derived from published guidelines. A single-state change model was constructed using social cost as the unit of analysis. Sensitivity analysis was performed for each variable. The benefit of screening was avoidance of immediate, permanent, nonameliorable, unilateral blindness. RESULTS: Using base case estimates and a discount rate of zero, we calculated the cost of the current guideline as $328,580 per quality-adjusted life-year saved. Sensitivity analysis identified screening cost as a critical variable. Discount rates and effectiveness of foreign body removal also were found to be important factors. Probability of injury and prevalence of foreign body may impact the analysis. CONCLUSION: Clinical screening before radiography increases the cost-effectiveness of foreign body screening by an order of magnitude, assuming base case ocular foreign body removal rates. Asking the patient "Did a doctor get it all out?" serves this purpose. Occupational history by itself is not sufficient to mandate radiographic orbital screening. Current practice guidelines for foreign body screening should be altered.
An incidental finding of a foreign body in the nose is an infrequent event. When foreign bodies are discovered incidentally, they are usually detected during an investigation of chronic symptoms. We describe a case that is of interest because a nasal foreign body had remained clinically silent for more than 50 years.
Pneumonic patches and atelectatic or bronchiectatic changes in the tributary lung distal to the bronchial foreign body are common radiographic abnormal findings in adults with foreign body aspiration into the lower airways. Nevertheless, plate (plate-like or discoid) atelectasis, a form of peripheral atelectasis, has not been reported to associate with this condition. In this report, we describe two men with the foreign body impacted in the right intermediate bronchus. In both cases, plate atelectasis was found in the base of the right lung and disappeared after successful removal of the foreign body via fiberoptic bronchoscopy. These two cases illustrate that plate atelectasis may be an implication of foreign body aspiration into the lower airways.
OBJECTIVE: To evaluate the effect of a campaign for proper education of the public on the risk of foreign body aspiration in children. METHODS: A retrospective analysis of 87 endoscopic foreign body removals in children was performed at the Department of Otorhinolaryngology, Head and Neck Surgery of the University Hospital of Crete, during the period between January 2000 and December 2004. Results were compared with those of a previous study conducted by the same Department during the period between 1991 and 1999. RESULTS: A foreign body was discovered in 44 cases, while in 43 cases there were no findings. Twenty-one foreign bodies (47.73%) were found in the right main bronchus, 20 foreign bodies (45.45%) were found in the left main bronchus and 3 (6.82%) in the trachea. Both crude and age-standardized bronchoscopy rates appear to be lower in the time period 2000-2004, as compared to the time period prior to the educational program. CONCLUSIONS: The decline in the total number of bronchoscopies during recent years has been a result of a campaign for proper education of the public and especially parents, caretakers and families. All aspects of the educational campaign are described in detail. The risk of high morbidity and mortality from foreign body aspiration makes it mandatory to increase even more the awareness of the general population.
AIM: The aim of this study was to establish the correlation coefficient between given parameters of the entering wound and final position of the metallic intraocular foreign body. MATERIAL AND METHODS: Fifty patients (50 eyes) with a penetrating injury of the eye and present metallic intraocular foreign body were included in this study. Clinically found data of the entering wound and final position of the intraocular foreign body (IFB) as well were transformed with a computer model into the three-dimensional parameters. Both parameters were statistically evaluated by means of correlation analysis, and correlation coefficient and determination coefficient were calculated. RESULTS: The extent of correlation between two variables is called correlation coefficient. The coefficient values range between -1 to +1. The closer is the calculated value to ranges (to -1 or to +1) the more are the two variables more correlated. The coefficient of determination values range from 0 to +1. The closer the results are to +1, the better the model describes the dependence between the two variables. The results obtained by means of correlation analysis were for the correlation coefficient 0.454, and for the coefficient of determination 0.6411 respectively. CONCLUSION: Results of the correlation analysis show that the knowledge of coordinates of the entering wound has no prediction value for final position of the foreign body in the eye. These two variables are not correlated and so the accurate final position of the foreign body cannot be predicted. The final position of the intraocular metallic foreign body is probably influenced by biophysical factors not included in this study.
Pistachio nutshell foreign bodies have been documented in the literature, occurring most commonly in the bronchi. The objective of this study is to report on two cases of oral cavity lesions, which were subsequently found to be pistachio nutshell foreign bodies. The first patient is a 9-month-old male who presented with a hard palate mass measuring 1.5 cm. The patient was evaluated in the operating room, and found to have a submucosal pistachio nutshell foreign body. The second patient is a 17-month-old female who presented with a firm, fixed midline hard palate mass. The lesion was subsequently noted to dislodge from the palate, and was identified as a pistachio nutshell.
OBJECTIVES: To evaluate the epidemiological aspects, diagnosis, therapeutical procedures, and factors of poor prognosis in patients with intraocular foreign bodies. METHODS: A descriptive and retrospective study carried out at The Hospital Comarcal del Bierzo (Leon), between June 1996 and May 2001, with an average follow-up period of 2 years. It comprises 86 patients affected by serious ocular traumatism who required hospitalization and surgery, 25 of whom had an intraocular foreign body (30%). RESULTS: The average age was 46, and 88% were males. Accidents at work account for 72% of cases, domestic accidents for 24%, and leisure activities for 4%. The nature of the material causing the accident was metallic in 80% of cases, and non-metallic materials in 20%. In 60% of patients, the final visual acuity was less than 0.5. CONCLUSIONS: Labour accidents cause ocular traumas with foreign body entrance. In most cases foreign bodies have a metallic composition. Diagnosis was made through direct exploration, roentgenography, CT scan and ultrasonography. We proceeded to carry out urgent admission, antitetanus and antibiotic prophylaxis as well as reconstruction of ocular globe. Main bad-prognosis factors were a diminished previous visual acuity, the presence of afferent pupillary defect, organic composition of foreign body and the occurrence of late complications.