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PubMed2002

[Esophageal foreign bodies at the Universitary Hospital in Dakar].

The diagnosis and the management of the foreign bodies of the oesophagus in the children have benefited from the digestive endoscopy and the anaesthesia progresses the last ten years. A 120 files review concerning children who suffered from foreign bodies of the oesophagus is reported. The average age was 4 years. The sex repartition showed that the boys where prevailing (62 %). The interrogation revealed a caustic old stenosis of the oesophagus among 4 children. In 91% of cases, the diagnosis was obvious on the X-ray prints. The endoscopy assessment found 124 foreign bodies mostly represented by coins (81,4 %). We recorded 2 oesophagus perforation cases and to deaths. The foreign body of the oesophagus is not always harmless. It can determine complications often revealing ones. It seems necessary to us to stress the prevention of that accident by a vast sensitising compaign of the parents.

Adolescent↗
PubMedDate not supplied

Adult foreign body airway obstruction in the prehospital setting.

BACKGROUND: Although the treatment of foreign body airway obstruction in adults has been well studied, few data exist on the characterization of prehospital experiences. OBJECTIVES: To describe the frequency, etiologies, and treatments of foreign body airway obstruction in adults in the prehospital setting and to discuss the relative efficacies of treatments and presenting factors that predict overall patient outcome. METHODS: A San Diego County prehospital database was retrospectively reviewed for all adult patients over a 17-month period with data extracted on demographic characteristics, incident outcome, patient disposition, item involved in obstruction, location of episode, initial vital signs, initial level of consciousness, pertinent medical history, treatments initiated by bystanders and paramedics, and response to those treatments. RESULTS: During the study period, there were 513 cases of foreign body airway obstruction in adults. Of these, 17 (3.3%) died. The mean age was 65.0 years, with increasing age correlating with worse outcome. The item causing obstruction varied widely, with medications and meat being the most common items. The Heimlich maneuver was the most commonly used intervention, with an 86.5% rate of patient improvement. Magill forceps proved useful for three cases refractory to the Heimlich maneuver. Presenting vital sign aberrations, particularly with respiratory rate, correlated with poorer patient outcome. CONCLUSIONS: Foreign body airway obstruction represents a true emergency in adults, with a 3.3% mortality rate in the current study. The Heimlich maneuver was used frequently and with good success.

Adolescent↗
PubMed1997

Combined forceps and catheter extraction of an oesophageal foreign body.

The extraction of impacted foreign bodies from the oesophagus is frequently performed using forceps under endoscopic guidance. We report the case of a 23-year-old prisoner who ingested a lump of cannabis resin which could not be removed from the upper oesophagus with forceps alone. We recommend the use of a Fogarty balloon catheter in conjunction with toothed forceps in such cases.

Adult↗
PubMed2001

Ingested foreign bodies associated with orthodontic treatment: report of three cases and review of ingestion/aspiration incident management.

Foreign body ingestion/aspiration episodes are potential complications in all branches of dentistry. The handling of small orthodontic components requires particular care, especially where the patient is supine or semi-recumbent. Three cases of foreign body ingestion are presented, involving patients undergoing orthodontic treatment. Once the foreign bodies had been located, all instances were treated using a combination of serial radiography and 'watchful waiting'. All patients remained asymptomatic during this period, although none of the foreign bodies were retrieved. No active intervention was deemed necessary, and the patients were able to resume their orthodontic treatment. The potential complications of ingestion/aspiration episodes are discussed and a management regime suggested.

Adolescent↗
PubMed1998

Open surgical removal of tracheobronchial foreign bodies: a case report.

Tracheobronchial foreign bodies can usually be extracted by skillful application of endoscopic techniques. The authors report on experience in the treatment of an infant in whom a plastic object was extracted by an open surgical approach. The authors discussed clinical presentation and treatment options in the treatment of this patient who had a plastic pencil top lodged in the lung. In highly selected cases, an open surgical procedure entails less risk than endoscopic extraction.

Bronchi↗
PubMed2005

Treatment of scattered glass foreign bodies in both the superficial and deep neck: a case report.

There have not been any reports about scattered glass foreign bodies in the neck, while injuries of the head and neck region as a result of traffic accidents have been frequently reported. We report the case of a 17-year-old male injured in a traffic accident, with scattered glass foreign bodies in both the superficial and deep neck. A CT scan indicated the existence of numerous glass foreign bodies in the various layers of the neck. Most of the foreign bodies were very fine or sand-like. The wounded skin was keloidal and expected to lead to remarkable facial edema of the left side. The foreign bodies and cervical keloidal lesions with small pieces of glass were carefully removed, and then reconstruction was conducted in stages using tissue expanders. The facial edema was reversed and the aesthetic reconstruction satisfied the patient.

Accidents, Traffic↗
PubMed1990

Long term follow up after inhalation of foreign bodies.

The long term results of treatment of inhalation of foreign bodies in a district children's hospital and in a tertiary referral centre were reviewed by clinical assessment, chest radiography, and standard four view 81mKr ventilation/99mTc macroaggregated albumin perfusion imaging (V/Q lung scan). The overall incidence in the population served by the district hospital was roughly one in 14,000/year. Of the 12 children reviewed there, three had abnormal chest radiographs and four had abnormal V/Q scans as a result of inhalation of the foreign bodies. Of 21 children treated and reviewed at the referral centre, eight had abnormal chest radiographs, and 14 had abnormal V/Q lung scans. Three factors were assessed for prognostic importance: site of impaction, initial radiographic appearance, and time before removal. A child who had inhaled a foreign body into the left lung and who had collapse/consolidation on the initial chest radiograph was at greatest risk of long term complications. These children merit close follow up.

Child, Preschool↗
PubMed2003

Clinically unsuspected foreign bodies: the importance of sonography.

OBJECTIVE: To show the value of sonography in the detection of clinically unsuspected foreign bodies appearing as soft tissue masses. METHODS: High-resolution B-mode and color Doppler sonography was performed in 288 patients referred with superficial soft tissue masses over a period of 2 years. RESULTS: In 8 lesions in 6 patients, sonography showed small curved or linear echogenic structures surrounded by hypoechoic masses characteristic of foreign bodies with granulation tissue. One lesion had increased vascularity on color Doppler sonography. Patients were referred for other imaging studies, including magnetic resonance imaging, computed tomography, and bone and labeled red blood cell scintigraphy, which did not add relevant information. Three patients underwent surgery; foreign bodies were found in 2, and infected granulation tissue was found in 1. Spontaneous resolutions and no growth of the lesions were seen in the other 2 patients. CONCLUSIONS: The possibility of a foreign body should be considered when scanning soft tissue masses even in the absence of a relevant clinical history. Once a foreign body is diagnosed, no further workup is indicated.

Adult↗
PubMed1994

Spontaneous closure of enterovaginal fistula caused by a neglected foreign body.

The problem of a foreign body left in the operative field is rarely discussed in the medical literature despite the multiple complications it might cause. The purpose of this article is to report on a patient who developed an enterovaginal fistula secondary to a pack left in the pelvis to temponade post-hysterectomy bleeding. The fistula closed spontaneously after three months of expectant management. Expectant management of enterovaginal fistulae is feasible. Adequate reporting of the operative procedures performed and the use of tagged sponges is a must.

Adult↗
PubMed1976

[Rupture of the aorta secondary to perforation of the esophagus by a foreign body].

A case of traumatic rupture of the aorta due to a foreign body in the esophagus is presented. After extraction of the foreign body and chemotherapy there was a rapid recovery. Thereafter, the patient died from a recurrent hematemesis. Two factors have produced the aortic lesion: the sharp edge of the foreign body (which probably provoked a superficial lesion of the aortic wall), and the diffuse mediastinitis (which provoked a necrosis of the aortic lesion).

Aorta, Thoracic↗
PubMed1995

Vascular complications of a foreign body in the hand of an asymptomatic patient.

Foreign bodies in the hand are common clinical problems. A patient with a foreign body (glass) in the hand who was initially asymptomatic subsequently experienced ulnar artery erosion, thromboemboli, digital ischemia, and skin necrosis. These complications could have been prevented by removing the glass antecedent to the ulnar artery erosion. Excellent results were obtained by removal of the glass, excision of the diseased ulnar artery segment, and primary ulnar artery anastomosis.

Adult↗
PubMed1992

Ingested foreign bodies: patient-guided localization is a useful clinical tool.

We prospectively studied the latest 60 patients who presented to the ENT Departments of St Mary's and St George's Hospitals with ingested foreign bodies. Localization of the foreign body by the patient was compared to the actual site of the foreign body at removal and graded accordingly. Localization was better the higher the object. When compared with objects above the cricopharyngeus muscle items impacted below this level were poorly localized (P < 0.0001) and lateralized (P < 0.0001). This suggests that for a patient who is able to lateralize a presumptive foreign body within the cervical region, then that object is likely to be above cricopharyngeus and on the side indicated. Further, it is likely to be visible on indirect laryngoscopy and amenable to removal in the casualty department. We hypothesize that the pharyngeal innervation by the vagus and glossopharyngeal nerves provides better sensation than in the oesophagus which is innervated less densely by the vagus and cervical sympathetic nerves.

Adolescent↗
PubMed2003

Phthisis bulbi with a large protruding foreign body--a rare complication of penetrating injuries.

Spontaneous extrusion of a retained intraocular foreign body is a rare occurrence. An unusual case is described in a 30-year-old male, where a foreign body remained in the eye for four years and then, as phthisis set in, the foreign body gradually extruded, causing constant irritation of the upper lid. Such a situation has not been documented before. Its management along with the histopathologic features are discussed in the light of the available literature.

Adult↗
PubMed2006

Inadvertent foreign body embolization in diagnostic and therapeutic cerebral angiography.

BACKGROUND AND PURPOSE: Inadvertent foreign body embolization is a rarely diagnosed and neglected complication of cerebral angiography that has not been studied systematically. METHODS: We undertook a comprehensive 5-year retrospective study of all available postmortem cases of postangiographic neurologic complications, as well as a comprehensive histologic examination of all surgically resected central nervous system arteriovenous malformations, at our institution. RESULTS: Among the autopsy series, we found 3 patients for whom cerebral infarction, sometimes catastrophic, is attributable to inadvertent cotton fiber, Gelfoam, or polyvinyl alcohol particulate emboli during cerebral angiography. All cases described had concurrent atherosclerotic vascular disease. Particulate embolization, which is usually cotton fiber, is present in as many as 25% of resected arteriovenous malformations: the risk of finding such emboli is in part dependent on a history of prior interventional (as opposed to diagnostic) angiographic procedures. It is not surprising that the amount of tissue examined also increases the risk of finding such emboli. CONCLUSIONS: Unintentional foreign body emboli remain common in modern angiographic practice and are probably underappreciated clinically. Although such emboli are usually asymptomatic, they can be clinically devastating, and a high index of suspicion is required for diagnosis. Foreign body emboli should be included in the differential diagnosis of postangiographic ischemia or infarction.

Cerebral Angiography↗
PubMed2000

[Orbital endoscopic surgery: experimental model for foreign bodies extraction].

PURPOSE: Endoscopy is a useful technique that may be applied to study orbital pathology because it is safe. In this paper we describe the surgical technique using endoscopy for orbital foreign body extraction. METHODS: In an experimental model in the dog we inserted a spheric metallic foreign body into the intraconal portion of the orbit. After general anesthesia we performed a 2 mm. peritomy in the conjuntiva. Then we introduced the optic system connected to a TV monitor. Associated to the optic system we fixed a 14-G Abbocath to introduce a 1.7 mm foreign body forceps. RESULTS: After a complete endoscopic exam of the orbit we identified the metallic foreign body. With the 1.7 mm forceps we could take out the foreign body. The extractions were very simple and the technique was not traumatic for the orbit. CONCLUSIONS: Endoscopic surgery of the orbit is a useful and safe technique to extract orbital foreign bodies in this experimental model.

Animals↗
PubMed2005

[Incorporation of multiple foreign bodies due to borderline personality disorder].

BACKGROUND: Autoaggressive behaviour is one of the pathognomonic characteristics in patients with borderline personality disorder. Clinical symptoms of such behaviour can be the self-induced incorporation of foreign bodies. In the head and neck area, this form of autoaggressivity causes primary or secondary infectious complications with different clinical manifestations. Below follows a description of diagnosis, therapy and follow-up of such a case, comparing our own findings with the corresponding literature. CASE REPORT: A 24-year-old woman with manifest borderline personality disorder was referred to the Department of Maxillofacial Surgery after developing a swelling in the infra-auricular region. After antibiotic therapy failed to reduce inflammatory symptoms, local revision was performed including excision of two metallic foreign bodies. Comprehensive radiological evaluation identified multiple foreign bodies in the head and neck region and lower arms. A total of 76 metallic foreign bodies was removed surgically. During early surgical follow-up and subsequent psychiatric treatment, the patient incorporated new foreign bodies. DISCUSSION: The case reported represents a pattern of foreign body incorporation which is unusual based on review of the literature but characteristic for patients with borderline personality disorder. Diagnostics and therapy require an individual concept which only can be implemented in close co-operation with psychiatrists. Secondary clinical benefit derived from surgical diagnostics and therapy as well as the possibility of autoaggressive relapse have to be taken into consideration.

Adult↗
PubMed1990

The role of ultrasound in the detection of non-radiopaque foreign bodies.

Fifty consecutive ultrasound examinations performed for suspected non-radiopaque foreign bodies in extremities were reviewed to establish the value of this procedure. Ultrasound detected 21 of 22 foreign bodies found at operation. There were three false positive examinations. The sensitivity was 95.4%, the specificity 89.2%, the positive predictive value 87.5% and the negative predictive value was 96.2%. This study demonstrates that ultrasound is a reliable method for detecting non-radiopaque foreign bodies and makes a significant contribution to patient management.

Adolescent↗
PubMed1997

Retained foreign bodies.

OBJECTIVE: To evaluate the frequency of occurrence and outcome of patients having retained foreign bodies after treatment in an urgent-care setting. MATERIALS AND METHODS: Closed case records from the files of the Medical Professional Mutual Insurance Company involving claims of retained foreign body were reviewed for a 7-year period. MAIN RESULTS: Thirty-two patients filed 54 claims against 32 physicians and 22 health care institutions. Defense costs were $298,906, and indemnity payments were $1,279,171. Glass was the most frequent retained foreign body, constituting 53% of claims. Despite the fact that glass is radiopaque, x-ray films were ordered for only 35% of these patients. Retention of glass fragments when no radiologic study was obtained resulted in unsuccessful defense of 60% of the claims and higher indemnity payments. Radiologic studies were ordered for only 31% of all patients. CONCLUSIONS: All wounds should be considered to be at risk for foreign body entry. Documentation in the medical record of wound exploration and patient follow-up, and ordering of plain films and other diagnostic imaging studies should be used more frequently toward this end.

Diagnostic Errors↗