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A patient was admitted with an impacted foreign body in the oesophagus. Repeated attempts to remove it during oesophagoscopy proved difficult and caused obstruction of the trachea during manipulation of the foreign body. A smaller endotracheal tube was subsequently placed in the trachea relieving the obstruction.
BACKGROUND: This study was done to evaluate the results of surgery performed for removal of glass intraocular foreign bodies. METHODS: A prospective study of consecutive cases which have been operated upon for removal of glass intraocular foreign body during the period from May, 1995 to May, 2001 was done. RESULTS: Nine eyes of 9 patients were operated upon during the study period. All were males with an average age of 21.8 years. Unbelted car occupants were the affected persons in 8 out of 9. In all cases, the foreign body was removed with repair of the injury related complications. Forty four percent had 20/50 or better vision. Eighty nine percent had 20/200 or more. Severe retinal injury was associated with poor visual outcome. CONCLUSIONS: Glass foreign bodies need special instruments for extraction. Good visual outcome can be obtained if the retina is not severely affected. Motor vehicle accidents affecting unbelted occupant are the main cause of glass intraocular foreign bodies.
The authors retrieved percutaneously an iatrogenic foreign body from the cardiovascular system in 10 patients without any complications. The Dormia basket catcher commonly used for stone extraction from the urinary tract was used in 9 out of 10 patients. The foreign body was extracted 6 times from the right atrium and once each from the pulmonary artery, the right ventricle, the iliac vein and the iliac artery. In view of the high rate of success of the transvasal retrieval and the absence of complications, practically every foreign body carried into the cardiovascular system represents an indication for its percutaneous extraction even in the case of not being opaque.
The foreign body aspiration is more frequent in children. The most usual etiology is the foreign bodies of vegetable nature, which can not be observed in the chest radiograph. The clinic signs are varied, including shortness of breath, cough and wheezing. Hemoptysis is a rare symptom, whose arising is generally connected with the existence of bronchiectasis. We present the case of a child who showed repeated hemoptysis and focal neumonitis due to Eikenelle corrodens three years after the aspiration of a spike. The diagnosis of the bronchial aspiration obtained after The most unusual in this case is the clinic manifestation of repeated hemoptysis, together with the long connected to the existence of foreign body inside the bronchus.
Over a 20 year period 26 patients were admitted because of ingesting foreign bodies. Ten patients, mostly children, remembered swallowing a metallic foreign body. Most of the patients were asymptomatic and were admitted for observation. Sixteen patients underwent operation. The distal large bowel was the area most commonly involved, not the ileocecal region as in the reviews published a number of years ago. Blunt as well as pointed foreign bodies caused bowel perforations, probably through slow pressure necrosis. Most of the patients had signs of localized peritonitis.. Unlike previous studies, roentgenographic studies were found helpful in the preoperative diagnosis.
We present a case of foreign body synovitis in the knee joint caused by a fragment of stainless steel imbedded in the tibial plateau for 10 years, which was extracted successfully using an arthroscope. The cause of synovitis was the long-standing release of small stainless steel particles resulting from the abrasion of the steel against the opposing lateral femoral condyle. For an articular foreign body, arthroscopy is by far the best treatment. Arthroscopy allows the surgeon to localize as well as to extract even the smallest foreign body fragment, and also provides for washing out of the joint cavity.
BACKGROUND: We evaluated 70 cases of ocular injuries with intraocular foreign bodies to determine the results of surgical management. METHODS: The site of penetration was cornea in 58 (82.9%), sclera in 8 (11.4%), and limbus in 4 (5.7%) eyes. The foreign body was in the vitreous in 40 (57.1%) and embedded in the retina in 30 (42.9%) cases. Before pars plana vitrectomy, the most common findings were found to be lens perforation (77.1%), vitreous hemorrhage (45.7%), endophthalmitis (20%), hyphema (4.3%), and retinal detachment (2.9%). RESULTS: After pars plana vitrectomy, visual acuity improved in 39 (55.7%), did not change in 19 (27.2%), and decreased in 8 (11.4%) cases. We observed secondary glaucoma in 11 (15.7%), retinal detachment in 10 (14.3%), and phthisis bulbi in 3 (4.3%) cases postoperatively. CONCLUSION: Pars plana vitrectomy is found to be an effective therapeutic approach in removing intraocular foreign bodies, but the preoperative and postoperative complications determine the visual outcome.
A review was made of 77 rigid esophagoscopies to remove a foreign body from the upper digestive tract. Mean age of patients was 59 years. Meat bones were the most frequent impacted foreign body and the cervical esophagus was the most frequent site of impactation. No foreign body was found in 22% of esophagoscopies, a high rate that could have been due to our lack of confidence in radiographic studies, which yield false positive and false negative information. Esophagoscopy is performed whenever patient-referred symptoms are clear. The only complications were three cases of major esophageal erosions without perforation and one pneumothorax. A case of intramural esophageal pseudodiverticulosis was found.
The experience in the treatment of 143 patients with foreign bodies of the rectum and sigmoid colon is analyzed. Groups of foreign bodies are distinguished according to their size, structure and ways of occurring. Methods of extraction of foreign bodies in typical and non-typical situations are described. It is demonstrated that in 2.8% cases of extraction surgeries laparotomy is required even without perforation of this organ.
Retained foreign bodies pose a risk to the patient from the perspective of potential morbidity. We describe a previously healthy 8-year-old boy with head and back trauma from a glass picture frame that fell off the wall. He sustained a closed head injury and a back laceration several centimeters lateral to the spine. A persistent drainage from the back laceration contained glucose and protein levels consistent with cerebral spinal fluid. A foreign body was easily visible on subsequent plain radiograph. The glass foreign body was removed by neurosurgeons after computed tomography and magnetic resonance imaging clarified the exact location of the glass fragment. Physicians should have a low threshold for obtaining plain radiographs in patients with glass foreign bodies and consider that projectiles may rest some distance from the laceration site.
Foreign body granulomas in the skin have been described frequently and may have various causes. Diagnosis is relatively easy in most cases, as most are related to foreign material penetrating into the skin due to different kinds of traumas. We present the case of a boy with multiple facial granulomas, persisting more than 6 months and related to the use of topical anti-pruriginous talc powder applied to papuloexudative lesions caused by varicella. Data gathered in the anamnesis, examination with polarized light and images seen through the electron microscope enabled us to identify the causal agent talc as the inducer of the granulomatous lesions that the patient presented, discarding other types of foreign body granulomas of exogenous origin.
BACKGROUND: The increasing use of flexible esophagoscopes leads to controversies regarding the current status of rigid hypopharyngo-esophagoscopy in case of suspected foreign body impaction. METHODS: In a retrospective investigation we analyzed 309 open tube hypopharyngo-esophagoscopies performed for suspected foreign body impaction. RESULTS: In 108 patients (35.0 %) a foreign body was detected endoscopically. 69 Patients (22.3 %) had other pathologic findings within the upper digestive tract. 72 % of the foreign bodies and 83 % of the pathologic findings were localized within the hypopharynx or the cervical esophagus. CONCLUSIONS: The superior diagnostic and therapeutic properties of the classical rigid endoscopy in this area underlines its still actual status in patients with suspected foreign body impaction.
We have described two cases involving unusual rectal foreign bodies and their subsequent removal. Suggestions are included to aid in the removal of colorectal foreign bodies, as well as references to provide for the appropriate management of these cases in the emergency department. Primary care providers need to be aware of the issue of colorectal foreign bodies as a clinical entity and the fact that their occurrence is expected to continue to rise dramatically. Patient education of the dangers inherent in the insertion of objects into the colorectal area should be more prevalent. At the very least, all physicians need to be aware of anal eroticism and the necessity to take a careful medical history.
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Insertion of foreign bodies into the urethram to obtain sexual pleasure may be complicated by their passage into the urinary bladder along with an inability for the patient to recover the foreign body. We present such a case, review the relevant literature, and discuss Emergency Department (ED) diagnosis and management.
PURPOSE: To present an ultrasonographic finding that simulated an intraocular foreign body after repair of a ruptured globe. METHOD: Case report. An ultrasonogram of a post-trauma eye was correlated with a computed tomographic scan. RESULTS: B-scan ultrasonography was performed on an eye after repair of a corneoscleral laceration. The ultrasonogram showed a highly reflective echo source suggestive of a foreign body; however, an orbital computed tomographic scan demonstrated that the lesion was intraorbital air. CONCLUSION: Although a highly reflective echo source in the presence of a ruptured globe may suggest a foreign body, the presence of orbital air should also be considered when interpreting ultrasonograms used in the preoperative and postoperative management of globe trauma.