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PubMed1978

Are Langhans giant cells precursors of foreign-body giant cells?

Granulomas were induced in rats by subcutaneous implantation of pieces of Melinex plastic into the dorsum. The pieces of Melinex were removed at intervals varying from 16h to 14 days, and the adherent cells were studied morphologically and quantitatively. Giant cell formation started about 32h after implantation. The first giant cells to appear were of the Langerhans type. Two days after implantation, most of the giant cells are still Langhans-type cells. A few giant cells of the foreign-body type and transition forms between the Langhans and foreign-body types are also present. From the third day on, the foreign-body type gradually becomes predominant. Independent of the duration of implantation, giant cells with 3, 4, or 5 nuclei are virtually without exception of the Langhans type. The higher the number of nuclei between 6 and 30, the more cells are of the foreign-body type. Giant cells with 30 or more nuclei are all foreign-body type. The findings are discussed in the light of current knowledge concerning giant cell formation. It is concluded that under the present experimental conditions, Langhans-type giant cells are the precursors of foreign-body-type giant cells.

Animals↗

PubMed1988

Ferrous intraocular foreign bodies and magnetic resonance imaging.

We placed various sized ferrous foreign bodies in and around the eye, sclera, and orbit in a rabbit model before performing magnetic resonance imaging studies. All foreign bodies were detected on plain x-rays. Only one of the largest fragments (3 x 1 x 1 mm) demonstrated movement on exposure to the magnetic field.

Animals↗

PubMed1990

Tracheobronchial aspiration of foreign bodies in children: a study of 94 cases.

Over the last seven years, there has been an increase in the number of children admitted to our hospital because of aspirated foreign bodies. An inhaled foreign body can become a serious matter if it results in acute respiratory distress or if it remains unrecognized for a long period in the bronchial system. Then, as a result of inflammatory tissue reactions, it can be extracted only with great difficulty. Of our 94 children with foreign body aspiration, 24% had been treated initially on the basis of a different diagnosis. In 30% of all cases, the children were admitted more than 3 days after aspiration. One third of the patients already had signs of marked inflammation on admission. Early treatment, under general anaesthesia, proved to be safe even for small babies. Bronchoscopic examinations should not last more than approximately 1 hour. All children who had complications after bronchoscopy (6%) recovered fully after treatment, except for one child who died of respiratory failure. A diminution of complications in children with inflammatory signs on admission was observed when they were treated before the operation with antibiotics and methylprednisolone.

Bronchi↗

PubMed1978

Are Langhans giant cells precursors of foreign-body giant cells?

Granulomas were induced in rats by subcutaneous implantation of pieces of Melinex plastic into the dorsum. The pieces of Melinex were removed at intervals varying from 16 h to 14 days, and the adherent cells were studied morphologically and quantitatively. Giant cell formation started about 32 h after implantation. The first giant cells to appear were of the Langhans type. Two days after implantation, most of the giant cells are still Langhans-type cells. A few giant cells of the foreign-body type and transition forms between the Langhans and foreign-body types are also present. From the third day on, the foreign-body type gradually becomes predominant. Independent of the duration of implantation, giant cells with 3, 4, or 5 nuclei are virtually without exception of the Langhans type. The higher the number of nuclei between 6 and 30, the more cells are of the foreign-body type. Giant cells with 30 or more nuclei are all foreign-body type. The findings are discussed in the light of current knowledge concerning giant cell formation. It is concluded that under the present experimental conditions, Langhans-type giant cells are the precursors of foreign-body-type giant cells.

Animals↗

PubMed1977

Unusual intracranial foreign bodies. Report of five cases.

Five patients surgically treated for unusual intracranial foreign bodies are presented. They include representative cases of the three most commonly encountered types of these injuries: industrial accidents, suicidal attempts and the result of criminal assault. Immediate radiological examination is mandatory because the deceptively small entrance wound is usually in no way commensurate with the large size of the foreign body the presence of which is frequently not suspected. The surgical removal of these foreign bodies requires careful pre-operative assessment to avoid hemorrhages and undue injury to the surrounding normal brain tissue.

Accidents, Occupational↗

PubMed1975

Foreign bodies of the tracheobronchial tree and esophagus.

Report of 850 cases of foreign bodies in the air and food passages is presented. The incidence of the accident was more in children between the age of 1-6 years than others. No sex difference was noted for the incidence of the accident. The presence of leech as a foreign body in this report is of interest. General anesthesia is recommended in the case that foreign bodies are present in the air way of children. In these cases bronchoscopy with oxygenation by insulfation in brochoscope or Ventury 50 or other similar techniques is recommended.

Anesthesia, General↗

PubMed2003

Esophageal perforation and neck abscess from ingested foreign bodies: treatment and outcomes.

Over a 6.5-year period, 5,848 patients who had ingested a foreign body were admitted to the ENT unit at the Prince of Wales Hospital in Hong Kong. Potentially serious complications developed in 12 patients (0.21%). Eight patients had an esophageal perforation; three had clinical evidence that their injury had been caused by the foreign body itself and five were deemed to have been injured iatrogenically during esophagoscopy. One of the latter group eventually developed an abscess. Four patients originally presented with an abscess. Three of these patients and the patient who later developed an abscess were treated with neck exploration and surgical drainage. One of the patients who initially presented with an abscess refused surgical treatment and was treated conservatively. Conservative treatment was also initiated for all patients who had a perforation. Patients on the conservative regimen were administered intravenous broad-spectrum antibiotics and were not permitted to take any food or liquids by mouth; they received their nutrition via either enteral feeding or total parenteral nutrition. Conservative treatment was successful in all seven patients with a perforation and no abscess and in the one patient with an abscess who refused surgery. Moreover, all four patients who underwent surgical treatment recovered. Our experience demonstrates that esophageal perforation related to an ingested foreign body can be safely treated by conservative means if the diagnosis is made before significant contamination occurs. Conversely, abscesses (cervical or mediastinal) related to an ingested foreign body should be explored and surgically drained.

Abscess↗

PubMed1986

Foreign bodies in the tracheobronchial tree: management and complications.

Accidental inhalation of a foreign body into the air passages is not an uncommon occurrence in any age group, but it is more frequent in the younger age group. Thirty-seven of the 47 patients (78.7 percent) in the present study were under 16 years of age. Most of the foreign bodies were found in the right bronchus. In this series, 73.9 percent of the interbronchial foreign bodies were recovered by bronchoscopy, while 6.5 and 19.6 percent were recovered during emergency tracheotomy and bronchotomy, respectively. The mortality in this series was 6.4 percent.

Adolescent↗

PubMed1987

Button batteries as foreign bodies in the nasal cavities.

Two cases of foreign bodies (button batteries) in the nasal cavities were reported. The first patient was a 6-year-old girl who put a button battery into her left nostril and ulceration of the septum and inferior turbinate was found. The other patient was a 3-year-old boy, the alkaline battery caused neither septal perforation nor stenosis of the nasal meatus. All button batteries as foreign bodies in the nasal cavities should be removed immediately to prevent severe local tissue damage, resulting in late sequels, such as septal perforation or stenosis of the nasal meatus.

Child↗

PubMed1986

Foreign body airway obstruction: considerations in 1985.

Management of foreign body airway obstruction continues to be a major controversy in emergency medical care. Much of the disagreement is without doubt based on lack of a uniformly accepted model of acute airway obstruction representative of the clinical event. A variety of models have been used to assess different aspects of airway obstruction by foreign bodies. These models have analyzed, among other variables, kinetic energy and inertial and aerodynamic forces in attempts to focus on specific aspects of this controversy. Human volunteers, anesthetized and paralyzed patients, and cadavers have also been used. In several recent studies it was concluded that subdiaphragmatic pressure is the treatment of choice, while in at least one additional study firm back blows applied with the patient's head hanging downward were recommended as the treatment most likely to relieve airway obstruction. It seems likely that these apparently conflicting views can be reconciled and that a consensus recommendation for treatment of this emergency can be effected.

Airway Obstruction↗

PubMed1981

Localization of suspected intraocular foreign bodies with a modified Delta 2020 scanner.

Metallic foreign bodies were localized in seven patients using a modified Delta 2020 scanner. In six of these seven, we compared the localization obtained by sector CT scan with ultrasound. The two methods were found to be complementary, with the sector CT scan giving more positive and more easily interpreted localizations, and ultrasonography giving more detailed soft tissue diagnosis. The new sector CT scanner greatly raised the level of confidence in the localization of metallic foreign bodies; however, we recommend the combined use of both techniques for a complete evaluation.

Adolescent↗

PubMed1996

Bronchoscopic extraction of aspirated foreign bodies in children in Harare.

Fifty eight children underwent rigid bronchoscopy under general anaesthesia for suspected aspirated foreign bodies. There were 36 boys and 22 girls with a median age of thirty three months. Physical examination showed decreased breath sounds and wheezing over the affected site in forty seven cases. Chest x-rays were diagnostic in eleven cases showing definite radiopaque shadow and suggestive of aspirated foreign body in thirty five (60%). Three patients had negative results of bronchoscopy (5.2%). Extraction of foreign bodies was performed by forceps under direct vision at bronchoscopy in fifty five patients. Two children had an intraoperative hypoxic arrest. Post endoscopic complications included mild to moderate croup in fifteen patients (26%), fever in four and pneumothorax in one. Rigid bronchoscopy of aspirated foreign bodies in children is a safe, effective and often life saving procedure. Morbidity is low and although mortality was 1.8% in this series zero mortality should be achievable.

Bronchi↗

PubMed1997

[Intrabronchial foreign body in adults: usefulness of computerized tomography].

The diagnosis of intrabronchial solid foreign body is recorded less often in adults than in children and becomes increasingly difficult to make as time passes after aspiration. Three cases of intrabronchial foreign body in adults with no history of loss of consciousness are reported. Clinical and radiological features are discussed, with special mention of the diagnostic role of computed tomography, a technique that has not often been mentioned in the literature on foreign body aspiration, but that is more sensitive and specific than the simple X-ray. In patients with symptoms inconsistent with X-ray images, computed tomography can be a useful, noninvasive technique for guiding diagnosis and assessing the need for bronchoscopy.

Aged↗

PubMed1999

[A fatal aorto-esophageal fistula due a foreign body: a foreseeable accident?].

BACKGROUND: The ingestion of foreign bodies is the second most frequent cause of aorto-esophageal fistulization after aneurysms of the thoracic aorta. CASE REPORT: A 28-year-old man died from catastrophic hematemesis 7 days after ingesting a bone splinter. The CT scan performed 3 days before the fatal event had demonstrated a fistulous formation originating in the aorta. DISCUSSION: Aorto-esophageal fistulae develop progressively from the esophageal perforation caused by the foreign body. Clinically, there is medical chest pain, followed by arterial hematemesis and finally terminal exsanguination. Diagnosis must be achieved during the free intervals in this triad of often rapidly succeeding signs.

Adult↗

PubMed1998

[Endoscopic treatment with laryngeal masks for the removal of tracheobronchial foreign bodies].

We studied the endoscopic removal of tracheobronchial foreign bodies from 13 patients. Eight patients were treated under local anesthesia and 5 under general anesthesia. Complications included mild bleeding during endoscopic treatment of 3 patients. One patient was placed under general anesthesia because the patient was irritable and because hemorrhage made observation difficult. Laryngeal masks were used in 4 cases, and resulted in no complications. The follow-up courses ranged from 4 months to 12 years and were uneventful for all patients. Use of a fiberoptic bronchoscope in combination with laryngeal masks facilitated the management and removal of tracheobronchial foreign bodies by providing a secure airway and by minimizing the effect on the cardiorespiratory system.

Adult↗

PubMed2001

[Orbital wooden foreign body].

A 76-year-old-female patient fell in her garden, inducing a right orbital wound in which no foreign body was primarily found. As pain and diplopia followed the orbital trauma, a CT-scan was performed, disclosing a linear external foreign body in the right orbit. An anterior orbitotomy was performed to remove an 18-mm-long wooden foreign body. Histopathology of the tissue surrounding the foreign body showed an inflammatory fibrous tissue with small granulomas around telluric particles. Improvement after the operation was dramatic with complete disappearance of diplopia the day following surgery. Antibiotics were prescribed and tetanus prophylaxis was performed.

Accidental Falls↗

PubMed2005

[Intraorbital foreign body--three years follow-up].

A case of patient with metallic intraorbital foreign body, was described. The foreign body went trough the eye and finally was situated close to the optic nerve. After three years, no signs of siderosis were found (ERG). The patient is still under control.

Adult↗

PubMed1998

A case of self-inflicted intraorbital injury: wooden foreign body introduced into the ethmoidal sinus.

A patient with an intraorbital wooden foreign body is presented. A 43-year-old schizophrenic male patient purposely introduced a twig through his left medial canthus and into the orbital cavity 6 months before presentation. Magnetic resonance imaging showed a well-delineated intraorbital object that partially penetrated the ethmoidal sinus through the medial orbital wall. Under general anesthesia, a 55-mm-long and 6-mm-diameter twig was removed through an incision along the sulcus palpebromalaris. Thick capsule formation around the foreign body, fibrosis of the adjacent tissues, and severe infection were observed. Diagnosis and management of intraorbital foreign bodies are discussed.

Adult↗