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PubMed1998

Spontaneous migration of foreign bodies in the central nervous system.

The authors present four cases where foreign bodies within the central nervous system had spontaneously migrated. Two of these were surgical clips and two were bullets. The clips seemed to pass intradurally into the lumbar region with minor or no symptoms. Possible explanations for the migration are the circulation of CSF and the gravity. A new observation was that an infection may develop at the site where the foreign body had been situated before migration. From the clinical point of view, the removal of foreign bodies from the intradural space is not indicated, if the patient has no connected symptoms.

Adolescent↗
PubMed1989

[Foreign bodies in the tracheobronchial tree of adults].

In the years 1965-1987 in adult patients 4172 bronchoscopies were done and 26 of them (0.62%) were done in 13 patients with foreign bodies in the tracheobronchial tree. The age of the patients was from 16 to 66 years. The diagnoses and treatment of these cases of foreign body aspiration are discussed. In 10 patients they were present in the right and in 2 in the left bronchus, and in 1 case in the trachea. In 11 cases the foreign body was removed during the bronchoscopy, the endotracheal body was removed surgically and in one case the foreign body was coughed up. No complications were noted after removal of foreign bodies.

Adolescent↗
PubMed2000

Foreign bodies in the nasal cavities: a comprehensive review of the aetiology, diagnostic pointers, and therapeutic measures.

Otolaryngologists frequently encounter nasal foreign bodies, particularly among children and mentally retarded patients. There are isolated reports describing the removal of unusual foreign bodies from the nose. But no comprehensive reviews of this important subject have been published for many years. This article includes a detailed discussion of the different types of nasal foreign bodies, the various clinical presentations, management options, and complications associated with nasal foreign bodies.

Adolescent↗
PubMed1997

[Intestinal foreign body with sigmoid perforation in an area of carcinomatous stenosis: incidental finding or etiology?].

Ingestion of a foreign body is a common incident. In most cases it rarely produces symptoms, but sometimes may cause severe complications such as abscess formation, obstruction or perforation. A definite diagnosis can be difficult to obtain for the following reasons: 1. the past history doesn't give any clue; 2. the symptoms are veiled by another intestinal disease; 3. radio opaquity of the foreign body is absent; 4. complications can mimic different symptoms inspite of their unique etiology. The following case reports a patient with an intestinal perforation, where a foreign body and a stenosis, caused by a sigma neoplasm, were simultaneously present. Histological findings showed that the foreign body, not the neoplasm, was causing the perforation, whereas for the underlying disease it only was an incidental finding.

Adenocarcinoma↗
PubMed2003

Bronchoscopy for evaluation of foreign body aspiration in children.

PURPOSE: The aim of this study was to present the entire spectrum of pediatric bronchoscopy performed for foreign body aspiration (FBA), with emphasis on accuracy of diagnostic tools, technical aspects, and predictors of complications. METHODS: Records of patients who underwent bronchoscopy for evaluation of FBA in our unit from 1991 to 2000, inclusive, were reviewed retrospectively. Age, sex, history of FBA, symptoms, results of radiologic studies, bronchoscopy findings, complications, and outcome were recorded and statistically analyzed to find out the most accurate diagnostic tool. RESULTS: A total of 740 bronchoscopies were done in 663 children (402 boys, 261 girls) presenting with a mean age of 3.1 +/- 0.1 years. FBA was confirmed in 563 (85%) patients, whereas normal bronchoscopic findings, signs of pulmonary infection, and endobronchial mass were noted in 43 (6%), 54 (8%), and 3 (0.4%) patients, respectively. There was significant difference between patients with and without FBA with regard to presence of definite history (91% v 54%), normal physical examination findings (14% v 46%), and normal radiologic findings (13% v 31%). However, none of these parameters or their associations were found to be reliable to predict the presence of FBA or clinical complications. Presence of history was the most sensitive (91%), accurate (84%), and specific (46 %) diagnostic tool. Bronchoscopic removal of-foreign bodies was succeeded in 558 (99%) children. Worsening of respiratory tract infection (n = 13), cardiac arrest (n = 6), laryngeal edema (n = 5), pneumothorax (n = 5), pneumomediastinum (n = 2), tracheal laceration (n = 2), and bronchospasm (n = 2) were the life-threatening complications observed in 21 (4%) patients with FBA and 14 (14%) patients without FBA (P <.05). There were 5 (0.8%) deaths. Of these, 2 patients presented with cardiopulmonary arrest immediately after FBA. Although foreign bodies were removed as quickly as possible, cardiac arrest was irreversible. The remaining 3 patients died of complications of bronchoscopy as irreversible cardiac arrest during bronchoscopy (n = 1) and worsening of respiratory tract infection after bronchoscopy (n = 2). CONCLUSIONS: The third year of the life carries the highest risk for FBA. There are no specific symptoms and signs to make a clear-cut differential diagnosis between FBA and respiratory tract infection. Bronchoscopy is invariably indicated on the basis of reliable history alone even when symptoms are minimal, and imaging studies are negative. Secondary bronchoscopy should be done in patients with persistent signs and symptoms to rule out overlooked organic foreign body particles or to remove persistent granulation tissue to avoid long-term complications necessitating lobectomy. The long duration of the procedure, presence of dense granulation tissue, and type of foreign body are important predictors of complications. Bronchoscopy should be regarded as an expert procedure and done with great care to avoid lethal complications. Differential diagnosis of respiratory tract infection by various diagnostic tools is of utmost important to avoid morbidity and mortality related to needless bronchoscopy.

Adolescent↗
PubMed2007

The heterodox nature of "Turban Pins" in foreign body aspiration; the central anatolian experience.

OBJECTIVE: The aim of this study is to determine the age and sex distribution and the nature of aspirated foreign bodies (FBs). We also compared Turban Pins (TP) with other FBs and discussed the extracting techniques. METHODS: From 1987 through 2006, 414 patients were managed and the records of the patients were retrospectively reviewed. RESULTS: Girls (56%) were influenced much more than the boys (44%). The median age was 4, however median age for girls and boys were 11 and 2, respectively. The 50% of the foreign body aspiration (FBA) were observed in the first years of life. There was also a great tendency to occur in the adolescent age group (32%), especially for girls. The most commonly aspirated foreign body was Turban pin (TP) (n=121) among 332 foreign bodies. FBs were successfully removed by rigid bronchoscopy in 94% of the patients. In patients who had a negative history (n=49), bronchoscopy was performed according to clinical suspicion, and it revealed foreign bodies in 41%. Thoracotomy was performed in eight (2.4%) patients. We had no mortality. CONCLUSIONS: These cases showed us that the type and age groups of FBA varies according to cultural conditions. We found that TP aspiration has different characteristics and it deserves a special attention. Suspicion is an important indication for bronchoscopy. We prefer rigid bronchoscopy because success rate is satisfactory.

Adolescent↗
PubMed1999

[Foreign bodies in the upper airways of children - problems relating to diagnosis and treatment].

The authors share their experience and systematic observations with regard to the correlation between "chronic pneumonia" and foreign bodies in the respiratory tract, based on a survey of 480 bronchoscopic examinations for a period of 10 years. It was established that misdiagnosed foreign bodies in the lower respiratory tract account for 12.5% of all these cases. The percentage of undiagnosed bilateral foreign bodies is unusually high, as well as that of the left-sided foreign bodies, although to a smaller degree. The study also shows that very often in pediatric practice foreign bodies are wrongly diagnosed as bronchopneumonia and bronchial asthma.

Asthma↗
PubMed1978

The nonsurgical retrieval of intracardiac foreign bodies--an international survey.

An international survey of nonsurgical retrieval of intracardiac foreign bodies provided data on 180 published and unpublished cases. The data was analyzed to evaluate the respective merits and drawbacks of the 3 basic retrieval techniques, the snare, the wire basket, and the endoscopy forceps, the routes and methods of insertion, the success rate, and the complications. Eighty percent of foreign bodies were polyethylene central venous pressure catheters, cut in two by the needle introducer. The site of lodgement of these fragments was predictable and determined by the site of entry and length of the fragment. The basic retrieval instruments and their modifications are described. Operating instructions are detailed together with adjunct methods of repositioning fragments for easier retrieval. Factors associated with the small percentage of unsuccessful retrieval attempts include fragments totally in the distal pulmonary artery, extravascular lodging sites, chronically-implanted fragments, and pacemaker-catheter fragments. For the vast majority of cases, however, these simple and uncomplicated techniques have been highly successful and widely utilized in the nonsurgical retrieval of intracardiac foreign bodies.

Cardiac Catheterization↗
PubMed1999

Reversible retinal toxicity associated with retained intravitreal copper foreign body in the absence of intraocular inflammation.

PURPOSE: To report on a patient who developed retinal toxicity from an intraocular copper foreign body in the absence of any signs of chalcosis or inflammation. METHOD: Case report. RESULT: Removal of the copper foreign body resulted in electroretinographic improvement and the patient has retained good vision. CONCLUSION: Retinal toxicity from intraocular copper can be subclinical and such foreign bodies should be removed. Removal of the foreign body can be associated with at least partial reversal of retinal toxicity.

Adolescent↗
PubMed1997

[Clinical analysis of huge intraocular foreign body extraction in seventeen cases].

OBJECTIVE: To discuss the definition of huge intraocular foreign body (IOFB), the selection of operation and the improvement of cure rate. METHODS: (1) The foreign body was localized by X-ray, and extracted through sclera; (2) direct localization by indirect ophthalmoscope; (3) extraction of IOFB in combination with pars plana vitrectomy (PPV); (4) extraction through anterior chamber. RESULTS: The IOFBs were extracted successfully in all cases. The foreign bodies of 13 eyes were extracted in combination with PPV (72.2%, secondary enucleation with coral porous hydroxyapatite implantation was performed on one case later), and extracted through sclera in 5 eyes. Post-operative visual acuity was improved in 6 eyes, not changed in 9 eyes and decreased in 3 eyes. CONCLUSION: IOFB extraction in combination with PPV is less damaging, accurate and safe, that reduces the complications and enhances the cure rate. It is worth to popularize.

Adolescent↗
PubMed1991

Esophageal foreign bodies in children. 15-year review of 484 cases.

The findings of a retrospective analysis of the charts of 426 children admitted on 484 occasions with diagnoses of esophageal foreign bodies that were managed at the Hospital for Sick Children for 15 years to the end of 1989 are reported. In the majority of cases, ingestion of the foreign body was either witnessed or suspected. Removal was completed with the use of general anesthesia with endotracheal intubation in 90% of cases. The postcricoid area was the commonest site for impaction. Coins were the commonest foreign body. Approximately 5% of children had more than one foreign body. Fifty-nine children had esophageal anomalies. Thoracotomy or laparotomy for the retrieval of foreign bodies was necessary in less than 1% of patients. Complications occurred in 13% of patients; there were no deaths.

Adolescent↗
PubMed2004

Ongoing foreign body reaction to subcutaneous implanted (heparin) modified Dacron in rats.

Dacron-containing heart valve repair devices trigger chronic inflammation characterized by the presence of activated macrophages, foreign body giant cells, and capsule formation. Upon blood contact, proinflammatory proteins adsorb to the material and provide a substrate for monocyte binding and differentiation. Various heparin-coated polymers have been shown to reduce adsorption of proinflammatory proteins in vitro and in vivo. In this study, the effect of knitted, heparin-coated Dacron on the foreign body reaction was tested subcutaneously in rats. We hypothesized that the anti-inflammatory effect of heparin would reduce monocyte recruitment and differentiation and therefore limit the inflammatory reaction. An ongoing foreign body reaction, characterized by the presence of foreign body giant cells and high vascularization, was observed in uncoated as well as (heparin-)coated Dacron at up to 180 days of implantation. Also, a thin capsule was formed around each material up to this time. In conclusion, although heparin coatings might have an effect on the acute inflammatory response, we were not able to show a difference between heparin-coated and uncoated Dacron after 180 days' implantation in rats. Further research needs to be conducted to assess the difference in proinflammatory protein adsorption between the tested materials and the effect this has on the long-term foreign body reaction.

Adsorption↗
PubMedDate not supplied

Percutaneous retrieval of foreign bodies: experience with the nitinol Goose Neck snare.

PURPOSE: The authors present their experience with the nitinol Goose Neck snare system in the retrieval of retained foreign bodies in 20 patients. PATIENTS AND METHODS: Foreign bodies were located in the vascular system in 13 patients, urinary tract in four, biliary system in one, gastrointestinal tract in one, and the peritoneal space in one. All retrievals were performed with use of standard angiographic/interventional techniques. RESULTS: Success was achieved in all cases without attendant complications. Foreign bodies removed included catheter and guide-wire fragments, an embolization coil, broken or occluded double pigtail catheters, a Wallstent, and a surgical laparotomy sponge. CONCLUSION: All procedures were performed quickly, safely, and without difficulty. Because of its excellent torque control, positive grasping capacity, excellent radiopacity, lack of traumatic effect, and availability in different sizes appropriate for use in a wide variety of difficult anatomic spaces, the authors recommend that this device be considered the first choice for all foreign body retrieval procedures.

Adult↗
PubMed1981

Plasmacytoma arising in the vicinity of a foreign body in the nasal cavity.

The development of a plasmacytoma in the vicinity of a long residing metallic foreign body in the nasal cavity is presented. In spite of the multitude of reports concerning neoplasma associated with trauma, most of which arise in chronic scars, this presentation is very rare. It is speculated that the plasma cell proliferation, occurring nearby the foreign body, roots from an immunologic and granulomatous reaction. This case is discussed in light of the vast data on foreign body tumorigenesis obtained from laboratory animals, and the implications of this data are outlined. Further attention should be drawn to the clinical associations of malignant processes co-existing with long-standing foreign bodies.

Aged↗
PubMed2000

Combined phacoemulsification, vitrectomy, foreign-body extraction, and intraocular lens implantation.

PURPOSE: To assess the outcome of simultaneous phacoemulsification, pars plana vitrectomy, intraocular foreign-body extraction, and intraocular lens (IOL) implantation. SETTING: SSK Ankara Eye Hospital, Department of Vitreoretinal Surgery, Ankara, Turkey. METHODS: Seventeen patients with corneal perforation, intraocular foreign body, vitreous hemorrhage, and lens opacity had simultaneous clear corneal phacoemulsification, pars plana vitrectomy, intraocular foreign-body extraction, and IOL implantation. RESULTS: Postoperative complications included massive retinal fibrosis in 2 patients, retinal detachment in 1, and cilioretinal artery occlusion in 1. At a mean follow-up of 15.2 months, best corrected visual acuity improved in the remaining 13 eyes (76%). The IOL was stable in all cases. CONCLUSION: Combined phacoemulsification with IOL implantation and vitreoretinal surgery was safe in selected cases of penetrating ocular trauma resulting from an intraocular foreign body.

Adolescent↗
PubMed2001

Corneal foreign bodies--first aid, treatment, and outcomes. Skills review for an occupational health setting.

Eye injuries from foreign body incidents remain prevalent in the workplace setting. Often the professional nurse provides the first line of treatment. The informal class presented at the authors' facility offered a comprehensive, organized presentation of a common injury encountered in the practice of occupational health nursing. Strenghts of the presentation included handouts demonstrating eye eversion technique and a flip chart summarizing the content to be placed in each medical station as quick reference. One challenge involved presenting the information to all nurses. The site encompasses four locations and some nurses function as the only staff in the plant for a given shift. With the support of administration and some creative scheduling, 10 of 17 nurses attended one of three classes offered in one morning, and the remaining 7 were able to view the class on videotape. Videotaping the presentation also provided material for future orientation, as well as an opportunity for review. Overall analysis found this a worthwhile offering relevant to practice. A brief formal written evaluation indicated the objectives for the class were achieved and elicited subjects for future topics. Informal chart reviews to check for documentation of visual acuity testing and eversion of the upper lid for foreign body injuries is another outcome measure currently in progress. In addition, a performance improvement project could be accomplished easily by retrospective chart review of assessment and treatment documentation, and tracking of revisits and referrals. Knowledge of current standards in the assessment, first aid, and treatment of eye injuries is every occupational health nurse's responsibility. However, prevention of foreign body injuries is far superior to any treatment modality available. As highly visible leaders within the occupational setting, nurses can be advocates and role models for safe work practices. Occupational health nurses may promote safe eye practices by actively seeking collaboration with safety departments to continuously monitor and improve eye injury and outcome statistics and use of protective eye-wear. By consistently wearing proper safety eyewear, such as approved goggles or prescription safety glasses with side sheilds, during each and every venture into the work area, occupational health nurses provide a strong role model and have the opportunity to educate employees and encourage safe work practices. It is important to encourage shared responsibility and awareness between workers and management for prevention of foreign body incidents and prompt, accurate treatment when necessary to promote optimal outcome.

Cornea↗
PubMedDate not supplied

[Endoscopic management of foreign bodies in the esophagus. Results of a retrospective series of 501 cases].

We present the results of a retrospective study of endoscopic management (with flexible endoscopy) in 501 patients admitted for suspected ingestion of a foreign body between 1977 and 1997. The mean age of the patients was 55.73 19.38. Foreign bodies were found in the esophagus in 322 patients (64.3%) and endoscopic removal was successful in 307 (95.35%). More experienced endoscopists, with more than 45 cases, had a higher success rate (98.1%) than did less experienced endoscopists (87.9%) (p < 0.01). The most frequent type of foreign body in our series was meat bolus (32.8%). Underlying disease was found in 38.9%, and peptic stenosis was the most frequent. The only severe complication found was esophageal perforation in one patient (0.3%). Emergency flexible endoscopy is the most effective method for managing patients admitted for suspected ingestion of a foreign body and for the removal of foreign bodies located in the esophagus.

Adult↗
PubMed1994

[A case of traumatic intrapulmonary foreign body].

A case of 60-year-old man with traumatic intrapulmonary foreign body that was not inhaled, but through the chest wall was described. In July 1992 a grass cutter was working in a forestry with a circular saw when he was struck into the right lung. He had a sharp pain in the anterior chest. No abnormality was seen in front of his neck and the chest wall. The next month he developed a cough with bloody sputum. The chest X-ray showed a metallic foreign body at the right side of manubrium. Computed tomogram showed a steel wire fragment lodging beside the innominate artery and vein and in the right lung. Median sternotomy was performed and a foreign body was successfully removed with partial resection of upper lobe.

Foreign Bodies↗