Experiences in the handling of intraocular and intraorbital foreign bodies.
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Eye Foreign Bodies↗
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Rectal foreign bodies: case reports and a comprehensive review of the world's literature.
The surgical management of two patients presenting with incarcerated, apparently self-inserted foreign bodies is reported. The large volume of prior literature on this subject is reviewed, with tabulation of 182 previous cases by type and number of objects recovered and with a discussion of patients' age distribution, history, complications, and prognosis. Management problems addressed include history, differential diagnosis of reported pruritus ani, and handling of suspected assault. The variety of surgical techniques used to remove rectal foreign bodies transanally or after celiotomy is discussed. Vaginal foreign bodies and large bowel injuries due to fist fornication, colorectal instrumentation, pneumatic rupture, foreign body ingestion, impalement, and abdominal trauma are also discussed.
Adult↗
Intraocular wooden foreign body clinically resembling a pearl cyst.
Five years after injuring his right eye with a wooden arrow, an 11-year-old boy had an iris lesion resembling a pearl cyst. Surgery demonstrated an intraocular wooden foreign body. Wooden foreign bodies are uncommon but may be surprisingly well tolerated if uncontaminated. A differential diagnosis of iris mass lesions in the posttraumatic eye is provided.
Anterior Chamber↗
Occult foreign bodies of the foot.
This article illustrates several case reports of occult foreign bodies of the foot. The patients came for treatment from weeks to years after the inciting incident with chronic, sterile, draining wounds. The diagnosis of these foreign bodies can be quite difficult. Several radiographic and clinical clues are included, yet the single most valuable tool for the physician remains a high index of suspicion.
Adult↗
Delayed effects of a migrated foreign body (sewing needle) in the cervical spine: a case report.
STUDY DESIGN: A case report is presented. OBJECTIVE: This report documents one case of intraspinal migration of a metal foreign body. SUMMARY OF BACKGROUND DATA: The migration and penetration of foreign bodies into the spine have been described, but there are only three reports of a needle as the causative object. METHODS: This case report included a chart review, an examination of the patient, and a literature search. RESULTS: The patient successfully underwent surgery, in which the foreign body (a sewing needle) was removed. CONCLUSION: It is important to be aware of the possible delayed penetration of a foreign body into the spine even in patients with few or no symptoms.
Adult↗
Intraperitoneal foreign body as a cause of acute abdomen in pregnancy.
Although surgical textbooks commonly include foreign bodies in the differential diagnosis of acute abdomen, this cause of abdominal pain has not been reported in the obstetric literature. A 35-year-old woman presented at 24 weeks' gestation with right lower quadrant pain and peritoneal signs. The only abnormal finding at exploratory laparotomy was a free-floating intraperitoneal foreign body, presumably left inadvertently during prior surgery. The differential diagnosis of acute abdomen in pregnancy should include intraperitoneal foreign body in any woman with a history of previous abdominal surgery.
Abdomen, Acute↗
["Masquerade foreign body" of the conjunctiva].
CASE REPORT: An eight months old child presented with a "red eye" and a corneal erosion since a week. The parents reported on a "hair" which was invisible most of the time but appeared intermittently at the lid margin. The medical history was otherwise unremarkable. In general anaesthesia, a long structure could be easily extracted. The tapering structure disclosed several tiny hair-like filaments sprouting from the thickened end. This end was embedded within a fold of conjunctiva, thus giving the impression of a hair sheath. Clinically, an ectopic "giant hair" was supposed. Histology, however, revealed plants cells and a birefringence too high for a hair so that a diagnosis of a plant foreign body was established. CONCLUSION: Conjunctival foreign bodies may be overlooked especially in young children with no history of foreign body acquisition. They may occur as a "masquerade foreign body".
Conjunctiva↗
The intravenous foreign body: a report of 2 cases.
Two cases of metallic foreign body injury to the upper limb are described. In both cases the foreign body was clearly visible on x-rays, considered to be lodged in the soft tissues, but migrated to one of the large subcutaneous veins. One subsequently migrated to the heart; the other was removed from the peripheral vein.
Accidents, Occupational↗
Inhaled foreign bodies: management according to early or late presentation.
OBJECTIVE: This retrospective study aims to compare the early and late clinical and management aspects of tracheobronchial aspirated foreign body (AFB), to evaluate the factors associated with delayed diagnosis of foreign body aspiration (FBA) in children and to compare clinical, radiological and bronchoscopic findings in the patients with suspected FBA. A retrospective review of a 10-year experience (from 1995 to 2005). A 1512-bed Mansoura University Hospital and 184-bed Mansoura University Emergency Hospital. METHODS: The medical records of 3300 patients who underwent bronchoscopy for suspected FBA were reviewed. The data were analysed in three groups: the patients with negative bronchoscopy for FBA (group I), early (group II) and delayed diagnosis (group III). Foreign body was removed using the rigid bronchoscope with or without using the extracting forceps (Egyptian novel technique described in the hand made illustration). RESULTS: The majority of the patients with FBA were between 3 and 10 years of age. The penetration syndrome and decreased breath sounds were determined in a significantly higher number of the patients with FBA. The plain chest radiography revealed radio-opaque foreign bodies (FBs) in 23.56% of all patients with FBA. Pneumonia and atelectasis were significantly more common in the groups with negative bronchoscopy and with delayed diagnosis (P<0.01). The FBs were most frequently of vegetable origin, such as seeds and peanuts. A significant tissue reaction with inflammation and postbronchoscopic complications were more common in the delayed cases. The novel technique was used since then in 100 cases (4.62%) with a history of FBI (Pins and or small rounded materials). It was successful in 73 (73%) cases of non-impacted inhaled pins. Use of forceps was needed in 21 (21%) cases. Rebronchoscopy despite using both techniques was needed in six (6%) cases within 72h. Failed extraction of the inhaled FB occurred in three cases (3%) for whom bronchotomy was needed. CONCLUSIONS: Bronchoscopy is indicated on appropriate history and on suspicion. To prevent delayed diagnosis, characteristic symptoms, signs and radiological findings of FBA should be checked in all suspected cases. As clinical and radiological findings of FBA in delayed cases may mimic other disorders, the clinician must be aware of the likelihood of FBA.
Adolescent↗
[Intra-ocular foreign bodies. Microsurgical technics of extraction and prevention of retinal detachment: apropos of 30 cases].
Surgery was performed in 30 cases to extract foreign bodies located in the posterior segment of the eye, between october 1st, 1985 to november 15th, 1986 in the Hotel-Dieu of Paris Department of Ophthalmology. In 20 cases, the foreign bodies were lead-shot fragments resulting from assaults in 17 cases, from hunting accidents in 3 cases. In 10 cases they were other metallic bodies, resulting from working or pottering accidents. We present the anatomical lesions and the surgical techniques employed, in particular vitrectomy in conjunction with foreign body extraction using the diamond coated jaws forceps. Anatomical results are 83.3% flat retinas. 60% of the patients achieved visual acuity between 0.1 and 1.0. The following points are discussed: true opportunity to perform retinopexy around the retinal tears; problems created by the foreign bodies embedded into the eyeball; operative timing, taking into consideration both the haemorrhagic conditions, i.e. hyphema, choroïdals, massive intra-vitreal bleeding, and the prevention of tractionnal retinal detachment.
Adolescent↗
Tracheobronchial foreign body aspiration in children.
In this retrospective study, we reviewed the demographic and radiographic findings of 155 children with bronchoscopy-proven tracheobronchial foreign body aspiration (FBA). Two thirds of the patients were male, and most were children between 1 and 2 years of age. An aspirated peanut accounted for one third of all cases. Foreign body location was distributed nearly evenly to the right and left primary bronchi; tracheal foreign body was noted in 16 patients. The most frequent symptoms of FBA were cough (85 patients) and wheezing (60 patients). Although most patients were seen within 1 day of aspiration, 30 patients had symptoms that lasted at least 1 week before diagnosis. The most common radiographic findings were unilateral or segmental hyperlucency (59) or atelectasis (38). The trachea was the site of the foreign body in one half of children with a normal chest radiograph and FBA.
Age Factors↗
Corneal laceration and intraocular foreign body in a post-LASIK eye.
PURPOSE: To describe a case of full-thickness corneal laceration and intraocular foreign body in an eye that underwent laser-assisted in situ keratomileusis (LASIK). METHODS: A 43-year-old man underwent uneventful bilateral LASIK. Seventeen months after LASIK, the patient suffered penetrating trauma to the right eye while hammering metal without safety glasses. Examination on the night of the injury showed an uncorrected visual acuity of 20/30 in the right eye. Slit-lamp biomicroscopy showed a 2.4-mm full-thickness peripheral corneal laceration at the 11-o'clock position extending over the edge of the previous LASIK flap and a foreign body partially embedded in the superior iris. He was started on prophylactic topical and intravenous antibiotics. Under general anesthesia, the corneal laceration was repaired, and the intraocular foreign body was removed without any complications. RESULTS: At the follow-up visit 9 months after the surgery, the uncorrected visual acuity was 20/25 in the right eye. On slit-lamp examination, the corneal sutures and the well-positioned LASIK flap were in place. CONCLUSION: Penetrating trauma of the cornea did not lead to flap-related complications in this post-LASIK eye. Repair of the corneal laceration and removal of the intraocular foreign body after LASIK were managed without complications. Care must be taken to try not to manipulate or lift the LASIK flap during corneal laceration repair.
Adult↗
Foreign body removal: a new role for the fiberoptic bronchoscope.
Artificial and animal lung models initially were used to investigate the removal of foreign bodies from the tracheobronchial tree with the flexible fiberoptic bronchoscope. Different extraction instruments (claw, basket, forceps, and balloon catheter) were passed separately through the channel of the bronchofiberscope, and tested for usefulness prior to human application. The Fogarty balloon catheter served as a valuable aid in dislodging impacted objects so that the operator could then grasp them with the claw, basket or forceps. The wire claw recovered many of the metallic and organic objects, the wire basket was successful in retrieving only the bulky objects and the forceps (ACMI) was effective in capturing all of the metallic foreign bodies. These techniques, developed in our laboratory, are now being used to augment rigid bronchoscopy in the removal of foreign bodies from adults and older children. At the present time fiberoptic foreign body removal is not recommended for pediatric cases because of the small diameter of the trachea and glottis in infants and young children.
Adult↗
Foreign body embolism of retinal arteries as a complication of carotid angiography.
Two cases of foreign body embolism of the retinal arteries after percutaneous carotid angiography were encountered within a period of 7 months. Both patients were non-arteriosclerotic. Loss of visual function in direct relation to carotid angiography and the observation of a dark foreign body in a retinal arteriole indicated exogenous embolism. No or only slight remission occurred. Careful ophthalmoscopy in cases of visual complaints after carotid angiography is advised, and if foreign body embolism is suspected, treatment with vasodilators (e. g. amyl nitrite) should be given a trial.
Adult↗
[Indications for transvitreal removal of foreign bodies from posterior eye segments].
Results of treatment of 40 patients (43 eyes) with foreign bodies in the posterior segment of the eye are discussed. Special attention is paid to correct assessment of the risk and efficacy of removal of a fragment in each case. Only 67.5% of patients presented with obvious indications for removal of a foreign body through the vitreous. Fragments were removed in 83.3% of these patients. Complications occurred in 6.6%. The main causes of failure of sparing removal of a foreign body from the posterior segment of the eye were detachment of the retina and hemophthalmia.
Adolescent↗
Unusual cause for non-detection of retained metallic foreign body on ocular ultrasonography.
Ultrasound biomicroscopy has become a valuable adjunct in the evaluation of occult ocular foreign bodies. An unusual cause for non-detection of a metallic retained intraocular foreign body is described. In this case, the usual 'shadowing' was not discernible as the foreign body was lying just over the optic disc.
Accidents, Occupational↗
Fine-needle aspiration diagnosis of foreign body granulomatous reaction presenting as an orbital mass: case report and review of the literature.
Foreign body granuloma is a rare cause for an orbital mass. A case with proptosis and an orbital mass on CT scan is presented. Fine-needle aspiration of the mass was performed. Numerous foreign body giant cells were seen which contained polarizable filamentous material. A diagnosis of foreign body granuloma was rendered which was confirmed on histopathology.
Adult↗
Parapharyngeal space foreign body.
We present a case of an unusual toothbrush foreign body in the parapharyngeal space in a 1.5-year-old child. Children are most affected by this kind of trauma. Quicker and exact diagnosis guarantee proper treatment and recovery. The toothbrush had broken and one-third (about 6 cm) of it was left in the child's mouth, causing some swallowing problems. We do not observe any injury of neurovascular structures or inflammation complications. Under general anesthesia, neck exploration was undertaken and the toothbrush removed. External exploration of the neck is the method of choice in the treatment of big parapharyngeal space foreign body as we demonstrated in our case. This method guarantees a good exposure of the neurovascular structures of the neck.
Female↗