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The author describes two cases of bronchial foreign bodies that were not inhaled. One of them was found in the right lower bronchus after having penetrated through a wound in the chest wall. The other was lodged in the right main bronchus after penetration through a wound in the soft tissue of the neck. Both foreign bodies were successfully removed with the bronchoscope.
We report the case of a 58-year-old man who despite having an intralenticular metallic foreign body maintained good vision for at least 40 years. We describe the natural course of intraocular foreign body and the healing capacity of the anterior lens capsule as well as management issues to consider when dealing with intraocular foreign bodies.
A case of long term retention of a bronchial foreign body in a 62-year old female patient is presented, which mimicked lung carcinoma. Despite a negative history of choking, the diagnosis airway foreign body should be kept in mind.
A statistical study of 41 cases with denture foreign bodies in the air and upper food passages which were treated in our department during the past 21 years was done. (1) Males were more frequently affected. The ratio of male to female was about 2 to 1. (2) Of 41 dentures, 2, 2 and 37 were lodged in the air passages, hypopharynx and esophagus respectively. (3) There were 5 complete mandibular dentures in 41 cases. (4) The causes of the denture foreign bodies were originated to the problem of denture itself in 29 cases, that of the patient himself in 2 cases and both in 10 cases. (5) Of 39 problematic dentures, 16 showed the breakage such as plate fracture and clasp deformity, but the other 23 showed no breakage. In this latter group, poor holding of the denture was ascribed to miss-making or miss-planning. (6) Of 12 patients with problems in their physical function, 5 had suffered from cerebrovascular disease and 3 from geriatric dementia. (7) The denture foreign body in aged patients with physical hypofunction tends to increase in recent years. (8) Of 39 dentures tried to remove by esophagoscopy, 18 were done with difficulty and they were detachable partial dentures with one artificial tooth and 2-arm-clasps lodged at the first and/or second isthmus of the esophagus. Though we have a denture removed successfully at the third trial, we have no case needed external esophagotomy. (9) Duplicated denture models were made in 20 cases prior to the procedure, and we certify that these models play an important role for the safer removal of denture foreign bodies.
PURPOSE: To present the clinical and histopathological characteristics of a retained orbital foreign body. METHODS: A 34-year-old male was hit in his left eye by a flower stake. At first examination there was a massive haematoma of the left orbit and eyelids, reduced movement of the left eye and a small conjunctival lesion beneath the upper lid. There were no signs of deeper orbital or ocular lesions. During the subsequent months the haematoma disappeared, but increased proptosis and impaired eye movements with diplopia were noticed. One year after the injury, ultrasound and CT-scan revealed an ovoid cystic tumour behind the globe. During surgery the content of the cyst appeared purulent and from the centre of the cyst a foreign body measuring 25 x 13 x 1 mm was removed. RESULTS: Microscopy of the foreign body showed the typical structure of a decidual leaf. The superficial cells were empty, whereas the centrally located cells contained remnants of cytoplasm. Confined to the border between the empty and the filled cells, a band of cells containing groups of gram positive cocci was noted. Staining for immunoglobulins revealed traces of IgG in the superficial empty cells only. CONCLUSION: The high degree of preservation of the leaf and the survival of the cocci may be due to a barrier function of the intact plant cell walls with their high content of cellulose.
Two cases of longstanding foreign bodies in the larynx and lower laryngo-pharynx were accurately localised by direct coronal3 and limited axial CT scans of the neck. The relationship of the foreign bodies with the surrounding structures and associated changes are demonstrated clearly.
PURPOSE: To evaluate visual and surgical outcomes as well as complication rates after cataract extraction and primary intraocular lens (IOL) implantation during pars plana vitrectomy for removal of foreign bodies embedded or impacting in the retina. METHODS: Six consecutive cases of simultaneous cataract extraction and IOL implantation combined with vitreous surgery and intraocular foreign body extraction were retrospectively analyzed. In five cases, the foreign body was intraretinal; in one case, it was preretinal with retinal impact site. The follow-up period ranged from 5 to 45 months (mean 21.3 months). RESULTS: Visual acuity improved by two or more lines in five of six eyes. In five eyes, best-corrected postoperative visual acuity was better than 20/40. One eye was successfully reoperated for retinal detachment that developed 2 months postoperatively. In four eyes, the IOL was implanted into the capsular bag; in two cases, the IOL was placed in the ciliary sulcus. No postoperative complication was attributed to IOL implantation. CONCLUSION: Primary IOL implantation after combined cataract and vitreoretinal surgery is a safe and attractive option, reducing the need for two separate operations in selected patients with penetrating ocular injury and retained intraocular foreign bodies. The main advantage is more rapid visual rehabilitation with a single operation, reducing costs and patient discomfort.
In the 11 years 1977 to 1987, 36 confirmed cases of tracheobronchial foreign body were seen in the Bristol Children's Hospital. The distribution of ages, sites, and natures of the objects inhaled are similar to those in other reviews. Complications of removal of the foreign body once diagnosed were few, and have been absent since the Storz rod lens system was introduced in 1982. Eleven patients experienced delay of at least 7 days between the beginning of the symptoms and diagnosis, of whom 3 subsequently required open thoracotomy. Six of these had sought medical advice during this period, of whom 4 had a positive history of choking or inhalation. Inhaled foreign bodies remain a source of diagnostic difficulty, although this should be improved by greater attention to history and appropriate investigation. Technical advances have ensured their safe bronchoscopic removal in most cases.
This review of the outcome of the conventional management of magnetic foreign bodies shows that, with the exception of the severe open-eye injuries associated with large foriegn bodies, where immediate lensectomy and vitrectomy is required, conventional magnetic extraction should be performed as close to the foreign body as is feasible. It is important to assess posterior segment damage both before and after extraction of the foreign body, as the subsequent management will depend on the presence of vitreous haemorrhage and retinal damage.
We present a previously undescribed event where an inhaled foreign body was propelled into the post-nasal space by the Heimlich manoeuvre. We present figures showing a drop in the mortality following inhaled foreign bodies since the introduction of the Heimlich manoeuvre.
The article shows the description of the seldom met case of simultaneous appearing of numerous foreign bodies situated both in air passages and in the alimentary canal at patient of mentally handicapped with the tendency to swallowing of small objects. After observing by guardians of the patients fact of swallowing metallic foreign bodies by him the specified research were made (X-ray pictures, computer tomography) and the presence in the bronchial tree of both lungs and in the upper and lower section of the alimentary canal were confirmed. Swallowed and aspirated objects did not cause no complaints at the patient. Revealed foreign bodies were removed from air passages by using of the bronchofiberoscopy method and the surgical treatment. Foreign bodies of the alimentary canal were voided by patient through natural tract.
OBJECTIVE: To evaluate the clinical application of CT virtual bronchoscope in foreign-body in bonchus. METHOD: The CT virtual bronchoscope were used in 21 cases with foreign-body in bronchus, all the images and reports were compared with the actual bronchoscopy. RESULT: The reports and images of CT virtual bronchoscope are very agreed with that of actual bronchoscopy. CONCLUSION: CT virtual bronchoscope is a very good complemental method in preoperative diagnosis of foreign-body in bronchus.
This study reports a series of 130 foreign bodies of the oesophage treated at the Gabriel Toure Hospital in Bamako. We tried to determine their nature, their intra-oesophage struck period, and the possible consequences being observed. At the some time the age and the sex are given. A predominance of foreign bodies in a male sex child (67%) is found, as it usually in literature. Complications are rare, this is a public health issue whose solution lies in prevention. We are the only specialized center from Mali, therefore we are sometimes confronted to stuck and very old foreign bodies. In spite of that, no death were registered.
We present the case of a 50-year old man who progressively developed tricuspid valve insufficiency with opening of a patent foramen ovale responsible for right-to-left shunt with polycythaemia. The tricuspid valve insufficiency was due to a foreign body, probably of surgical origin as suggested by its radiological image and by the patient's previous history. It would have been introduced, far away from the tricuspid valve (compound fracture of the wrist), several years previously. At surgery, we found the foreign body embedded in the valve system. As a possible mechanism for the mutilation, an undiagnosed endocarditis was suspected but could not be confirmed. Three cases tricuspid endocarditis (with foreign bodies in the right ventricle) and 3 cases of asymptomatic tricuspid valve foreign bodies have been published. Fifty-five cases of foreign bodies introduced peripherally and migrated into the heart, the pericardium and the pulmonary artery are reviewed.
CT findings in 2 patients with a wooden foreign body in the orbital region soft tissue, and a series of CT measurements of wooden elements are presented. The wooden foreign bodies presented low HU numbers in CT and were initially interpreted as a gas collection. Different species of trees presented a large spectrum of densities, varying from the -550 HU of pine up to the +289 HU of ebony. The density of a spruce plank increased along with water-logging from -470 HU to -86 HU in 4 weeks, and peak enhancement up to 106 HU was found in the layer closest to the surface. It was concluded that a wooden foreign body in soft tissues may present CT patterns simulating materials as different as a gas bubble or a bone fragment.
A review of the identification of foreign body hand injuries is presented with criteria for removal of a foreign body in the emergency department. Indications for acute surgical intervention are presented, and expectant management is discussed.
A 34-year-old man was evaluated for posttraumatic endophthalmitis with hypopyon. A previous CT scan of the orbit along with B-scan ultrasonogram failed to confirm the presence of an intraocular foreign body. Nevertheless, at the time of vitrectomy, a polyvinyl chloride (PVC) plastic foreign body was encountered. The atypical posttraumatic uveitis that developed was apparently secondary to the PVC material, as the inflammation cleared rapidly following removal of the foreign body. This case illustrates the necessity for maintaining a high level of suspicion for the possibility of an intraocular foreign body in the event of ocular trauma, even in the presence of unconfirming ancillary tests.
During 10 years, 127 children were admitted to the pediatric ward because of aspiration of foreign bodies (0.56% of all admissions). Eighty-one percent of the children were under 3 years of age. One hundred and one children (80%) had a positive history of foreign body aspiration. Vegetable substances, particularly peanuts and grains, were the commonest type of foreign body removed. Clinical signs and radiological studies were, in most children, pathognomonic, but sometimes not conclusive. Chest X-rays were normal in 18%; fluoroscopy was diagnostic in 92%. Rigid bronchoscopy and subsequent removal of the foreign body was the treatment instituted. Pneumonia (the commonest complication) developed before and after bronchoscopy in 28% of the children. Pneumomediastinum and subcutaneous emphysema were present on admission in 2 children. Cardiac arrhythmias, bronchospasm, and cardiac arrest were recorded during bronchoscopy. Bronchiectasis developed in one, and persistent intractable pneumonia, requiring lobectomy, developed in another patient. One death occurred.