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Unusual herpes simplex virus infection mimicking foreign body reaction after cosmetic lip augmentation with expanded polytetrafluoroethylene threads.

BACKGROUND: Adverse reactions after cosmetic lip augmentation with synthetic implant materials include inflammation, infection, and extrusion of and foreign body reaction to the implant. Clinically, all of them are characterized by pain, erythema, swelling, and formation of papules and/or pustules. OBJECTIVE: To describe an unusual herpes simplex virus infection in a 48-year-old female patient after cosmetic lip augmentation with expanded polytetrafluoroethylene threads clinically resembling a foreign body reaction. METHODS: Case report and literature review. RESULTS: A histopathologic examination showed no signs of a foreign body reaction. Instead, herpes simplex virus-specific DNA was demonstrated by polymerase chain reaction from lesional tissue. CONCLUSION: Cosmetic lip augmentation with expanded polytetrafluoroethylene threads may be complicated by a delayed local herpes simplex virus infection clinically mimicking a foreign body reaction to the implant.

Female↗

Management of ingested foreign bodies within the appendix: a case report with review of the literature.

A case is reported of an elective appendectomy in a patient with known ingestion of a sharp foreign body. The metal drill bit was ingested unintentionally 3 months before presentation at our institution. Plain abdominal films demonstrated the foreign body in the right lower abdominal quadrant. Because the gold dental drill bit was sharp and thought to be lodged in the terminal ileum or cecum, an attempt was made to remove the object during colonoscopy. This attempt was unsuccessful because no drill bit could be detected in the colon or terminal ileum. A laparoscopic exploration was performed, and the foreign body was found to lie in the appendix, after bowel manipulation under fluoroscopic guidance and with direct laparoscopic visualization. A laparoscopic assisted appendectomy was performed. On pathologic examination the drill bit was embedded in the tip of the appendix with signs of intramucosal acute inflammation. Management and indication for surgery of foreign bodies in the appendix are discussed, and we review the related literature. This is the second reported case of a dental drill bit in the appendix causing appendicitis.

Aged↗

Delayed complication of a foreign body causing retropharyngeal granuloma--a case report.

A 37 year old female who presented with a history of foreign body ingestion ten months previously was found on examination to have a retropharyngeal swelling. An initial differential of foreign body granuloma or retropharyngeal tuberculous abscess was considered. The usefulness of the lateral neck radiograph in demonstrating retropharyngeal pathology and the supplementary role of the computed tomography scan in confirming and elucidating the identity of the radio-opacity is highlighted. This presentation is a timely reminder of the need for a simple inexpensive lateral neck radiograph in situations of doubt as to persisting foreign body impaction.

Adult↗

[Problems of anesthesia and resuscitation in the extraction of tracheo-bronchial foreign bodies in children].

After briefly considering the high incidence of foreign bodies found in the bronchi of children, and some characteristics connected with their nature, the early and late complications that may occur as a results are illustrated. Resuscitation and anaesthesia techniques are then described, stress being laid on the importance of the ketamine-TCT injection and local anaesthetic association. The latter has proved most effective in personal cases as it resolves the laryngotracheo-bronchial spasm responsible for asphyctic crisis and prevents any dangerous deepening of narcosis during bronchoscopic manoeuvres for the extraction of the foreign body.

Adolescent↗

[Migrating pharyngeal and cervical esophageal foreign bodies].

OBJECTIVE: A retrospective study of four patients at Singapore Tan Tock Seng Hospital was done to evaluate the presentation, investigation, and diagnosis of migrated forcing bodies. METHOD: Migration is said to have occurred in the presence of positive neck radiography and negative rigid esophagoscopy. Computed tomography is the investigation of choice to confirm migration and invaluable in localising the foreign body for exploration. RESULT: All the migrated foreign bodies were linear, sharp fish bones and had been removed successfully. CONCLUSION: Ingested foreign bodies which migrate extra-luminally are rare occurrences, and they may result in life threatening complications and should be treated.

Aged↗

Subgingival foreign body embedment in a preschool child: management with three and a half years follow-up.

CASE REPORT: This is a case report of diagnosis and management of a foreign body embedded in the gingivae of a preschool child. A 3 year-old girl presented with pain, mobility and intraoral oedema of the upper left primary canine (#63). An angular, diffuse radiolucency on the mesial aspect of the primary canine was observed in the periapical radiograph and within this radiolucency, a linear radiopacity was noted in contact with the mesial surface of the root. A clinical diagnosis of severe localized periodontal involvement due to foreign body embedment was made. It was initially attempted unsuccessfully to remove the foreign body by subgingival root scaling and planning. The area was then surgically exposed. Upon flap elevation, a tubular plastic material similar to those used for the insulation of electric wires was found to encircle tightly the cervical area of the root of the primary canine, which was removed. Three months after the surgery, the gingiva of the affected tooth had attained its normal color but had started to recede for about 1 mm. One year post surgery, the gingival recession had progressed to 3 mm and a carious lesion had already developed at the denuded root surface. Three and a half years post surgery a mild inflammation of the buccal gingivae was apparent, but periodontal healing had occurred. CONCLUSION: The dentist must always consider the possibility of a foreign body embedment in the periodontal tissues of children and be familiar to the clinical signs and symptoms as well as the proper treatment procedures.

Child, Preschool↗

[The reasons for leaving foreign bodies in the abdominal cavity and the prevention of this complication].

An investigation performed in 38 surgical and obstetrics-gynecology departments has established that during 20 years foreign bodies were forgotten in the abdominal cavity of 46 patients which makes up 0.03% of all laparotomies. In 30 patients they were forgotten in emergency operations and in 16 patients in elective operations. Among the victims there were 31 women. The textile foreign bodies such as gauze pads, tampons, towels were left most often (35 things), forgotten surgical instruments and other things were less frequent. The foreign bodies stayed in the abdominal cavity during the period from 6 hours till 15 years and in 26.1% of the patients they resulted in lethal outcomes. The main causes of accidental leaving the foreign bodies in the abdominal cavity during operative interventions are analyzed in detail. Means of prevention of such neglect of surgeons are proposed.

Abdomen↗

Unusual foreign body in the esophagus: a challenge for the anesthesiologist.

A foreign body in the esophagus is usually removed by endoscopy. An elder man entered the emergency room dyspneic and dysphagic. A chest X-ray showed that he had a table fork stuck in the upper esophagus. An endoscopist tried to remove it without success. After bilateral block of the superior laryngeal nerve, transtracheal injection, topical anesthesia of the mouth, and sedation, an awake laryngoscopy was carried out. Pushing the laryngoscope into the opening of the esophagus the fork was seen and extracted by the anesthesiologist. This case focuses on the role of the anesthesiologist in the removal of esophageal foreign bodies.

Aged↗

[Delayed discovery of a metallic intraocular foreign body: diagnostic and therapeutic stakes].

Ocular siderosis is a serious and rare complication when a penetrating ocular injury with a metallic foreign body goes unnoticed. The foreign body must be urgently removed from the eye. If it is located on the ciliary body or the zonule, it may be difficult to visualize clinically. In this case, high-frequency ultrasound biomicroscopy can pinpoint its precise location and guide the surgical intervention.

Adult↗

Endolaser photocoagulation in penetrating and perforating intraocular foreign bodies.

Ten consecutive eyes that had undergone a pars plana vitrectomy and argon endolaser photocoagulation for penetrating or perforating posterior segment foreign bodies were reviewed. All eyes had undergone a pars plana vitrectomy plus or minus lensectomy, removal of the intraocular foreign body in those eyes with a retained foreign body, endolaser photocoagulation of posterior chorioretinal tears, and peripheral buckle for peripheral retinal pathology. Postoperatively (minimum follow-up, 6 months), all eyes had an attached retina. Eighty percent of the eyes had a visual acuity of 20/40 or better. Advantages of endolaser photocoagulation of posterior breaks include: microscopically controlled sealing of posterior tears, less destructive than posterior cryotherapy, effective when severe choroidal swelling is present, and absence of dispersion of viable retinal pigment epithelial cells which has been documented with external cryotherapy.

Adolescent↗

Lead foreign body arthropathy in a horse.

A diagnosis of degenerative joint disease secondary to an intra-articular metallic foreign body in the right metacarpophalangeal joint was made in a Quarter Horse gelding. Arthroscopy, performed to evaluate the joint and remove the foreign body, revealed yellow discoloration of the articular cartilage and synovium, and blunting and proliferation of the synovium. The foreign body was identified as a lead sphere. Microscopic examination of synovium revealed chronic synovitis, with accumulation of hemosiderin and multifocal, mild mineralization. Another pigment was evident extracellularly in the synovium. Lead arthropathy was diagnosed. Lead arthropathy results from the dissolution of intra-articular lead, causing signs of chronic pain, restricted motion, joint effusion, and synovial proliferation.

Animals↗

[Retained foreign bodies from the surgical point of view].

The number of foreign bodies remaining in the patient after a surgical procedure is presumably higher than mentioned in the literature. According to US insurance statistics, the incidence amounts to 1 in 1,500 surgical procedures. As a basic principle--also from the legal aspect--it is necessary to determine whether a foreign body was left in situ accidentally (i.e. due to a material fault) or if it was simply forgotten. In 70% of cases, fabric items (e.g. swabs etc.) are left behind, while around 30% are metal objects. A particularly high risk is seen in emergency settings, in unexpected changes in the surgical procedure, or for patients with a high body mass index. The outcome for the patient differs depending on the nature of the object left behind and the individual patient's situation. Usually, metal items cause more acute clinical symptoms at an earlier time after the operation. Fabric items tend to induce, in the absence of primary contamination, a chronic progression of symptoms over several years. Reoperation has a high mortality (between 11% and 35%). Precautions in terms of risk management have to be established and need to be strictly respected, especially in high risk settings. Visually or acoustically controlled monitoring before wound-closure are recommended to eliminate "human error" as thoroughly as possible.

Cross-Sectional Studies↗

Extraction of large tracheal foreign bodies through a tracheostoma under bronchoscopic control.

Despite various technical manipulations through contemporary endoscopic equipment, large tracheal foreign bodies may be lost during bronchoscopic extraction, with a 1 to 2% in-hospital mortality. Recently, emergency tracheostomy was performed during bronchoscopy after a tracheal foreign body had become dislodged in the subglottic region causing blockage of the airway, and the results of this procedure provoked its deliberate application in a second patient. In 3 additional infants, aspirated tracheal T tubes (Montgomery tubes), which were producing acute respiratory distress, were brought from the carina to the performed tracheostoma under bronchoscopic manipulation and were withdrawn. Elective application of this simultaneous approach--tracheostomy with bronchoscopy--may decrease morbidity and mortality from large tracheal foreign bodies.

Airway Obstruction↗

[Endoscopic removal of an ingested foreign body--indications and choice of procedure].

The majority of ingested foreign bodies does not cause problems for the patients and leaves the gastrointestinal tract spontaneously without complications. However the low risk of modern fiberendoscopy allows a safe approach of endoscopic extraction. In children and all other cases, where general anesthesia is required for the extraction procedure, indication for endoscopic extraction should be limited. From 1980-1986 we followed a concept, which differentiated for emergency, early-elective or elective extraction, depending on localisation and nature of the foreign bodies as well as the necessity for general anesthesia. In 88 endoscopic extractions (22 emergency, 66 elective) no complications were observed.

Adult↗

[Foreign body in the orbital cone: case report].

Orbital injuries may be associated with the presence of foreign bodies in which long retention leads to damages such as loss of vision or cerebral abscess. We present the case of a 21-year-old male patient that developed ptosis, limitation of movements and an inflammatory reaction in the right eye after being hit by a tree branch. A CT scan of the orbits revealed an increased density in the right orbital cone. After the neurosurgical approach for the removal of the foreign body, a wooden fragment measuring 2.0x0.3 cm, the patient had a good outcome without visual deficits, ptosis regression and resolution of the inflammatory process. The postoperative CT scan didn't identify any remaining foreign body fragment. This case calls attention to the fact that the wooden splinter presented on CT scan with high density (136 HU) two months after the trauma and was removed by a supraorbital craniotomy.

Adult↗