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Hysteroscopic removal of foreign bodies and its method of monitoring.

OBJECTIVE: To evaluate transcervical removal of foreign bodies (TCRF) and to estimate the effectiveness of its monitoring methods. METHODS: One hundred and thirteen women were identified as having residual intrauterine devices (IUD), residual pregnancy products, unabsorbed strings and broken hooks, which were not removed during routine curettage or IUD removal. All patients were monitored using B ultrasonography while TCRF was performed. Four cases were monitored by laparoscopy simultaneously. One case was monitored by laparoscopic ultrasonography. RESULTS: Foreign bodies of one hundred and nine patients were taken out by TCRF. Uterine bleeding, amenorrhoea, discharge, abdominal pain, micturition and hematuria disappeared postoperatively. Fetal bones embedded into intramural uterin in four cases were not removed completely. Of these four, one became pregnant 4 months later after TCRF and term delivered. One case encountered uterine perforation that was sutured by laparoscopy. CONCLUSIONS: TCRF is safe and efficient. Sufficient cervical canal distension, selection of equipment and methods to be used is important for successful TCRF. As a non-invasive and effective monitoring method, B ultrasonography is the first choice to monitor for TCRF. For patients with high risk factors for uterine perforation, laparoscopic monitoring should be done simultaneously. Laparoscopic ultrasonography monitoring has both the advantages of B ultrasonography and laparoscopy monitoring, but is invasive and expensive.

Adult↗

[Rare foreign body fistulas of the female bladder].

Fistulae between kidney and vagina caused by foreign bodies are very rare nowadays. Two casuistics illustrate the curious anamnesis of such patients: in an 18-year-old girl a foreign body inserted during masturbation led to a perforation, in the case of a 66-year-old woman a pessary which had been forgotten since 35 years penetrated into the urinary bladder.

Adolescent↗

Insecticidal activity of common reagents for insect foreign bodies of the ear.

OBJECTIVE: Insects commonly present as painful and distressing foreign bodies of the external ear canal. Removing live insects can be challenging, especially for primary care physicians who have limited equipment. The purpose of this study is to compare the insecticidal activity of commonly available preparations for insects that are most frequently recovered from ear canals: cockroaches (German and American), ticks, beetles, and honeybees. STUDY DESIGN: Prospective, blinded. METHODS: One hundred seventy insects of each species were placed in test tubes and submerged in 17 test preparations (10 tubes per preparation, 1 insect per test tube). Insect activity was stimulated by agitation of the test tube. Responses were monitored, and the time until death was measured. RESULTS: Most test preparations exhibited some insecticidal activity against most insect species. Ticks were completely resistant to all of the test reagents. Ethanol killed the American cockroaches (mean time, 32.6 s), German cockroaches (mean time, 29.6 s), and honeybees (mean time, 19.6 s) the most rapidly. CONCLUSION: Many commonly available reagents may be used to kill or immobilize insect foreign bodies of the ear.

Acetic Acid↗

Therapy-resistant foreign body giant cell granuloma at the periapex of a root-filled human tooth.

Although the primary etiological factor of periapical lesions is microbial, there are other independent factors that can adversely affect the outcome of endodontic treatment. In this communication, we present morphological evidence in support of the role of a foreign body reaction of periapical tissue to root-filling materials. The specimen consisted of a surgical biopsy of an asymptomatic periapical lesion which persisted after a decade of postendodontic follow-up. The biopsy was processed for correlated light and electron microscopy and was analyzed by various microtechniques. The unique feature of the lesion was the presence of vast numbers of large multinucleated cells and their cytoplasmic inclusion bodies. Morphologically, these multinucleated cells resembled foreign body giant cells. They contained characteristic birefringent cytoplasmic inclusions which on electron-probe X-ray microanalysis consistently revealed the presence of magnesium and silicon. The magnesium and silicon are presumably the remnants of a root-filling excess which protruded into the periapex and had been resorbed during the follow-up period. These observations strongly suggest that in the absence of microbial factors, root-filling materials which contain irritating substances can evoke a foreign body reaction at the periapex, leading to the development of asymptomatic periapical lesions that may remain refractory to endodontic therapy for long periods of time.

Biopsy↗

Unlikely foreign bodies in unusual facial sites.

Two cases are reported in which retained wooden foreign bodies in the facial tissues posed considerable diagnostic difficulty and were the source of persistent and distressing symptoms. In both patients the embedded foreign material defied radiological identification and in case 1 the time between injury and final removal of the foreign body was 9 years. The cases are described to highlight the problems in managing penetrating injuries when there is the possibility that radiolucent material is implanted in the wound.

Adolescent↗

[High-energy ocular trauma and changes in vision: a reason for a careful search for an intraocular foreign body].

A 50-year-old man visited his family physician one day after he had felt something entering his left eye following the blow of a metal hammer on metal, after which he began to see black spots. After the eye had been occluded for 4 days, his visual acuity had decreased to 0.1. Ophthalmologic examination revealed a defect in the cornea and iris, a foreign body in the vitreous and local cataract. Following surgical removal of the metal splinter and the lens, the visual acuity was restored to 0.8. Implantation of an artificial lens was planned. Ocular trauma is a major cause of permanent visual loss or blindness in (young) adults in the western world. Traumas in which a foreign body is propelled into the eye with high energy are most likely to penetrate the sclera. Damage and complications due to intraocular foreign bodies may lead to loss ofvision. The entry site of an intraocular foreign body may be difficult to find and the diagnosis may be missed. Therefore, an ophthalmologist should be consulted in case of a high-energy trauma in combination with visual loss.

Eye Foreign Bodies↗

Comparison of the Texan foreign body retrieval device and the Amplatz goose neck snare in vivo and in vitro.

PURPOSE: To compare the capturing ability of the Texan foreign body retrieval device with that of the Amplatz gooseneck snare in a swine model and to analyze their capturing mechanisms. MATERIALS AND METHODS: The Texan device with a < or = 30-mm adjustable loop was compared with the 5-mm, 15-mm, and 35-mm Amplatz snares for retrieval of foreign bodies from the iliac vein, infrarenal aorta, inferior vena cava, and stomach. Capture times by two investigators were compared. RESULTS: All 24 attempts with the Texan device were successful, as were 21 of 23 attempts with the Amplatz snare; two attempts with the 5-mm Amplatz snare were abandoned, and the failures were attributed to the suboptimal size of the snare. Other than the two abandoned attempts, there was no difference between the capturing performances of the Texan device and the 5-mm, 15-mm, and 35-mm Amplatz snares when they were compared side by side. In all vascular interventions, however, the Texan device performed significantly better in capture times than did the 5-mm and 15-mm Amplatz snare (P = .015). In all interventions, the Texan device performed significantly better in capture times than did all three sizes of the Amplatz snare (P= .012). CONCLUSION: The overall performance of the Texan device based on its capturing ability was significantly better than that of the Amplatz snares. The adjustability of the loop and the more versatile capturing technique made capture and retrieval of foreign bodies easier.

Animals↗

Long-term evaluation of degradation and foreign-body reaction of subcutaneously implanted poly(DL-lactide-epsilon-caprolactone).

The aim of this study was to evaluate the degradation and foreign-body reaction of poly(DL-lactide-epsilon-caprolactone) (PLA85CL50) bars. This specific biomaterial is used for the construction of nerve guides, which can be used in the reconstruction of short nerve gaps. Subcutaneously implanted PLA85CL50 bars were harvested after implantation periods ranging from 3 to 12 months and evaluated for the rate of degradation and the degree of foreign-body reaction. It was observed that this copolymer degraded completely within 12 months and that no lactide or epsilon-caprolactone crystals were formed. Furthermore, we conclude that the foreign-body reaction of PLA85CL50 is very mild. These properties make the amorphous copolymer of DL-lactide and epsilon-caprolactone (50:50) suitable for the construction of nerve guides.

Administration, Cutaneous↗

Orthopedic grand rounds. Retained wooden foreign body in the foot detected by computed tomography.

A 20-year-old female presented with a 12-week history of a penetrating wound by a pointed wooden slat to the dorsum of her right foot. She had persistent pain, swelling, and an open wound. Initial radiographs were normal, and three surgical explorations failed to find a foreign body. Later radiographs showed erosion of the second metatarsal. Computed tomography detected and localized the wooden foreign body. Removal of the foreign body was followed by healing of the foot.

Adult↗