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Foreign bodies ingestion is a common cause of emergency endoscopic therapy. Usually ingestion is accidental for children and elderly patients, instead is voluntary in some others as psychopathic people or prisoners. The authors report their experience with 46 cases from January 1992 to December 1998: this technique is safe, with low rate of complications and hospitalization.
Although foreign bodies left in the abdominal cavity may remain asymptomatic for long periods, they may also cause serious complications. We present a case of gauze forgotten in the lower abdomen which remained asymptomatic for almost 1 year. When a granuloma had formed, it infiltrated the bladder wall giving the clinical and imaging appearance of an invasive bladder tumor.
Although much is known about the urologic aspects of genitourinary foreign bodies, the psychiatric profile of the adolescent male who inserts a foreign body into his urethra is not available. Six cases from a urologic service are presented, and the pertinent literature is reviewed. Psychiatric consultation for such selfinserters will allow the development of such a profile. An appropriate management plan can then be formulated.
Our experience in 10 years in management of foreign bodies in the Gastrointestinal Tract is presented. We are at the Urgency Department, Hospital General de Mexico, S.S. We made 5580 endoscopy studies, 457 (8.1%) being performed in search of foreign bodies, in upper and lower G-I. Confirmation and endoscopic management was done in 218 patients (47.7%), being excluded in 239 (52.3%). We used both, flexible and rigid scopes, with a lower percentage of complications and high rate success in removing theme.
Needle-wire localization of foreign bodies and nonpalpable breast lesions is commonly used to allow for more accurate excision or biopsy. We present three examples of complications of the localization procedure: (1) wire migration into the chest wall with retained fragment, (2) transection of a wire during biopsy with retained hook fragment, and (3) wire migration within the thigh soft tissues with breakage at the hooked end. Recommendations to minimize the incidence of these complications and their sequelae include (1) bending the hookwire 90 degree at the skin surface following localization, (2) transferring the patient between the radiology suite and the operating room via a stretcher, with minimal movement of the body part localized, and (3) accounting for the entire length of wire by the surgeon, pathologist, and radiologist following the procedure to exclude retained fragments.
We report the urethra and bladder foreign bodies seen in our department from 1976 to September 2004. We review the kind of the foreign bodies, the psychological profile of the patient, the clinical findings, diagnosis and treatment. We also review the literature about this matter.
This unusual foreign body in the tongue of a 45-year-old lady must be unique. The most interesting feature of the present case was that the patient had sustained a gun-shot injury about five months earlier leading to traumatic extraction of the first left lower molar tooth and its impaction into the tongue. The patient herself was not aware of it and she attended the hospital complaining only of a simple swelling of tongue.
Foreign body obstruction at the level of the cricopharynx is not an uncommon presentation in the accident and emergency department. If this is visualised with a fibro-optic endoscope, it can be safely removed in the emergency department with the help of short acting inhalational anaesthesitic agents such as sevoflurane. This method is safe and effective and also saves valuable operating theatre resources.
Three cases of foreign bodies in the bronchi, aspiration of which has gone unnoticed for the patients, are considered. In view of great diagnostic difficulties of related inflammation in atelectasis-affected sites of the lungs encountered in such cases, the study of the disease history and bronchological examination seem essential and should be detailed and comprehensive. This is especially true in torpid and atypical course of pneumonia, signs of aspiration and bronchial obstruction.
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Analyzes 147 cases with perforating wounds of the eyes and foreign bodies in the posterior segment. Describes the surgical policy in removing the foreign bodies in cases with transparent and opaque refracting madia. Recommends the transciliary methods providing better functional results.
The authors demonstrate how a delay in diagnosis, in the case of an orbito-cranial foreign body, serves to underscore importance of CT in even minor, orbito-facial injuries, when there is some suspicion of intracranial penetration. This examination, which should be requested as soon as possible in such cases, usually permits detection of the intracranial foreign body. However, if the image is much clearer than those of conventional X-rays, it can in certain cases, remain a matter of subtle interpretation, particularly in cases of less dense materials such as wood.
Implanted foreign materials, used to restore or assist tissue function, elicit an initial acute inflammatory response followed by chronic fibrosis that leads to the entrapment of the biomaterial in a thick, poorly vascularized collagenous capsule. Matricellular proteins, secreted macromolecules that interact with extracellular matrix proteins but do not in themselves serve structural roles, have been identified as important mediators of the foreign body response that includes inflammation, angiogenesis, and collagen synthesis and assembly. In this report we delineate functions of hevin and SPARC, two homologs of the SPARC family of matricellular proteins, in the foreign body response. Despite their sequence similarity, hevin and SPARC mediate different aspects of this fibrotic response. Using mice with targeted gene deletions, we show that hevin is central to the progression of biomaterial-induced inflammation whereas SPARC regulates the formation of the collagenous capsule. Although vascular density within the capsule is unaltered in the absence of either protein, SPARC-hevin double-null capsules show substantially increased numbers of vessels, indicating compensatory functions for these two proteins in the inhibition of angiogenesis. These results provide important information for further development of implant technology.
BACKGROUND: Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention. AIMS: To establish clear guidelines for management of paediatric FB ingestion. METHODS: A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999. RESULTS: Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery. CONCLUSION: Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.
Real-time ultrasonography was used to detect a small foreign body (a broken tip of a barbed broach) which had migrated into the upper lip of a 26-year-old female from the bone defect of the upper canine apex during root canal treatment 10 months previously. Intra-operative use of ultrasound was of great-help in clarifying the positional relationship between the foreign body and the surgical instruments used, and lead to a satisfactory result.
The present case involves an intranasal foreign body that was discovered five months after conservative therapy of a myocardial infarction. In such cases, oxygen tubes are fixed by plastic blocks which can accidentally become lodged in the nose. In this case, an elderly patient was suspected of having a carcinoma of the inner nose.