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Destructive arthritis due to silicone: a foreign-body reaction.

The authors report 3 cases of erosive arthritis resulting from a foreign-body reaction to a silicone implant in the wrist. No patient had a history of inflammatory arthritis. Radiographic changes included well-defined lytic lesions with thin, sclerotic margins, normal mineralization, and loss of volume of the implant. Pathologically, a destructive foreign-body reaction was seen, with intra- and extracellular silicone debris.

Adolescent↗

[Ingested foreign bodies].

Analysis is made of the results of treatment of 54 patients with ingested foreign bodies in the gastrointestinal tract. The factors which led to this type of accidents are evaluated. The clinical manifestations, diagnosis and treatment are discussed. Treatment was conservative in 93 per cent of the cases, while in 7 per cent operative removal was undertaken. On the basis of personal observations, indications for attempting surgical treatment of ingested foreign bodies in the gastrointestinal tract are proposed.

Adolescent↗

Medical and legal evaluations of the retained foreign bodies in Turkey.

Like other countries, the physicians accusation that might be right or wrong, have increased nowadays in Turkey. Even all precautions are taken in the operation theatre, there are still some cases in which foreign bodies are retained in the abdominal cavity. It is not likely for the cases of retained foreign bodies in the abdominal cavity to be considered as an acceptable complication. Therefore, the surgeon must keep in mind that in such situations they are going to be judged as faulty both in the civil courts and in the courts of first instance. In this study incidences, causes and legal outcomes of the foreign bodies that are left behind in the abdominal cavity in Turkey are discussed.

Abdominal Cavity↗

[Experiences with Extraction of 232 intraocular and 30 intraorbital non-magnetic foreign bodies].

The characteristics, localisation and extraction of 262 non-magnetic intraocular and intraorbital foreign bodies in 148 consecutive patients are described. The postoperative visual acuity results show no change in 45%, an improvement in 35% and a worsening in 20% of the eyes. The precise dynamic localisation before and during surgery, and particularly the intraoperative visualisation of the non-magnetic foreign bodies are to be considered as the most important points in surgical treatment of these cases.

Adolescent↗

[Secondary amaurosis after infraorbital injury with a wooden foreign body].

We report a 68-year-old male who had orbital trauma from a bicycle accident. His vision was initially normal but deteriorated over 8 days to complete blindness. After 13 days, when he first consulted a physician, clinical investigation revealed total ophthalmoplegia, ptosis, and chemosis. Computed tomographic scan showed fractures of the medial orbital wall, orbital floor, and posterior ethmoid with dislocation into the orbital apex near the optic nerve. The patient was sent to our department for optic nerve decompression. Clinical examination showed induration and an already healed infraorbital entry wound suggesting an orbital foreign body, which was confirmed by ultrasound. Renewed analysis of CT scans in different window settings could clearly demonstrate a wooden foreign body in the lower eyelid. Additionally, a diffuse inflammation in the orbital apex was diagnosed. The foreign body was removed and decompression of the orbita and optic nerve was performed. Antibiotics and corticosteroids were administered i.v. Unfortunately, no visual improvement could be achieved.

Aged↗

Late diagnosis of foreign body aspiration in children with chronic respiratory symptoms.

BACKGROUND: Children with undiagnosed and retained foreign bodies (FBs) may present with persistent respiratory symptoms. Delayed diagnosis is an important problem in developing countries and several factors affect the delay. OBJECTIVES: To investigate, the incidence of clinically unsuspected foreign body aspiration (FBA) in our flexible bronchoscopy procedures, the causes resulting in late diagnosis of FBA, and the incidence of the complications of FBA according to elapsed time between aspiration and diagnosis. METHODS: We reviewed the records of all the patients who underwent flexible bronchoscopy between 1997 and 2004 in our clinic. Patients with FBA were identified and their medical records were reviewed. RESULTS: During the study period, 654 children underwent flexible bronchoscopy; 32 cases (4.8%) of FBA were identified. Median age of patients was 29.5 months at presentation with a median symptomatic period of 3 months. None of the patients had a history of FBA. The most common misdiagnosis was bronchitis. Flexible bronchoscopy was performed to these patients within 1 week following presentation. In 87% of the patients (n=28), FBs were in organic nature. Patients were followed up for 21.0 months after removal of the FBs. Fifty-three percent (n=17) of the patients had a complete remission after bronchoscopic removal of the FBs. However, nine (28.8%) patients had chronic respiratory problems and six patients (18.8%) developed bronchiectasis. CONCLUSIONS: Atypical or prolonged respiratory symptoms should alert the physician and clinical and radiological findings should be carefully evaluated for a possible FBA. Delay in diagnosis and treatment of FBA should be avoided to prevent complications.

Bronchitis↗

[Removing breast foreign body resulted from augmentation with polyacrylamide hydrogel injection and silicone prosthesis implantation at one stage].

OBJECTIVE: This study was to investigate an operation, in which removing breast cysts of foreign body resulted from augmentation with polyacrylamide hydrogel injection was performed simultaneously with silicone prosthesis implantation under SEPS endoscope in order to relieve tissue injury and increase the accuracy of clearance. METHODS: Eight patients were included in this study. Preoperative type B ultrasound examination was performed to mark the mass. Through an axillary approach, the cysts of foreign body that were distributed in the subcutaneous tissue, breast or muscle were separated and ablated under SEPS endoscope. After removal of the foreign body, a silicone implant was located submuscularly for breast augmentation. RESULTS: The operations were completed without hematoma and infection. Follow-up of the eight patients for 3 to 12 months showed that preoperative symptoms relating to the injected material, such as breast pain, lump and asymmetry, have no longer existed. The shapes of the breasts were satisfactory. CONCLUSIONS: We believe that endoscope-assisted mammoplasty offers more satisfactory clinical results with less injury, less morbidity, less scars, more accuracy and greater patient acceptance.

Acrylic Resins↗

[The foreign body granuloma after pyeloplasty: report of a case].

We report a rare case of foreign body granuloma on plain catgut which developed after Anderson-Hynes pyeloplasty for obstruction of the ureteropelvic junction in a 3-year-old boy. We use plain catgut as the suture material on pyeloplasty and seldom experience such a complication. Regarding suture material on pyeloplasty, excessive sutures intended to make anastomosis water-tight to prevent urinary leakage should be avoided in children because they are apt to form foreign body granuloma.

Catgut↗

Cutaneous sarcoidosis and foreign bodies.

A histopathological diagnosis of sarcoidosis is, by convention, one of exclusion and is reached only when other potential causes of granulomatous disease, such as foreign bodies, are eliminated. We report herein three cases of systemic sarcoidosis with cutaneous manifestations of the disease, in which polarizable foreign particles were associated with the granulomata in the skin. We submit (a) that a granulomatous foreign body reaction and sarcoidosis are not mutually exclusive, (b) that particulate foreign matter may actually serve as a nidus for granuloma formation in sarcoidosis, and (c) that the occasional presence of extraneous material within the granulomata of sarcoidosis requires greater recognition by pathologists.

Adult↗

[Vesicovaginal fistula associated with a vaginal foreign body: a case report].

A 14-year-old girl was referred to our hospital with severe pyuria pointed out in a school health check up. An intravenous pyelography and a cystography revealed a foreign body in the pelvic region outside the bladder and pooling of contrast medium in the vagina. Conputed tomography confirmed the foreign body in the vagina. About 1 year earlier, she inserted a hair spray can into the vagina but could not remove its cap. Under the diagnosis of vesicovaginal fistula due to vaginal foreign body, the cap was removed manually and transvaginal repair of the vesicovaginal fistula was performed under general anesthtesia, but it recurred twice. Finally, she underwent successful abdominovaginal repair of fistula. Although a variety of self-introduced objects in the vagina illegally used as a means of sexual gratification have been described, a vesicovaginal complication is very rare.

Adolescent↗

[Delayed infections after foreign body inclusion in the maxillofacial region].

Nine cases of so-called late infections following foreign body inclusions due to trauma as well as possible developmental mechanisms were discussed. The question arises as to whether a nonirritating incorporated foreign body should be surgically removed as early as possible to eliminate the possibility of late infection.

Abscess↗

Utilizing gravity in the removal of a large intraocular foreign body.

This article describes an unconventional technique for the removal of a nonmagnetic intraocular foreign body that is too large or too smooth to be grasped by intraocular forceps and does not float on perfluorocarbon liquids. By flipping the patient to a face-down position and allowing the gravitational forces to help remove the object, one can hope to avoid further ocular damage. This approach should be considered in similar cases of very large and smooth intravitreal foreign bodies to avoid severe and irreversible damage to the retina.

Adult↗

[Percutaneous removal of foreign bodies from the cardiovascular system: two experienced cases in addition to a review of 35 cases reported over the past 9 years in Japan].

From 1984 to 1992 in Japan, 37 cases, including 2 cases of our own, have been reported to involve the percutaneous removal of foreign bodies from the cardiovascular system by catheter. We reviewed the cases of these foreign bodies and the locations, approaches and types of catheters used for removal. The reported foreign bodies were usually iatrogenic in origin and were approximately two times larger than those found in patients who had self-dislodged catheters. The most common catheter approaches were from either the right femoral or saphenous veins.

Aged↗

Foreign body reaction to hemostatic materials mimicking recurrent brain tumor. Report of three cases.

Chemical agents routinely used in neurosurgery to achieve intraoperative hemostasis can cause a foreign body reaction, which appears on magnetic resonance (MR) images to be indistinguishable from recurrent tumor. Clinical and/or imaging evidence of progression of disease early after surgical resection or during aggressive treatment may actually be distinct features of granuloma in these circumstances. A series of three cases was retrospectively analyzed for clinical, imaging, surgical, and pathological findings, and the consequences they held for further disease management. All patients were boys (3, 3, and 6 years of age, respectively) and all harbored primitive neuroectodermal tumors. Two tumors were located in the posterior fossa and one was located in the right parietal lobe. Two boys exhibited clinical symptoms, which were unexpected under the circumstances and prompted new imaging studies. One patient was asymptomatic and imaging was performed at planned routine time intervals. The MR images revealed circumscribed, streaky enhancement in the resection cavity that was suggestive of recurrent disease. This occurred 2 to 7 months after the first surgery. At repeated surgery, the resected material had the macroscopic appearance of gelatin sponge in one case and firm scar tissue in the other cases. Histological analysis revealed foreign body granulomas in the resected material, with Gelfoam or Surgicel as the underlying cause. No recurrent tumor was found and the second surgery resulted in imaging-confirmed complete resection in all three patients. Because recurrent disease was absent, the patients continued to participate in their original treatment protocols. All patients remain free from disease 34, 32, and 19 months after the first operation, respectively. During or after treatment for a central nervous system neoplasm, if unexpected clinical or imaging evidence of recurrence is found, a second-look operation may be necessary to determine the true nature of the findings. If the resection yields recurrent tumor, additional appropriate oncological treatment is warranted, but if a foreign body reaction is found, potentially harmful therapy can be withheld or postponed.

Brain↗

Bamboo foreign bodies in lung parenchyma: CT features.

The computed tomography (CT) findings in two cases of posttraumatic bamboo foreign bodies imbedded for many years in lung parenchyma are presented. These foreign bodies consisted of relatively cylindrical structures of high density, and were highly suggestive of bamboo.

Accidental Falls↗