[Surgical removal of intraocular non-magnetic foreign body--foreign body endoscope and bulbotomy].
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Adult↗
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Etiological factors, stages, and the role of the foreign body in foreign body tumorigenesis: a review.
Attempts were made to analyze the process of foreign body (FB) tumorigenesis and to identify etiologically significant factors by correlating information in the literature and recent experimental data from our labroatory. It appears that the process of FB tumorigenesis is dependent on sequence of specific conditions as expressed by the following criteria: (a) cellular proliferation and tissue infiltration during acute FB reaction; (b) fibrosis of the tissue capsule surrounding the FB; (c) quiescence of the tissue reaction, i. e., dormancy and phagocytic inactivity of FB-attached macrophages; and (d) availability of a FB surface for direct contact with clonal preneoplastic cells. There is no indication that the initial acquisition of neoplastic potential and the determination of specific tumor characteristics are based on direct physical or chemical reaction between cells and the FB. These etiological key events occur presumably in mesenchymal stem cells associated with the microvasculature no later than during the acute stage of FB reaction and certainly long before clonal descendants of these cells are first found in contact with the FB surface. In fact, there is no reason to assume that cells with neoplastic determination may be present in normal tissue prior to the introduction of a FB and that the FB would only create the conditions required for stepwise preneoplastic maturation.
Animals↗
Foreign bodies.
Foreign bodies are uncommon, but they are important and interesting. Foreign bodies may be ingested, inserted into a body cavity, or deposited into the body by a traumatic or iatrogenic injury. Most ingested foreign bodies pass through the gastrointestinal tract without a problem. Most foreign bodies inserted into a body cavity cause only minor mucosal injury. However, ingested or inserted foreign bodies may cause bowel obstruction or perforation; lead to severe hemorrhage, abscess formation, or septicemia; or undergo distant embolization. Motor vehicle accidents and bullet wounds are common causes of traumatic foreign bodies. Metallic objects, except aluminum, are opaque, and most animal bones and all glass foreign bodies are opaque on radiographs. Most plastic and wooden foreign bodies (cactus thorns, splinters) and most fish bones are not opaque on radiographs. All patients should be thoroughly screened for foreign bodies before undergoing a magnetic resonance imaging study.
Diagnosis, Differential↗
Esophageal foreign bodies.
Foreign body ingestion is a common occurrence in children and in specific high-risk groups of adults such as those with underlying esophageal disease, prisoners, the mentally retarded, and those with psychiatric illnesses. Although most foreign bodies pass through the gastrointestinal tract without difficulty, sharp, pointed, and elongated foreign bodies are associated with a greater risk of perforation, vascular penetration, and other complications. Foreign body ingestion is usually diagnosed based on a history of ingestion given by the patient or an observer. However, children and impaired adults may be unable to give an accurate history, and a high index of suspicion must be maintained in these groups. Dysphagia and odynophagia are the usual symptoms of foreign body impaction in the esophagus. Respiratory symptoms due to compression of the adjacent trachea are also common in younger children and are occasionally the presenting symptom in adults. The preferred method of removal of esophageal foreign bodies is extraction with the flexible endoscope. This may be accomplished in both adults and children with the use of conscious sedation rather than general anesthesia. The availability of grasping instruments specifically designed for foreign body removal and snares greatly facilitates endoscopic extraction. An overtube conveys all of the advantages of the rigid esophagoscope to the flexible endoscope, enabling extraction of sharp and pointed foreign bodies while protecting the mucosa from injury. Adherence to the general principles of foreign body removal and proper preparation result in successful removal rates as high as 98%, with minimal or no complications. Nonendoscopic methods of removal are associated with increased risks of perforation and aspiration and generally should be avoided, with the exception of a trial of intravenous glucagon. Surgical removal is rarely indicated except in the event of perforation or other foreign body complications.
Esophagoscopy↗
Management of subglottic foreign bodies.
Foreign body aspiration is not an infrequent encounter in the practice of otolaryngology and requires immediate attention. The vast majority of foreign body aspirations occur in children less than 3 years of age, and the actual event of aspiration is frequently not witnessed. Although inhaled foreign bodies most often lodge in the bronchi, laryngotracheal foreign bodies also occur and are potentially more dangerous. Specifically, subglottic foreign bodies present unique clinical challenges. The diagnosis of subglottic foreign bodies is often difficult and they are commonly confused with other causes of upper airway obstruction. We present our experience with the diagnosis and management of seven patients with subglottic foreign bodies, who presented with an abnormal airway and whose problems were initially misdiagnosed. The radiographic and clinical features are discussed with a review of our surgical management.
Child↗
The role of CT imaging in the evaluation of cervical esophageal foreign bodies.
Foreign bodies in the hypopharynx and cervical esophagus, such as chicken and fish bones, occur frequently and usually need radiologic work-up in order to demonstrate the presence of the foreign body and its location. Plain antero-posterior and lateral X-ray views of the neck, and if needed, a barium swallow, are the standard. When these studies fail to show the foreign body, unenhanced CT may demonstrate these small calcified esophageal foreign bodies. We evaluated 13 patients with cervical esophageal foreign bodies by CT. It is readily available and rapid and exposes the patient to less radiation than a barium swallow. CT evaluation with soft tissue and bone windows may replace the barium swallow because of its better detection of thin, small, minimally calcified foreign bodies which are often obscured by overlying tissues in the usual X-ray studies.
Adolescent↗
Endoscopic transnasal management of intracranial foreign bodies.
Foreign bodies may be introduced into the paranasal sinuses or cranium through a variety of traumatic or iatrogenic events. A variety of open and, more recently, endoscopic approaches have been used for the removal of sinonasal foreign bodies. Intracranial foreign bodies, however, typically require retrieval via a craniotomy approach, which continues to carry significant perioperative risks. We describe the first reported case of an intracranial foreign body removed using the transnasal endoscopic approach with intraoperative image guidance. We discuss the preoperative evaluation required for this approach to be applied safely and successfully in properly selected cases.
Adult↗
Soft tissue foreign bodies.
Foreign bodies embedded in soft tissue can cause toxic and allergic reactions, inflammation, or infection, but the severity of these complications varies widely. Removal can be difficult and time consuming, and the potential damage to tissues caused by the procedure must be weighed against the risk posed by a particular foreign body. Plain and mammographic radiography, xeroradiography, computed tomography, and ultrasonography can be used to detect foreign bodies suspected during clinical evaluation. The exact position of an object buried in soft tissue is difficult to determine using two-dimensional imaging techniques. Surface markers, multiple-projection radiographs, wire grids, fluoroscopy, or stereotaxic devices may help to locate it. Not all foreign bodies are discovered during the initial patient encounter; several signs reveal the presence of a retained foreign body in a wound.
Foreign Bodies↗
[Compulsive swallowing of foreign bodies. Esophageal foreign body].
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Adult↗
Image-guided removal of foreign bodies.
Foreign bodies are common in the head and face. We investigated the use of image-guided navigation systems for the removal of foreign bodies in 10 patients between 1998 and 2004. In all cases foreign bodies were retrieved. There were no major complications. Image-guided removal of foreign bodies is safe and valuable.
Adolescent↗
Hypopharyngeal and oesophageal foreign bodies.
Foreign bodies in the food passages are quite common in Jos Community. Majority of 119 cases seen over a period of four years were children 92.4% and a coin was the commonest foreign body (86.5%). The site of lodgement of the foreign body was hypopharynx and abdomen in 11 cases each while 97 were held in oesophagus, mainly in its upper part. Removal of the foreign body by oesophagoscopy was difficult in patients who presented late. The coins formed a pouch in posterior oesophageal wall in six cases while their anterior surfaces got discoloured in 14 cases causing difficulty in their identification. Besides coins in children and dentures in adults, nine patients accidently swallowed a wide variety of foreign objects of different shapes and sizes. Management of such cases has been discussed.
Adult↗
Rectovulvar fistula in a child secondary to an unusual foreign body.
Foreign bodies in the female genital tract are well recognized as a cause of pain, discharge, secretions, and infection. In the small child, the presence of a vaginal discharge is usually associated with either a common object which has been inserted or sexual abuse complicated by a sexually transmitted disease. A 3-year-old child presented with a recurrent labial secretion and drainage due to an unusual foreign body. It was only during a second operation that the possibility of a foreign body was entertained, and diagnostic testing was begun. A third operation permitted removal of the foreign body, a large bone probably of animal origin. The fistula tract was closed after a colostomy was performed. This represents the first reported case of a rectovulvar fistula not of a congenital nature.
Bone and Bones↗
An unusual case of intraparotid foreign body.
Foreign bodies in salivary glands are an unusual event; foreign bodies simulating parotid tumors are an exceptional finding. A posttraumatic case of intraparotid foreign body and a brief literature review are presented.
Adult↗
Intraoperative imaging techniques: a guide to retrieval of foreign bodies.
Foreign bodies are frequently introduced into the tissues of the head and neck by various mechanisms, and oral and maxillofacial surgeons are often called upon to retrieve these embedded objects. Retrieval may be quite challenging depending on many factors such as the size of the object, the location, and the surrounding anatomical structures. Preoperative imaging is very important in deciding upon the surgical approach. Computerized tomography is considered the gold standard for detection of foreign bodies because of the ability to localize an object in multiple planes and the creation of a 3-dimensional image. Difficulty arises when looking for a small object in an area with multiple important anatomical structures, such as the infratemporal fossa or the neck. Surgery can become tedious secondary to the risk of postoperative morbidity with injury to various anatomical structures. Foreign bodies in the head and neck are often difficult to manage even when a plan has been formulated from static preoperative images. Intraoperative feedback or guidance, especially when navigating through troublesome locations, can be extremely useful. In this paper, we report 2 cases and discuss the various modalities used for intraoperative imaging as a guide for surgical retrieval of foreign bodies.
Adult↗
Cockroach in right main bronchus--an unusual foreign body.
Foreign body aspiration in children is not a uncommon clinical problem. Usually the foreign body is of vegetable origin. It is distinctly uncommon to find a living organism like cockroach, especially a large one as a foreign body in respiratory tract. Here we report one such rare experience.
Animals↗
Infected granuloma and inclusion cyst secondary to a retained foreign body.
Foreign body granuloma formation and epidermal inclusion cyst formation are a common result of retained foreign bodies. The subsequent rupture of an inclusion cyst will result in abscess formation along with ulceration. The following is a review of pathology involved in granuloma formation, as well as a presentation of an interesting case involving granuloma formation secondary to a retained foreign body.
Adult↗
Gastric perforation secondary to ingestion of a sharp foreign body.
Foreign body ingestions are commonly seen by pediatricians and emergency room personnel. The majority of foreign bodies transit through the gastrointestinal system without any complications. Perforations are uncommon and usually involve peritonitis. We present a case of gastric perforation secondary to ingestion of a sharp metallic pin. Our patient did not demonstrate any of the classic findings described in the literature. His complaints, physical examination, and radiological findings all pointed to acalculous cholecystitis or biliary dyskinesia as the source of pain. Laparoscopy, however, provided the definitive diagnosis. Gastroduodenal perforation secondary to foreign body ingestion should be included in the differential diagnosis of these atypical cases of abdominal pain, especially if such history can be elicited from the patient.
Adult↗
Unusual complication of ingestion of a foreign body.
Foreign bodies of the upper aerodigestive tract are common problems dealt with by the otolaryngologist. Among all foreign bodies in the oesophagus, an open safety pin still presents a challenge for the ENT specialists because of its propensity to pierce the oesophagus and surrounding structures. We present an interesting case of a long-standing foreign body i.e. an open safety pin, which, after piercing the hypopharynx, caused fatal common carotid artery rupture.
Adult↗