201
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Dumberger LD, Chao TN. Transoral management of pharyngeal ballistics. Am J Otolaryngol 2022; 43:103490. [PMID: 35570132 DOI: 10.1016/j.amjoto.2022.103490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To present a case of a ballistic foreign body in the pharynx after a gunshot wound to the maxillofacial area, an accompanying review of relevant literature, and our approach to management. METHOD A 68-year-old male with no prior medical history presented to our trauma center with gunshot wounds to the left chin, left wrist, right chest, and sternum. A CT Angiogram of the neck revealed a bullet fragment left neck and additional fragment adjacent to the L hypopharynx at the level of the hyoid. The patient was taken to the operating room for direct laryngoscopy with foreign body removal and esophagoscopy. RESULTS We document our workup and successful surgical removal of the pharyngeal ballistic foreign body via our video abstract, compiling preoperative imaging, intraoperative imaging, and video. Literature review of the subject accompanying our video abstract highlights the extensive complications that can occur from a retained foreign body in this area, supporting surgical removal of the foreign body if safely possible. CONCLUSION Given the demonstrated feasibility and success of endoscopic foreign body removal from the pharyngoepiglottic space, in addition to overwhelming support for removal in the literature we recommend surgical extraction of ballistic foreign bodies located in the upper aerodigestive tract in stable patients to avoid early and long-term complications that can impact swallowing function, airway stability and the vital structures contained within the neck.
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Affiliation(s)
- Lukas D Dumberger
- Department of Otolaryngology-Head and Neck Surgery at the University of Pennsylvania, United States of America.
| | - Tiffany Ng Chao
- Department of Otolaryngology-Head and Neck Surgery at the University of Pennsylvania, United States of America
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202
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Subspecialty Group of Gastroenterology, the Society of Pediatrics, Chinese Medical Association, Editorial Board, Chinese Jouranl of Pediatrics. [Expert consensus on diagnosis, management and endoscopic treatment of aerodigestive tract foreign bodies in Chinese children]. Zhonghua Er Ke Za Zhi 2022; 60:401-7. [PMID: 35488632 DOI: 10.3760/cma.j.cn112140-20211227-01081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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203
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Kehagias D, Mulita F, Maroulis I, Benetatos N. Caudate lobe: the last barrier - an unusual place for a foreign body. ANZ J Surg 2022; 92:1218-1220. [PMID: 34550639 DOI: 10.1111/ans.17226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Dimitrios Kehagias
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
| | - Francesk Mulita
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
| | - Ioannis Maroulis
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
| | - Nikolaos Benetatos
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
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204
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Eliçora A, Sezer HF, Abdullayev G, Avcı A, Topçu S. Accidental Foreign Body Aspiration Through Tracheostomy Inlet; 26 cases. Arch Iran Med 2022; 25:308-313. [PMID: 35943006 DOI: 10.34172/aim.2022.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/12/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Foreign body aspiration from tracheostomy is very rare, and materials related to tracheostomy are usually aspirated. This condition, which can lead to serious complications, can be treated using bronchoscopic procedures. In this study, we aimed to present our clinical experience in foreign body aspiration via tracheostomy. METHODS Data from 26 patients who presented to our hospital for foreign body aspiration via tracheostomy from 2006 to 2020 were analyzed retrospectively. RESULTS Foreign bodies were removed by fiber optic bronchoscopy in 15 (57.7%) cases, by rigid bronchoscopy in 9 (34.6%) cases and both methods were used in 2 (7.7%) cases. During bronchoscopy, local anesthetic procedures were used in 13 (50%) cases and general anesthesia was used in 11 (42.3%) cases. No anesthesia was used in two (7.7%) patients who underwent bronchoscopy under intensive care conditions. While the mean operative time for flexible bronchoscopy was 8.77±0.83 (CI: 26.03-29.43) minutes, the mean operative time for rigid bronchoscopy was 27.73±2.53 (CI: 26.03-29.43) minutes. CONCLUSION Both rigid bronchoscopy and fiberoptic bronchoscopy (FOB) have advantages and disadvantages in foreign body removal. In our opinion, it is more reasonable to perform fiber optic bronchoscopy first in patients with a tracheostoma. In the light of our experiences, fiber optic bronchoscopy does not require general anesthesia and the operation time is shorter than rigid bronchoscopy. This feature makes fiber optic bronchoscopy advantageous.
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Affiliation(s)
- Aykut Eliçora
- Department of Thoracic Surgery, Faculty of Medicine,Kocaeli University, Kocaeli, Turkey
| | - Hüseyin Fatih Sezer
- Department of Thoracic Surgery, Faculty of Medicine,Kocaeli University, Kocaeli, Turkey
| | - Galbinur Abdullayev
- Department of Thoracic Surgery, Faculty of Medicine,Kocaeli University, Kocaeli, Turkey
| | - Adil Avcı
- Department of Thoracic Surgery, Kocaeli State Hospital, Kocaeli, Turkey
| | - Salih Topçu
- Department of Thoracic Surgery, Faculty of Medicine,Kocaeli University, Kocaeli, Turkey
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205
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Items Commonly Retained After a Surgical Procedure. AORN J 2022; 115:P19. [PMID: 35476196 DOI: 10.1002/aorn.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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206
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Mohamed Awang K, Abdullah SN, Mohamad I. Reprint of: Fishhook removal from the pinna of the ear. Dis Mon 2022; 68:101394. [PMID: 35489829 DOI: 10.1016/j.disamonth.2022.101394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Kamariah Mohamed Awang
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Siti Nazira Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Irfan Mohamad
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia.
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207
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Dai ZZ, Sha L, Zhang ZM, Li H, Li H. Arthroscopic retrieval of knee foreign bodies in pediatric: a single-centre experience. Int Orthop 2022; 46:1591-1596. [PMID: 35471609 DOI: 10.1007/s00264-022-05410-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/15/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The present study was to investigate the clinical features of foreign body (FB) residues in children's knee joints, surgical retrieval, and postoperative function of knee joints. METHODS This retrospective study included a total of 13 children (8 boys and 5 girls; the mean age is 6.69 years old, range from 2 to 16 years old) who underwent retrieval surgery of knee FBs in our hospital. Related clinical factors were recorded and analyzed to find the influence factors of surgical methods and FBs' location change. RESULTS The FBs in 11 cases were removed completely by arthroscopy, two cases by open surgery changed from arthroscopy. Besides glass pieces (n = 4, 31%) and wooden splinter (n = 1, 7%), sewing needle fragments were the most common type of knee foreign body (n = 8, 62%). There were two patients with FBs whom open surgery changed from arthroscopy was performed. The FBs of patients with open surgery changed from arthroscopy were more likely to locate in the posterior compartment (p = 0.04), and had a higher interval between injury and surgery than that in patients with arthroscopy (p = 0.01). The location of FBs (all were needle fragments) had changed intra-operatively in three patients, whose mean weight was lower than patients with fixed FBs (p = 0.04). The FB (small glass piece) of one patient was flushed out of the joint during arthroscopy. CONCLUSION Arthroscopic retrieval surgery was an effective procedure to remove the FBs of the children's knee joint. The earlier it is detected, the easier it is to be treated. The location change of FBs should be cautioned in arthroscopic surgery and they are more likely to migrate into the posterior compartment of the knee joint.
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Affiliation(s)
- Zhen-Zhen Dai
- Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu District, 1665 Kongjiang Road, Shanghai, China
| | - Lin Sha
- Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu District, 1665 Kongjiang Road, Shanghai, China
| | - Zi-Ming Zhang
- Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu District, 1665 Kongjiang Road, Shanghai, China
| | - Hao Li
- Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu District, 1665 Kongjiang Road, Shanghai, China
| | - Hai Li
- Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Yangpu District, 1665 Kongjiang Road, Shanghai, China.
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208
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Visser PCJ, Vink MA, Patterson MS, Yazdanbakhsh A, Arlan F, Kuipers RS. Cardiac arrest resulting from an unidentified foreign object, later identified as a balloon cover, within the left anterior descending coronary artery. BMJ Case Rep 2022; 15:e244786. [PMID: 35428662 PMCID: PMC9013957 DOI: 10.1136/bcr-2021-244786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/04/2022] Open
Abstract
A 31-year-old man with a history of hypertrophic cardiomyopathy and alcohol septal ablation one week before was presented after an out of hospital cardiac arrest in the setting of an anterior wall ST-elevation myocardial infarction. Immediate coronary angiography showed an unidentified foreign object within the left anterior descending coronary artery (LAD), later identified as the cover of a balloon that had been unintentionally inserted and abandoned within the LAD during the alcohol septum ablation one week earlier. Intracoronary imaging confirmed the presence of endothelial damage and thrombus formation within the LAD explaining acute myocardial infarction. The patient was treated by surgical retrieval of the balloon cover, extended septal myectomy and coronary artery bypass grafting (CABG) of the LAD. This case is both an example of unintentional neglect of unexpected objects, and the importance of multimodality imaging and multidisciplinary teamwork to get to a correct diagnosis and treatment.
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Affiliation(s)
| | - Maarten A Vink
- Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Mark S Patterson
- Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Aria Yazdanbakhsh
- Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, Noord-Holland, Netherlands
| | - Fatih Arlan
- Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, Utrecht, Netherlands
| | - Remko S Kuipers
- Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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209
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Adhikari A, Mahato NB, Khatri B. Surgical Removal of a Long-Standing Impacted Firearm in Neck: A Case Report. JNMA J Nepal Med Assoc 2022; 60:406-409. [PMID: 35633216 PMCID: PMC9252242 DOI: 10.31729/jnma.7327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/13/2022] [Indexed: 11/01/2022] Open
Abstract
The gunshot neck injury is an emergency and must be addressed immediately. However, as our case report, a long-standing retained foreign body (firearm) in the deep neck is rare. Surgical removal of a long-standing foreign body is challenging for the operating surgeon. A 36-year-old male with a history of a firearm injury to the neck dating 16 years back with complaints of recent onset of pain was evaluated. A computed tomography scan of the neck showed a metallic foreign body located in close proximity to the right common carotid artery. Neck exploration was performed under general anaesthesia, and the foreign body was removed without complications. The patient has recovered following the intervention and has resumed his normal activities. The use of methylene blue helps to locate the foreign body during surgery. However, the choice of intervention for a stable patient with a penetrating neck injury remains based on cases.
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Affiliation(s)
- Arun Adhikari
- Kantipur Hospital, Tinkune, Kathmandu, Nepal
- Correspondence: Dr Arun Adhikari, B.P. Eye Foundation, Hospital for Children, Eye, ENT and Rehabilitation Services, Lokanthali, Bhaktapur, Nepal. , Phone: +977-9851194898
| | | | - Bijay Khatri
- B.P. Eye Foundation, Hospital for Children, Eye, ENT and Rehabilitation Services, Lokanthali, Bhaktapur, Nepal
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210
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Dulal M, Tripathi P, Shrestha A, Acharya K, Niroula S. Aspiration of a Row of Artificial Dentures in an Adult: A Case Report. JNMA J Nepal Med Assoc 2022; 60:410-412. [PMID: 35633218 PMCID: PMC9252251 DOI: 10.31729/jnma.7314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/13/2022] [Indexed: 11/01/2022] Open
Abstract
Clinical findings of foreign body aspiration, generally, are subtle. Scrutinous clinical suspicion is always recommended. Here, we present a rare case of an adult male, who under the influence of alcohol had aspirated a row of his artificial denture without his conscience of where his denture got missing and presented to our outpatient department with non-specific symptoms. With clinical examination and advanced diagnostics, he was successfully managed with rigid bronchoscopy. With the advancement in diagnostic techniques and our widened knowledge of the condition, utmost early detection has been possible and our case report reinforces the need for a low threshold for foreign body aspiration suspicion, especially in adults with dentures, and the use of rigid bronchoscopy as a plausible tool for the prompt management of the aspiration.
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Affiliation(s)
- Malati Dulal
- Department of Ear, Nose, Throat-Head and Neck Surgery, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Prashant Tripathi
- Department of Ear, Nose, Throat-Head and Neck Surgery, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Amit Shrestha
- Department of Anesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
- Correspondence: Dr Amit Shrestha, Department of Anesthesiology, Tribhuvan University Teaching Hospital, Maharajganj, Kathmandu, Nepal. , Phone: +977-9849215189
| | - Kunjan Acharya
- Department of Ear, Nose, Throat-Head and Neck Surgery, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Sailesh Niroula
- Department of Anesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
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211
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Bruwier A, Fouhety A, Boursier JF, Leperlier D, Bedu AS. Ultrasonographic and computed tomographic features of a true gastro-gastric intussusception with concurrent foreign bodies in a dog. Can Vet J 2022; 63:407-410. [PMID: 35368404 PMCID: PMC8922379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 2-year-old intact male Cane Corso dog was presented for acute weakness, vomiting, and diarrhea. Abdominal ultrasound revealed the stomach had severe wall edema and a target appearance. Computed tomography was consistent with a gastro-gastric intussusception and concurrent mineral-like gastric foreign bodies. After reduction of the intussusception, bilateral incisional gastropexy was performed to prevent recurrence. True gastrogastric intussusception is a rare condition and should be considered if the stomach has severe wall edema with a target sign on abdominal ultrasound. Computed tomography was useful to confirm this rare diagnosis and screen the entire abdomen for concurrent lesions. Key clinical message: This case highlights the usefulness of a CT examination to confirm this rare diagnosis, to determine the position of gastric compartments, and to detect potential concurrent lesions prior to surgery.
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Affiliation(s)
- Aurélie Bruwier
- Centre Hospitalier Vétérinaire Pommery, 226 bd Pommery, 51100 REIMS, France
| | - Aurore Fouhety
- Centre Hospitalier Vétérinaire Pommery, 226 bd Pommery, 51100 REIMS, France
| | | | - Dimitri Leperlier
- Centre Hospitalier Vétérinaire Pommery, 226 bd Pommery, 51100 REIMS, France
| | - Anne-Sophie Bedu
- Centre Hospitalier Vétérinaire Pommery, 226 bd Pommery, 51100 REIMS, France
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212
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Abstract
OBJECTIVE To evaluate the clinical features and outcome in girls with a vaginal foreign body. METHODS The clinical data of 97 girls with a vaginal foreign body were collected between 2010 and 2020. The descriptive analysis was used to summarize the clinical characteristics. RESULTS The patients were aged between 1.5 and 14.8 years, and the age of peak incidence was shown to be 3-10 years, which accounted for 88% of the cases. Blood-stained vaginal discharge or vaginal bleeding was the most common symptom (48%). The most common foreign bodies were small hard objects (57%), followed by bits of cloth or toilet tissue (22%). The patient whose foreign object was a disk battery had the most severe symptoms. When an injury of the vaginal mucosal was suspected, antibiotics were used to prevent infection, with full recovery of all patients without any additional treatment after removal of the foreign object. CONCLUSION If there is no damage to the vaginal mucosa, no additional treatment is needed after the foreign body is removed. When a vaginal foreign body is suspected to be a battery, emergency surgery is needed to prevent further damage.
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Affiliation(s)
- Wei Ma
- Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China
| | - Yi-Fan Sun
- Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China
| | - Jun-Hong Liu
- Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
- Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China.
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China.
| | - Da-Wei He
- Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Tao Lin
- Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Guang-Hui Wei
- Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
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213
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Ambikkumar A, Arthurs B, El-Hadad C. Corneal foreign bodies. CMAJ 2022; 194:E419. [PMID: 35314442 PMCID: PMC9053958 DOI: 10.1503/cmaj.211624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Athithan Ambikkumar
- Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, Que
| | - Bryan Arthurs
- Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, Que
| | - Christian El-Hadad
- Department of Ophthalmology and Visual Sciences, McGill University Faculty of Medicine, Montréal, Que.
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214
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Samia-Aly E, Mellington F. Topical silicone gel mistaken for a retained orbital foreign body on MRI. BMJ Case Rep 2022; 15:e248103. [PMID: 35256371 PMCID: PMC8905986 DOI: 10.1136/bcr-2021-248103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/04/2022] Open
Abstract
MRI is now a well-regarded imaging technique, but due to its use of strong magnetic fields, some metallic objects are contraindicated. We present a case of a man in his 40s with thyroid eye disease, who underwent bilateral orbital decompression. Following surgery, he was advised to start scar massage with topical silicone gel (Dermatix). He later underwent an MRI head scan which was halted due to concerns of a retained metallic foreign body. Topical silicone gel is widely used clinically for scar management. Due to its properties, it can cause the appearance of an artefact on MRI and be mistaken for a metallic foreign body. We present the first case to our knowledge of an MRI susceptibility artefact which was attributed to topical silicone gel and describe the diagnostic confusion it caused. We recommend asking patients to wash off any topical silicone gel before having an MRI scan.
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215
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Jeyabalan K, Alaga A. Not all wheeze is asthma: A case of central airway foreign body mimicking asthma. Med J Malaysia 2022; 77:246-248. [PMID: 35338636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Foreign body aspirations are more commonly seen in the paediatric age as compared to adults. This is more widely seen in the older population due to the impairment of protective airway mechanisms or the absence of the swallowing reflex, for instance, in neurological diseases, head trauma, alcohol intoxication, sedation, or complications from dental manipulation. We report the case of a betel nut causing airway obstruction in an elderly lady, which was treated multiple times as respiratory tract infection and asthma. Subsequently, a bronchoscopy was performed. Following which, the betel nut was removed causing resolution of symptoms.
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Affiliation(s)
- K Jeyabalan
- Hospital Sultanah Bahiyah, Jalan Langgar, Alor Setar, Malaysia
| | - A Alaga
- Hospital Sultanah Bahiyah, Jalan Langgar, Alor Setar, Malaysia.
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216
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Zhou S, Qian Z, Qiang F, Qiao Z. A case of foreign body in digestive tract punctured into the liver. Asian J Surg 2022; 45:1439-1440. [PMID: 35232652 DOI: 10.1016/j.asjsur.2022.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/15/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Shuaiyang Zhou
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Zhenghai Qian
- Department of General Surgery, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Feng Qiang
- Department of Gastroenterology, Huzhou First People's Hospital, Huzhou, China.
| | - Zhenguo Qiao
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China.
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217
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Zhuang W, Wei P, Qiao G. Quadriplegia After Removal of an Accidentally Ingested Chicken Bone. Gastroenterology 2022; 162:e11-e13. [PMID: 34146568 DOI: 10.1053/j.gastro.2021.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/07/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Weitao Zhuang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Shantou University Medical College, Shantou, China
| | - Peijian Wei
- Shantou University Medical College, Shantou, China; Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guibin Qiao
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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218
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Malik R, Leviter J, Gross I, Saluja S, Cowles RA, Riera A. Point-of-Care Ultrasound to Evaluate the Acute Abdomen: A Case of Bowel Perforation After Unknown Single Magnet Ingestion. Pediatr Emerg Care 2022; 38:e1022-e1024. [PMID: 34116554 DOI: 10.1097/pec.0000000000002460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We report the case of a 3-year-old boy who presented to the pediatric emergency department in undifferentiated shock with an acute abdomen. Point-of-care ultrasound revealed viscous perforation with a large amount of free fluid. Intraoperatively, a single magnet was discovered as the likely cause of bowel perforation and the resulting state of shock.
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Affiliation(s)
- Rabia Malik
- From the Section of Pediatric Emergency Medicine, Department of Pediatrics
| | - Julie Leviter
- From the Section of Pediatric Emergency Medicine, Department of Pediatrics
| | - Isabel Gross
- From the Section of Pediatric Emergency Medicine, Department of Pediatrics
| | - Saurabh Saluja
- Division of Pediatric Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Robert A Cowles
- Division of Pediatric Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT
| | - Antonio Riera
- From the Section of Pediatric Emergency Medicine, Department of Pediatrics
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219
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Paap MK, Leuin S, Carvalho D. Pediatric Foreign Body Aspiration: Time of Occurrence and Factors Affecting Outcomes. Pediatr Emerg Care 2022; 38:e958-e960. [PMID: 34282090 DOI: 10.1097/pec.0000000000002503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The goal of this study was to assess which factors could affect outcomes in pediatric patients undergoing bronchoscopy for foreign body aspiration (FBA). METHODS This is a retrospective case series study evaluating patients who underwent bronchoscopies because of FBA at a tertiary pediatric hospital between January 1, 2010, and December 6. 2018. Data collected included demographic information, time of the aspiration event, history of developmental delay, time of the procedure, duration of the procedure, and outcome (discharged, admission to the hospital or pediatric intensive care unit [PICU], or deceased). Statistical analysis was performed using standard regression analysis and analysis of variance. RESULTS There were a total of 114 patients who underwent bronchoscopy for FBA (61% male and 39% female). The mean ± SD age was 2.8 ± 3.4 years, and 16% had developmental delay. The mean age for patients with developmental delay was 3.43 years, compared with 1.69 years for patients without developmental delay. The age difference between these 2 groups was statistically significant (P = 0.0047). The most commonly aspirated object was food (57%), and patients were usually with their parents at the time of aspiration (78%). Most aspiration events (57%) happened between 4 pm to 4 am. The mean ± SD time of procedure was 38 ± 28 minutes. The probability of admission to the hospital, PICU, and death increased with the duration of the procedure (P < 0.001). Patients with procedures longer than 60 minutes had a 40% probability of admission to the PICU, and patients with cases longer than 120 minutes had 13% probability of mortality. CONCLUSIONS Most FBA s occurred in the evening while the children were with their parents. Education of families regarding the risk of aspiration is crucial, so they are always attentive to this issue. Although the focus on prevention tends to be with younger patients, it is essential to emphasize the risk of FBA in older patients with developmental delay. Because most episodes of aspiration occur later in the day, it is imperative that tertiary pediatric centers ensure that the evening staff is trained and have the available equipment for these complex cases.
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Affiliation(s)
- Michael K Paap
- From the University of California, San Diego School of Medicine, La Jolla, CA
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220
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Guideline Quick View: Retained Surgical Items. AORN J 2022; 115:197-202. [PMID: 35084752 DOI: 10.1002/aorn.13632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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221
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Liao F, Zhu Z, Pan X, Li B, Zhu Y, Chen Y, Shu X. Safety and Efficacy of Nonoperative Treatment in Esophageal Perforation Caused by Foreign Bodies. Clin Transl Gastroenterol 2022; 13:e00451. [PMID: 35060929 PMCID: PMC8806378 DOI: 10.14309/ctg.0000000000000451] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Esophageal foreign bodies are often treated by endoscopy, but the treatment of esophageal perforation caused by foreign bodies remains controversial. The purpose of this study was to investigate the safety and efficacy of nonoperative treatment of esophageal perforation caused by foreign bodies. METHODS We retrospectively analyzed 270 patients admitted to our hospital for esophageal perforation caused by foreign bodies from January 2012 to December 2020, all of whom received nonoperative treatment. RESULTS The mean age of the patients was 56 ± 17 years, and fish bones were the most common type of foreign body. A total of 61.2% of the perforations were in the cervical esophagus. All patients received nonoperative treatment initially, and the foreign body removal rate using endoscopy reached 97%. The perforation healing rate reached 94.8%, whereas 3 patients (1.1%) died during hospitalization. The median (range) duration of hospitalization was 4 days (3-6). Multivariable analysis showed age ≥ 66 years (odds ratio [OR]: 2.196; 95% confidence interval [CI]: 1.232-3.916; P = 0.008), men (OR: 1.934; 95% CI: 1.152-3.246; P = 0.013), and time to treatment (OR: 1.126; 95% CI: 1.027-1.233; P = 0.011) were independent risk factors for infection, whereas the risk of infection was lower when the foreign body type was fish bone (OR: 0.557; 95% CI: 0.330-0.940; P = 0.028). DISCUSSION Nonoperative treatment is safe and effective for esophageal perforation caused by foreign bodies. Even if perforation is combined with infection, active nonoperative treatment can still achieve a good effect. Early intervention can effectively reduce the risk of infection and improve patient outcomes.
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Affiliation(s)
- Foqiang Liao
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhenhua Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaolin Pan
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Bimin Li
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yin Zhu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Youxiang Chen
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xu Shu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Human Genetic Resources Center, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Chandran V, Bansal S, Sahu RN. Penetrating Head Injury to Intact Skull with a Ball Point Pen: A Rare Case. Neurol India 2022; 70:466. [PMID: 35263955 DOI: 10.4103/0028-3886.338638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Vipin Chandran
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Sumit Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Rabi Narayan Sahu
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
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223
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Maqueda Vocos M, Bonanno NA, Blas L, Villasante N. Open surgery for urethral foreign body. Medicina (B Aires) 2022; 82:791-793. [PMID: 36220042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
The introduction of foreign bodies in the urethra are uncommon. Given its rarity, the approach to this condition is not standardized but it is highlighted that minimally invasive procedures should be prioritized depending on its feasibility. In the present study, we report a case of a 60-year-old male patient with bipolar disorder and a foreign body impacted in the bulbar urethra with open surgical resolution after a failed endoscopic treatment. We perform an analysis into the diagnostic and therapeutic methods used, with postoperative results.
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Affiliation(s)
| | - Nicolás A Bonanno
- Departamento de Urología, Hospital Alemán de Buenos Aires, Argentina
| | - Leandro Blas
- Departamento de Urología, Hospital Alemán de Buenos Aires, Argentina
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Volpi A, Laforgia R, Panebianco A, Paterno A, Lozito C, Punzo C, Mancarella R, Marzaioli R, De Giorgi C, L'Episcopia G, Rizzi A, Della Porta M, Tomasicchio G, Pezzolla A. 201 cases of foreign body ingestion in a Surgical Emergency Unit A 16-year retrospective study. Ann Ital Chir 2022; 92:9-15. [PMID: 35124664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM The aim of this study is to analyse clinical characteristics of FB ingestion and predictive factors for complications, in order to reduce mortality and morbidity. MATERIALS AND METHODS A retrospective study of emergency surgical consultation records has been carried out from June 2005 through June 2015 yielded 201 episodes with the diagnosis of ingestion of foreign objects at the Surgical Unit of the University of Bari. RESULTS Natural Removal in 44,8% of cases; Endoscopic retrieval in 42,4%, Surgical Procedures 4,4%. Statistical analysis was based on multivariate analysis and the model R2 of the Naegelkerke value. DISCUSSION First of all, the approach to ingestion should be endoscopic. The second approach is surgical in selected cases. The most frequent site of impaction were oesophagus, stomach and right colon. An EGD proved to be the most used procedure with a no morbidity and no mortality. CONCLUSION The ingestion of foreign bodies is a frequent, complex and expensive condition to treat. Observation and endoscopy are the most appropriate procedures to be considered to manage the ingestion of FB in Emergency Surgery Unit. KEY WORDS Emergency surgery, Foreign bodies, Ingestion.
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225
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Alhusban W, Aljfout Q, Alsardia Y, Tawalbeh N, Aboroman M, Abu-ain A. Endoscopic removal of a bullet from the parapharyngeal space just anterior-lateral to the first vertebral body: case report. Pan Afr Med J 2022; 42:132. [PMID: 36060842 PMCID: PMC9429984 DOI: 10.11604/pamj.2022.42.132.33344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022] Open
Abstract
In all head and neck bullet injuries, treatment has to be individualized, as there is no universal protocol for all cases. Five important steps of management should be taken: securing airways, hemorrhage control, recognizing other injuries, foreign body removal when necessary, and repair of facial wounds. In this report, the case of a 28-year-old male patient will be presented and discussed. The patient was referred from a surgery clinic to an ear, nose and throat (ENT) outpatient clinic complaining of right neck pain, throat pain, and foreign body sensation in the throat for 2 months following a firearm injury to his face. The entry wound was observed on the left alar cartilage of his nose, which was almost healed and had left a scar. A sinus computed tomography scan showed a bullet in the right parapharyngeal space about 3 mm in front of the first vertebral body. The bullet was successfully removed using a trans-nasal endoscopic approach with the support of an image-guided navigational system and frequent fluoroscopy. These 2 methods help to replace the old traditional open approaches.
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Affiliation(s)
- Wardeh Alhusban
- Department of Otolaryngology, Royal Medical Services, King Hussein Medical Centre, Amman, Jordan
- Corresponding author: Wardeh Alhusban, Department of Otolaryngology, Royal Medical Services, King Hussein Medical Centre, Amman, Jordan.
| | - Qais Aljfout
- Department of Otolaryngology, Royal Medical Services, King Hussein Medical Centre, Amman, Jordan
| | - Yousef Alsardia
- Department of Otolaryngology, Royal Medical Services, King Hussein Medical Centre, Amman, Jordan
| | - Nabeela Tawalbeh
- Department of Otolaryngology, Royal Medical Services, King Hussein Medical Centre, Amman, Jordan
| | - Mohammad Aboroman
- Department of Otolaryngology, Royal Medical Services, King Hussein Medical Centre, Amman, Jordan
| | - Amer Abu-ain
- Department of Otolaryngology, Royal Medical Services, King Hussein Medical Centre, Amman, Jordan
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226
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Stanishevsky AV, Aliev ZS, Gizatullin SK, Rafaelyan AA, Svistov DV, Gavrilov GV, Onnitsev IE. [Metallic foreign bodies of brain ventricles]. Zh Vopr Neirokhir Im N N Burdenko 2022; 86:25-35. [PMID: 36534621 DOI: 10.17116/neiro20228606125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Head injuries are often associated with intracranial foreign bodies that require decision making on the need for certain surgical treatment. Intraventricular foreign bodies are rare, so the question of surgical tactics is still open. OBJECTIVE To summarize the experience of treating the wounded with intraventricular foreign bodies. MATERIAL AND METHODS Treatment outcomes in victims with foreign bodies in lateral ventricles are presented. Searching in the e-Library, PubMed, Google Scholar databases included the following keywords: «penetrating wounds», «foreign bodies», «cerebral ventricles», «gunshot injury», «ventricular foreign bodies». We analyzed data on the treatment of victims with intraventricular foreign bodies. RESULTS Three victims underwent surgery, and foreign bodies were removed from the occipital horn of the lateral ventricle, third ventricle and temporal horn of the lateral ventricle. Conservative approach was preferred in 1 case. Follow-up ranged from 1 month to 7 years, GOS score - 3-4 points. Disability was due to severe injury and not associated with surgical treatment per se. We found 16 publications matching the searching criteria. Treatment methods varied from standard surgical approaches to stereotactic management. The indication for removal of foreign bodies was their migration through the ventricular system and occlusive hydrocephalus. None patient had neurological aggravation. CONCLUSION Intraventricular foreign bodies are rare and present certain difficulties in choosing the method and timing of treatment. Indications for their removal are migration, occlusive hydrocephalus and infectious complications. The method of removal is determined depending on location, magnetic properties, nature of injury, surgical preferences and other factors.
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Affiliation(s)
| | - Z Sh Aliev
- Burdenko Main Military Clinical Hospital, Moscow, Russia
- Military Hospital No. 426, Samara, Russia
| | | | - A A Rafaelyan
- Kirov Military Medical Academy, St. Petersburg, Russia
| | - D V Svistov
- Kirov Military Medical Academy, St. Petersburg, Russia
| | - G V Gavrilov
- Kirov Military Medical Academy, St. Petersburg, Russia
| | - I E Onnitsev
- Burdenko Main Military Clinical Hospital, Moscow, Russia
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227
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Abstract
BACKGROUND Foreign body (FB) ingestion is a common global issue in pediatrics. Most of the ingested FBs pass through the gastrointestinal tract, but up to 20% of cases require endoscopic removal. In this study, we retrospectively reviewed all pediatric cases of FB ingestion requiring endoscopic removal over a 10-year period in a tertiary hospital to compare the symptoms at presentation and outcomes with those reported in previous studies and to assess the association of the outcomes with patient and FB characteristics. METHODS A retrospective chart review of children 16 years or younger who underwent upper endoscopy for FB ingestion from 2008 to 2018 in a tertiary hospital was included. Data on demographics, clinical presentation, characteristics of FBs, endoscopic findings, and outcomes were reviewed. The clinical data were further evaluated to determine the circumstances surrounding FB ingestion, FB management, and patient outcomes. Descriptive analysis of the data was performed using medians, frequencies, and percentage; χ2 or Fisher exact test was used to assess the dependence between categorical variables. RESULTS Eighty-six patients (median age, 5.1 years; 67% males) underwent endoscopy for suspected FB ingestion, with a confirmation rate of 91%. Coins were the most commonly ingested FBs (n = 49, 57%). Most patients were symptomatic (84%); 97% of patients in whom the FB had an esophageal location and all patients in whom the FB was not detected by endoscopy were symptomatic (P = 0.007). The most frequent symptoms were drooling (70%) and unexplained crying (48%). Unexplained crying was more common in younger than in older patients (P < 0.001). The FB was more likely to be located in the esophagus in patients with drooling (P < 0.001) and dysphagia (P < 0.001). The distribution of FB location differed according to the FB type, with coins most frequently located in the esophagus and sharp and other FBs in the stomach (P = 0.023). Only 7 patients (8%) developed mild FB-related mucosal injury. No complications occurred during FB removal. All patients had an uneventful outcome. CONCLUSIONS Foreign body ingestion is common among younger children, and the clinical presentation can be variable. The presence or absence of symptoms, as well as the type of symptom, could aid clinicians in implementing diagnosis and proper management approaches in patients who ingest FBs requiring endoscopy.
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Affiliation(s)
- Valeria Dipasquale
- From the Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi"
| | - Claudio Romano
- From the Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi"
| | - Mauro Iannelli
- From the Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi"
| | - Andrea Tortora
- Division of Digestive Endoscopy, University of Messina, Messina
| | | | - Marco Ventimiglia
- Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy
| | - Socrate Pallio
- Division of Digestive Endoscopy, University of Messina, Messina
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228
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Vergani C, Venturi M, Melada E, Porro A. The Big Game: hunting for retained bullets and foreign bodies in Great War radiology. Ann Ital Chir 2022; 92:1-8. [PMID: 34224401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVES Searching for retained bullets has always been crucial in war surgery. Aim of this paper is to briefly outline the history of retained bullet identification methods before X-rays discovery and describe the proliferation of the most significant methods of foreign body localization during WWI. METHODS Coeval medical journals, reference textbooks, dedicated manuals and documents have been searched and compared in multiple archives and on the internet. RESULTS Before radiologic era, probing the wound was the only way to detect the bullet and minimize the need of a large surgical incision (anaesthesia was walking its first tentative steps and antisepsis still to be conceived). Nelaton's probe, specifically designed to detect General Garibaldi's retained projectile, gained popularity. Application of electricity provided further rudimental aids to find retained metals. X-rays discovery made bullet detection easy, but exact localization to guide removal was still difficult. Hundreds of imaginative X-Ray methods for localizing bullets and splinters more precisely in the countless complex wounds flourished during the Great War. Axis intersection, geometric reconstruction and anatomical criteria guided localization. Complex procedures and rudimental localizers to simplify calculations, and a number of compasses and magnetic or electric devices to aid surgical removal were developed, and are here outlined. Intermittent radiology assessment or combined radiology and surgery procedures started to play a role. CONCLUSIONS All these methods and tools are the ancestors of modern navigation systems, ensured by images digitalization and miniaturization technologies. KEY WORDS Foreign bodies, Mobile Health Units, Radiology, X-Rays, World War I, Wounds and injuries.
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229
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Zhemchugova-Zelenova OA, Petrov AS, Pichurov AA, Atyukov MA, Mishcheryakov SA, Novikova OV, Zemtsova IY, Yablonskii PK. [Treatment of patients with rare bronchial foreign body - spruce branch]. Khirurgiia (Mosk) 2022:65-73. [PMID: 36073585 DOI: 10.17116/hirurgia202209165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Spruce branch is a rare radiolucent bronchial foreign body. Despite modern imaging tests and endoscopic examination, this foreign body is often detected only intraoperatively. This study enrolled 4 patients with spruce branch aspiration. In the 4th case, spruce branch was removed during rigid bronchoscopy that was associated with «lodging» type of foreign body. In two cases, spruce branch migrated to peripheral bronchial segments («extrusive» type) that required surgical treatment (thoracoscopy with resection of the right basal pyramid segments and wedge resection of the right lower lobe). The 3rd case was the most interesting. Initially, the foreign body was «underlying», but it migrated after partial endoscopic removal that finally required right-sided lower lobectomy. This report describes the peculiarities of clinical course and management of patients with a rare type of radiolucent bronchial foreign body - spruce branch.
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Affiliation(s)
| | - A S Petrov
- St. Petersburg State University, St. Petersburg, Russia
- St. Petersburg City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
| | - A A Pichurov
- St. Petersburg City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
| | - M A Atyukov
- St. Petersburg City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
| | - S A Mishcheryakov
- St. Petersburg City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
| | - O V Novikova
- St. Petersburg City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
| | - I Yu Zemtsova
- St. Petersburg State University, St. Petersburg, Russia
- St. Petersburg City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
| | - P K Yablonskii
- St. Petersburg State University, St. Petersburg, Russia
- St. Petersburg City Multidisciplinary Hospital No. 2, St. Petersburg, Russia
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Leite TFDO, Pazinato LV, Bortolini E, Pereira OI, Nomura CH, Filho JMDML. Endovascular removal of intravascular foreign bodies: A single-center experience and literature review. Ann Vasc Surg 2021; 82:362-376. [PMID: 34936892 DOI: 10.1016/j.avsg.2021.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/18/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To describe causes, clinical signs, experience and endovascular techniques for extraction of intravenous foreign bodies (IFB) and literature review. METHODS This retrospective study was based on data collected from the medical records of 51 consecutive patients (26 women and 25 men) treated from July 2007 to May 2020 at a single quaternary center in Brazil and case series with data, published in the literature since 2000 on IFB removal, of at least five patients. The average patient age was 43.54 years (range, 2 months to 84 years). The different retrieval method using the following was used in the procedure: gooseneck snare, guidewire, balloon, and custom snares. RESULTS The retrieval process rate was 100%. Thirty-one port-a-caths, six guidewires, four double lumens, three permcaths, three Shiley® catheters, one intra cath, two peripherally inserted central catheters, and one stent were extracted. The locations where the IFBs were most frequently trapped were the right atrium (39.2%), the pulmonary artery (17.64%), the superior vena cava (13.72%), and the right ventricle (16.12%). Single venous access was used in 67.07% of the patients. Femoral access, which was the most commonly used approach, was used in 85.71% of the patients. The loop was used in 64.70% of the patients. A fractured catheter was the main IFB in 60.76% of the cases (31 patients). Only one complication related to the extraction of an IFB was noted in a single patient who suffered from atrial fibrillation (1.96%). The 30-day mortality rate was zero. CONCLUSION Percutaneous IFB removal should be considered as an alternative for the treatment and retrieval of IFBs because it is a minimally invasive procedure that is relatively simple, safe, and has low complication rates.
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Affiliation(s)
| | - Lucas Vatanabe Pazinato
- Interventional Radiology Unit, Department of Radiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Edgar Bortolini
- Interventional Radiology, Radiology Department, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil
| | - Osvaldo Ignacio Pereira
- Interventional Radiology Unit, Department of Radiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Cesar Higa Nomura
- Interventional Radiology, Radiology Department, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil
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Song Q, Zhang J, Jiao R. Electric wire as a urethral foreign body: A case report. Medicine (Baltimore) 2021; 100:e28103. [PMID: 35049238 PMCID: PMC9191387 DOI: 10.1097/md.0000000000028103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/16/2021] [Indexed: 12/02/2022] Open
Abstract
RATIONALE Most self-insertion of urethral foreign bodies is the result of exotic impulses, psychometric problems, sexual curiosity, or sexual practice while intoxicated. Ultrasound has been proven to be an effective tool for determining the presence, location, and characteristics of the urethral foreign body. PATIENT CONCERNS A 48-year-old man presented with a mass in the urethra for 2 years. Physical examination suggested swelling and ulcer in the scrotum. The white blood cell count was elevated (12.60 × 109/L). Urinalysis showed an increased white cell count (484.60/μL) and urine occult blood (±). DIAGNOSIS Ultrasound examination of the genitourinary system identified an 8.3 cm linear hyperechoic object and hyperechoic spots in the urethra. Computed tomography revealed an extremely hyperdense lesion in the penis. Intraoperative findings showed electric wire bending and winding surrounded by fibrous tissues with urethral rupture. INTERVENTIONS The patient was treated with urethrotomy as the endoscopic treatment failed. and the electric wire was removed successfully. OUTCOMES The patient was followed up for 45 days without discomfort. Ultrasound examination of the genitourinary system suggested that the wound was almost healed, but with a small urethral effusion, with a maximum depth of approximately 1.9 mm. LESSONS A foreign body was inserted into the patient's urethra for 2 years without any medical treatment. Urethral perforation was found during surgery. In such cases, ultrasound examination can determine the location, shape, and size of the urethral foreign body and play an important role in the diagnosis of foreign bodies.
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Affiliation(s)
- Qiqi Song
- Hebei Medical University, Shijiazhuang, China
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Jingwen Zhang
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Ronghong Jiao
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
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赵 延, 张 媛, 李 瑶, 李 彦, 徐 文. [Application of esophageal CT to establish the evaluation model of foreign body position in rigid esophagoscopic surgery]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 35:1097-1100. [PMID: 34886623 PMCID: PMC10127656 DOI: 10.13201/j.issn.2096-7993.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Indexed: 06/13/2023]
Abstract
Objective:Establish a correlation model with the true position of the foreign body in the esophageal foreign body surgery using the relevant diameter of the esophageal foreign body computed tomography(CT). Methods:Thirty-three patients who were diagnosed with esophageal foreign bodies by esophageal CT in the emergency department of the Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, were selected to measure the CT-related diameters of the esophageal tube(airway length, hyoid anterior edge-mandibular distance, incisor extension line-Posterior nasal ridge, distance from foreign body to hard jaw, distance from foreign body to incisor, front and back nasal crest line-spine line included angle, front and back nasal crest line and airway length line included angle, the lowest point of mandible-highest point of hyoid bone-and Spine angle), record the height and weight of the patient and calculate the body mass index(BMI). During the operation, the patient's head is fully tilted back, and the rigid esophagus is inserted through the mouth, and the front end of the esophagus is recorded when it touches a foreign body. The method of multivariate linear analysis was used to calculate the CT diameter that correlated with the distance between the foreign body and the incisor during the operation. Results:The most common foreign body in the esophagus is jujube pit(14 cases), followed by fish bones(13 cases); the distance between the foreign body and the hard jaw, the incisor teeth measured by CT of the esophagus is less than the actual distance between the foreign body and the incisor during the operation(P<0.001), the difference was statistically significant. Multiple linear regression analysis found that the patient's BMI(P=0.037) and the distance of the foreign body from the hard jaw(P<0.001) were correlated with the actual distance of the foreign body from the incisor during the operation. LR=3.708+0.130×BMI+0.857×Lct(cm), R²=0.736, adjusted R²=0.719. Conclusion:The distance between the foreign body and the hard jaw measured by esophageal CT combined with the patient's BMI can predict the distance of the foreign body during rigid esophagoscopic surgery under general anesthesia and provide a certain reference value for the detection of foreign body during the operation.
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Affiliation(s)
- 延明 赵
- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 北京市耳鼻咽喉科研究所 鼻病研究北京市重点实验室(北京,100730)Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100730, China
| | - 媛 张
- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 北京市耳鼻咽喉科研究所 鼻病研究北京市重点实验室(北京,100730)Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100730, China
- 首都医科大学附属北京同仁医院过敏科Department of Allergy, Beijing Tongren Hospital, Capital Medical University
| | - 瑶 李
- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 北京市耳鼻咽喉科研究所 鼻病研究北京市重点实验室(北京,100730)Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100730, China
| | - 彦如 李
- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 北京市耳鼻咽喉科研究所 鼻病研究北京市重点实验室(北京,100730)Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100730, China
| | - 文 徐
- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 北京市耳鼻咽喉科研究所 鼻病研究北京市重点实验室(北京,100730)Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, 100730, China
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233
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Affiliation(s)
- Jonathan Wong
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI
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234
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Hayashi H, Abe A, Ota M, Momokita M, Ishihama T, Furuta H, Taniguchi T, Takeuchi K. Endoscopic removal of accidental aspirated and ingested dental foreign bodies: A cross-sectional study. Medicine (Baltimore) 2021; 100:e27602. [PMID: 34797284 PMCID: PMC8601339 DOI: 10.1097/md.0000000000027602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/07/2021] [Indexed: 01/05/2023] Open
Abstract
The incidence of accidental ingestion and aspiration of foreign body (FB) is likely to occur. Many FBs are discharged spontaneously, but many dental FBs are often sharp and may remain in the pharynx, esophagus, and stomach, causing serious complications such as hemorrhage, asphyxia, perforation of the digestive tract, mediastinal emphysema, peritonitis, and ileus. We aimed to examine which type of dental foreign bodies can be removed by endoscope.In this study, we enrolled 32 patients who were evaluated at the Emergency and Critical Center between January 2014 and December 2019 and who accidentally ingested or aspirated dental FBs. Medical records were reviewed to determine the patients' sex, age, medical history, time from accidental ingestion of a FB to consultation, cause, location, occurrence status, nature of the FB, location of retained FB, treatment, complications, and outcome.We enrolled 32 patients (14 men, 18 women), with a mean age of 74.5 ± 12.8 years. Accidental ingestion at treatment was common. The most frequent site where the FB was retained was upper gastrointestinal tract (26 cases, 81.3%). In this study, endoscopic removal was indicated for dentures under the size of 43.3 mm, for dental FB (except dentures) more than 13.6 mm. In dentures, between the number of missing teeth, clasp, type, and endoscopic removal was not statistically significant.Dentures under the size of 43.3 mm was likely to be removed by endoscope. Dental FB (except dentures) more than the size of 13.6 mm was likely to be removed by endoscope. There were no indications for endoscopic removal except for size.
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Affiliation(s)
- Hiroki Hayashi
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Atsushi Abe
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Mitsuhiko Ota
- Oral and Maxillofacial Surgery, Sakura General Hospital, Japan
| | - Moeko Momokita
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Takanori Ishihama
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Hiroshi Furuta
- Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Toru Taniguchi
- Oral and Maxillofacial Surgery, Sakura General Hospital, Japan
| | - Kazuo Takeuchi
- Department of Gerodontology and Home Care Dentistry, Aichi Gakuin University, Japan
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235
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Ayotunde O, Burkard DJ, Kolacki C, Zamarripa A, Ouellette L, Hamilton M, Jones JS. Nasal foreign body removal: Success rates for techniques and devices. Am J Emerg Med 2021; 56:384-385. [PMID: 34840003 DOI: 10.1016/j.ajem.2021.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Oluwatosin Ayotunde
- Department of Emergency Medicine, Spectrum Health, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - David J Burkard
- Department of Emergency Medicine, Spectrum Health, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Christian Kolacki
- Department of Emergency Medicine, Spectrum Health, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Angela Zamarripa
- Department of Emergency Medicine, Spectrum Health, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Lindsey Ouellette
- Department of Emergency Medicine, Spectrum Health, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Megan Hamilton
- Department of Emergency Medicine, Spectrum Health, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Jeffrey S Jones
- Department of Emergency Medicine, Spectrum Health, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
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236
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Tiong J, Grant K, Gray A. A rare case of iliopsoas abscess caused by a retained shrapnel from a blast injury. BMJ Case Rep 2021; 14:e247100. [PMID: 34772686 PMCID: PMC8593738 DOI: 10.1136/bcr-2021-247100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/03/2022] Open
Abstract
Iliopsoas abscesses (IPA) are uncommon, with an associated mortality rate of up to 20%. We describe the case of a 55-year-old man war veteran who presented with an unusual cause of IPA secondary to retained foreign body (FB). His initial trauma 30 years before was a result of a blast injury with shrapnel penetration suffered after inadvertently driving over a landmine as an ambulance driver in a conflict region. A CT scan was performed, revealing a 13 mmx8 mm radio-opaque FB within the right psoas at the level of the fifth lumbar vertebra with a surrounding collection. Subsequent open surgical exploration removed two gravel fragments. Given the knowledge of a traumatic blast injury with retained FB and repeated episodes of sepsis, surgical exploration is warranted. To our knowledge, this is the first case of recurrent IPA secondary to a retained FB from a historical trauma.
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Affiliation(s)
- Jonathan Tiong
- Department of Clinical Surgery, The University of Edinburgh, Edinburgh, Edinburgh, UK
- Department of General Surgery, Monash Health, Clayton, Victoria, Australia
| | - Katherine Grant
- Department of General Surgery, Monash Health, Clayton, Victoria, Australia
| | - Andrew Gray
- Department of General Surgery, Monash Health, Clayton, Victoria, Australia
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237
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Vitito L. PRIMARY AORTOESOPHAGEAL FISTULA DUE TO ESOPHAGEAL FOREIGN BODY: A CASE REPORT. Gastroenterol Nurs 2021; 44:458-462. [PMID: 34319938 PMCID: PMC8635267 DOI: 10.1097/sga.0000000000000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/30/2021] [Indexed: 11/26/2022] Open
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238
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Abstract
A 3-year-old male domestic shorthair cat presented with sudden ataxia. Neurologic examination showed complete loss of proprioception in the thoracic and pelvic limbs. Computed tomography and magnetic resonance imaging revealed a non-metallic foreign body penetrating the spinal cord. The foreign body was removed by the ventral approach to the atlanto-occipital junction. Mild improvement of proprioception was observed the day after surgery. In a follow-up two months after surgery, the owner reported a complete recovery of the patient, showing a normal gait. To the author's knowledge, this is the first case report describing successful removal of an intramedullary foreign body penetrating cervical spinal cord by ventral approach in a cat.
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Affiliation(s)
- Kihoon KIM
- Baeksan Feline Medical Center, Nonhyun-ro 86-gil #22, Gangnam-Gu, Seoul, South Korea
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239
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Yazici H, Namdaroglu OB. A laparoscopic approach to gastric foreign bodies. A video case presentation. Ann Ital Chir 2021; 10:S2239253X21036835. [PMID: 34738536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Foreign body ingestions are one of the common reasons for Emergency Department applications. Although it is mostly seen in the pediatric age group, adult patients could be more complicated. The majority of swallowed foreign bodies could pass through the digestive system spontaneously. Only %1 of them needs surgical interventions. In this study, we present a case that swallowed his denture and needs surgical treatment. CASE PRESENTATION A 59-year-old male patient was admitted to Emergency Department for swallowing his dental prosthesis accidentally. He had the feeling of being stuck in his chest while swallowing, and there were no additional symptoms. On the chest x-ray, it was detected in the middle part of esophagus. Upper Gastrointestinal System Endoscopy was performed to remove it. Foreign body was detected in the stomach during the endoscopy. However, it was not suitable for endoscopic extraction. Surgery was performed, and the foreign body was removed from the stomach laparoscopically. The patient was discharged from the hospital uneventfully on the fifth day after surgery. CONCLUSION Although they have seemed in many cases, a small percentage of foreign body ingestions needs surgical treatment. Developments in recent years have increased the frequency of using minimally invasive techniques in emergency surgeries. Because of advantages such as fast recovery and small scars, laparoscopic surgery is recommended as an option that can be used safely in emergency cases. KEY WORDS Foreign Body, Gastric, Laparoscopy, Surgery.
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240
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Lansing MG, Sivaraman Kannan KK, Hayati F. Re: 'PulmoNAILy' injury: surgical management of rare tracheobronchial foreign body aspiration in an adult. ANZ J Surg 2021; 91:2224. [PMID: 34665496 DOI: 10.1111/ans.17042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Meryl Grace Lansing
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | | | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
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241
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Chen L, Cha J. Removing Foreign Bodies From the Maxillary Sinus: Sinus Area Classification and Technique Selection. Compend Contin Educ Dent 2021; 42:e5-e8. [PMID: 34606294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The displacement or invasion of a foreign object (eg, amalgam, dental bur, dental cement, dental implant) into the maxillary sinus can lead to various negative sequelae. Several techniques have been described for the removal of such objects, but although all of them require correct diagnosis and accurate determination of the exact size and location of the foreign object before the removal procedure is performed, high postoperative complication rates often result from these invasive procedures. The authors propose the categorization of two different types of maxillary sinus areas that can be invaded by dental implants and/or foreign objects; diagnosis and treatment are predicated on differentiating and/or identifying these two spaces. The clinical implications of these classifications include the ability to select from and execute appropriate and minimally invasive removal techniques, which are described and demonstrated in three presented case reports.
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Affiliation(s)
- Leon Chen
- Chairman and Chief Executive Officer, Dental Implant Institute, Las Vegas, Nevada
| | - Jennifer Cha
- President, Dental Implant Institute, Las Vegas, Nevada
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242
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Bhattarai A, Adhikari D, Paudyal N, Giri P, Khadka A, Devkota Y. Toothbrush, an Unusual Foreign Body. Kathmandu Univ Med J (KUMJ) 2021; 19:522-524. [PMID: 36259200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Accidental consumption of foreign body is a common presenting complain among patients especially in young age group. Majority of patients can be discharged safely after reassurance while a fraction of patient requires observation and further management. Here we report a case of a 35-year-old gentleman who presented to the out-patient department of our hospital in June 2021 for accidental ingestion of toothbrush. After detailed history and physical examination upper gastrointestinal endoscopy was planned for the patient. Failed endoscopic removal was considered the indication for surgery. A supraumbilical midline incision was used to remove the toothbrush. Following the surgical removal, he was managed conservatively and was discharged without significant complications. We describe this case in detail in addition to reviewing the pertinent literature.
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Affiliation(s)
- A Bhattarai
- Department of General and Laparoscopic Surgery, Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - D Adhikari
- Department of General and Laparoscopic Surgery, Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - N Paudyal
- Department of General and Laparoscopic Surgery, Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - P Giri
- Department of General and Laparoscopic Surgery, Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - A Khadka
- Department of General and Laparoscopic Surgery, Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
| | - Y Devkota
- Department of General and Laparoscopic Surgery, Nobel Medical College Teaching Hospital, Kanchanbari, Morang, Biratnagar
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243
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Al-Natsha RR, Salama FS, Akkielah DA. Incidental Radiographic Detection of a Foreign Body in the Nose of a Child. J Dent Child (Chic) 2021; 88:202-205. [PMID: 34937631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Foreign bodies in the nasal cavity are common in children, possibly due to their curiosity to explore body openings. The purpose of this report was to describe a case of an undetected nasal foreign body in a 10-year-old girl who presented to a pediatric dentistry clinic for a routine dental examination. A foreign body in the nasal cavity was discovered during a panoramic radiographic examination. A prompt referral to the otorhinolaryngologist was critical to confirm the diagnosis and successfully remove the foreign body. This case report demonstrates that dentists can play a significant role in the diagnosis of foreign objects in children.
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Affiliation(s)
- Reem R Al-Natsha
- Dr. Al-Natsha is a pediatric dentist consultant, Dental Department, Security Forces Hospital, Ministry of Interior, Riyadh, Saudi Arabia
| | - Fouad S Salama
- Dr. Salama is a former professor, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia; fspdkids@gmail. com
| | - Dima A Akkielah
- Dr. Akkielah is a resident, Dental Department, Security Forces Hospital, Ministry of Interior, Riyadh, Saudi Arabia
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244
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Shatani N, Alshaibani S, Potts J, Phillips B, Bray H. Chest Radiograph Alone Is Sufficient as the Foreign Body Survey for Children Presenting With Coin Ingestion. Pediatr Emerg Care 2021; 37:e524-e527. [PMID: 30461670 DOI: 10.1097/pec.0000000000001688] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Radiographic survey of the entire aerodigestive tract (nares to anus) is common practice in children presenting to the emergency department following coin ingestion. The purpose of our study was to determine the optimal protocol for radiographic survey post-coin ingestion. We hypothesized that for children presenting with a clear history of coin ingestion a frontal chest radiograph including the entire esophagus is adequate to guide treatment. METHODS We reviewed the clinical history and radiographic surveys of 134 patients presenting with suspected or witnessed coin ingestion to the emergency department of a tertiary care pediatric hospital between January 2012 and June 2016. Patient demographics, presenting symptoms, anatomic coverage of survey, type, number and location of radiopaque foreign bodies, intervention, and follow-up were recorded. RESULTS Coins were identified on radiographic surveys in 109 of 134 patients; 25 of 134 patients had no coin. Of those with coins, none of 109 had coin(s) in the airway, 42 of 109 had coin(s) in the esophagus, and 67 of 109 had coin(s) distal to the esophagus. Of those with esophageal coins, 35 of 42 reported symptoms, 7 of 42 were asymptomatic, 40 of 42 underwent endoscopic coin removal, and 2 of 42 had no intervention. Of 92 of 134 surveyed patients with no coin or coin distal to the esophagus, 30 of 92 reported symptoms, 62 of 92 were asymptomatic, 90 of 92 had no further intervention, and 2 of 92 eventually underwent endoscopic coin removal for specific indications (abdominal pain, delayed passage). When there was no coin found in the esophagus, the negative predictive value for intervention was 97.8%. CONCLUSIONS Following a clear history of coin ingestion, a frontal chest radiograph including the entire length of the esophagus provides sufficient information to direct patient management.
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Affiliation(s)
- Naoya Shatani
- From the Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Sara Alshaibani
- Medical Imaging Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | - Bruce Phillips
- Division of Emergency Medicine, Department of Pediatrics
| | - Heather Bray
- Department of Radiology, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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245
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Inada H, Maeda J, Ozaki T, Ikeda N. [S10 Segmentectomy by Thoracoscopic Surgery for a Bronchial Foreign Body Presenting More than One Year]. Kyobu Geka 2021; 74:660-663. [PMID: 34446617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
It is often difficult to remove long-standing bronchial foreign bodies by bronchoscopy. A 77-year-old male was referred to our department for removal of a foreign body. Chest computed tomography revealed a nail in the right S10b. A bronchoscopic examination could not detect the nail due to locating beyond the subsegmental tree, so thoracoscopic right S10 segmentectomy was performed. Intraoperative ultrasonography and X-ray fluoroscopy were useful in understanding the margin for resection.
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Affiliation(s)
- Hidehiro Inada
- Department of Thoracic Surgery, Ageo Central General Hospital, Ageo, Japan
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246
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Sieniawski K, Kreisel A, Kaczka K, Wierzchniewska-Lawska A, Pomorski L, Smigielski J. Abdominal Wall Actinomycosis Associated with Foreign Body Perforation. Chirurgia (Bucur) 2021; 116:1-5. [PMID: 34463247 DOI: 10.21614/chirurgia.116.ec.1760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/23/2022]
Abstract
Abdominal wall actinomycosis is a very rare infection caused by anaerobic Gram-positive bacteria Actinomyces. We present a case of a 72-year-old female with chronic pain located in the right hypochondriac region and anterior abdominal wall mass which had developed six months before. An ultrasonography (USG) and computed tomography (CT) scan of the abdomen were performed and showed an inflammatory change with a strong internal linear reflection in the right upper abdomen. The tumor was located inside the rectus abdominis muscle and connected with internal organs and subcutaneous tissue. The patient qualified for surgery. En block tumor excision was made with partial resection of the transverse colon. Postoperative study revealed fishbone-associated inflammatory actinomycosis tumor. The patient was successfully managed postoperatively with penicillin and discharged on the 11th day after the surgery.
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247
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Li S, Wu L, Huang M, Zhou J, Wang Y, Chen Z. Cardiopulmonary bypass as a bridge for bronchial foreign body removal in a child with pulmonary artery sling: A case report. Medicine (Baltimore) 2021; 100:e26908. [PMID: 34397925 PMCID: PMC8360435 DOI: 10.1097/md.0000000000026908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/26/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Successful removal of an airway foreign body (FB) in some intractable cases can be very challenging, because of tracheal anomalies, unstable respiratory status of the patients, and the location of FB. The use of cardiopulmonary bypass (CPB) support for the treatment of a FB is extremely rare. PATIENT CONCERNS We present a case of a 39-month-old previously healthy girl who was admitted to our hospital for suspected FB aspiration (FBA). Initially, the attempt for removal of the FB by conventional bronchoscopy failed because of hypoxic intolerance. DIAGNOSES Bronchoscopy revealed tracheal anomalies and subsequent computed tomography angiography demonstrated the presence of a pulmonary artery sling (PAS), which confirmed the diagnosis of PAS accompanied with FBA. INTERVENTIONS With the assistance of CPB, multidisciplinary treatment involving the respiratory, cardiothoracic and anesthetic teams were involved and the bronchial FB was removed by flexible bronchoscopy successfully and then PAS was corrected by surgical intervention. OUTCOMES The patient remained asymptomatic, without shortness of breath or wheezing during the 15 months follow-up. LESSONS This case highlights that in a complicated case of FBA, bronchoscopy and computed tomography imaging are of great importance to achieve an accurate diagnosis, and a multidisciplinary treatment approach is essential for a satisfactory outcome. If the patient is unstable for bronchoscopy, CPB can be temporarily used in the stabilization of the patient to allow safe removal of the FB.
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Affiliation(s)
- Shuxian Li
- Department of Pediatric Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Lei Wu
- Department of Pediatric Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Meixia Huang
- Department of Pediatric Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Junfen Zhou
- Department of Pediatric Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Pediatrics, Wenling Maternal and Child Health Care Hospital, Wenling, Zhejiang, China
| | - Yingshuo Wang
- Department of Pediatric Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
- Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Zhimin Chen
- Department of Pediatric Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
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Abstract
QUESTION A 2-year-old boy presented to my clinic after a caregiver witnessed him swallow a foreign body. The caregiver recalls seeing a small metallic object but is unsure exactly what was ingested. The child was asymptomatic upon examination. How should I identify and localize the foreign body? Do metal foreign bodies need to be removed endoscopically? ANSWER Foreign body ingestion is very common in children. Considerations must be made for the type of foreign body and site of impaction. A clear patient history and radiographs should be used to localize and identify the object. Handheld metal detectors can also be used to localize known metallic foreign bodies. Most metallic objects that pass the esophagus and reach the stomach will continue to pass without complication. Bowel perforation, sepsis, and even death have been documented in extremely rare cases of multiple magnets, button batteries, and long, angular, or 2-pointed sharp objects. These objects must be removed. Other metallic foreign bodies including coins and single magnets can be managed conservatively with stool monitoring.
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Abstract
OBJECTIVE The aim of the study was to investigate the appropriate time of removal of button batteries (BB) from the esophagus and stomach in children. METHODS This is a retrospective descriptive single-center study reviewing the medical records of all children with BB ingestion seen in the Royal Hospital between January 1, 2011, and December 31, 2014. All children younger than 13 years with a history of BB ingestion were included. Biodemographic data including age and sex were obtained. In addition, time of ingestion of BB, location of BB, time of endoscopic removal, and any complications were recorded. RESULTS Forty-six patients with BB ingestion were identified out of 385 who presented with foreign body ingestion (12%) during the study period. Twenty four (52%) were boys and 22 (48%) were girls. All children had BB of 20 mm in diameter. Two children had the BB in the esophagus, whereas 13 children had the BB in the stomach up on presentation. The mean time of presentation of children with BB in the esophagus was 1.75 hours after ingestion, whereas those with BB in the stomach presented on average 19.4 hours after ingestion (P < 0.035). An endoscopic intervention was done in only 8 of the 46 children. Two children had the BB in the esophagus and 6 children in the stomach. One child required intensive care unit with subsequent esophageal strictures. The mean time of esophageal BB removal was 1.7 hours from ingestion, whereas removal from the stomach was on average 27 hours after ingestion. Endoscopic injuries were noted in 87.5% of the children with BB in the esophagus or the stomach. No mortality occurred during the study period. CONCLUSIONS Button batteries ingestion is a common problem with variable time of presentation to the emergency department. Esophageal BB presents the highest risk of injury even in as short time as 2 hours. Gastric mucosal injury can occur within 10 hours of ingestion. Button batteries of 20-mm diameter need to be urgently removed from the esophagus and be considered for removal earlier than 24 hours if in the stomach.
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Ruan W, Fishman DS, Kramer RE, Walker T, Khalaf RT. Endoscopic Management of Button Batteries. J Pediatr Gastroenterol Nutr 2021; 73:e48-e49. [PMID: 34016880 DOI: 10.1097/mpg.0000000000003169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Wenly Ruan
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Houston, TX
| | - Douglas S Fishman
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Houston, TX
| | - Robert E Kramer
- Digestive Health Institute & Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Thomas Walker
- Digestive Health Institute & Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Racha T Khalaf
- Department of Pediatrics, Division of Gastroenterology, University of Southern Florida Morsani College of Medicine, Tampa, FL
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
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