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Du WW, Huang T, Yang GD, Zhang J, Chen J, Wang YB. Submucosal protuberance caused by a fish bone in the absence of preoperative positive signs: A case report. World J Clin Cases 2022; 10:1586-1591. [PMID: 35211596 PMCID: PMC8855262 DOI: 10.12998/wjcc.v10.i5.1586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/30/2021] [Accepted: 12/31/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Submucosal protuberance caused by fish bone insertion into the digestive tract has rarely been reported. These cases usually include patients with clear signs such as a history of fish intake, pain, and dysphagia, as well as positive findings on endoscopy and imaging. Here, we report a case of a fish bone hidden in the submucosal protuberance of the gastric antrum during endoscopic submucosal dissection without preoperative obvious positive signs.
CASE SUMMARY A 58-year-old woman presented with epigastric pain for the past 20 d and a submucosal protuberance. Abdominal computed tomography and endoscopic ultrasonography did not indicate the presence of a fish bone. We assumed the cause to be an ordinary submucosal eminence and performed an endoscopic submucosal dissection to confirm its essence. During the operation, a fish bone approximately 20 mm in length was found incidentally.
CONCLUSION Our report could potentially prevent the oversight of embedded fish bones and associated adverse effects in patients with similar presentation.
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Affiliation(s)
- Wei-Wei Du
- Department of Gastroenterology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610000, Sichuan Province, China
| | - Tao Huang
- Department of Gastroenterology and Hepatology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Guo-Dong Yang
- Department of Gastroenterology and Hepatology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing Zhang
- Department of Gastroenterology and Hepatology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing Chen
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Ying-Bang Wang
- Department of Gastroenterology and Hepatology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Qi Q, Chen L, Kou G. Sepsis due to kidney injury caused by a toothpick: a case report and literature review. BMC Infect Dis 2022; 22:115. [PMID: 35109820 PMCID: PMC8811973 DOI: 10.1186/s12879-022-07058-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Toothpicks are common foreign bodies which may injure surrounding organs leading to a series of atypical symptoms. We present a rare clinical case that septicemia caused by a toothpick penetrated into the right kidney. CASE PRESENTATION We describe a 51-year-old patient who presented with right-sided backache and hematuresis for 2 days. Blood culture persistently grew Streptococcus gordonii. Ultrasound of the patient's urinary tract revealed a strong striated echo in the middle of the right kidney. Complete abdominal computed tomography revealed a duodenal foreign body penetrating into the right kidney. The toothpick was removed under endoscopy and hemostasis was given. Antibiotic treatment was upgraded. The patient was recovered and discharged from his stay on the fifteenth day. CONCLUSIONS Early identification of the etiology of sepsis can effectively alleviate patient's distress and reduce hospital stay. Clinicians should identify the source of sepsis through a medical history and examination.
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Affiliation(s)
- Qi Qi
- The Infection Department of Mianyang Central Hospital, Mianyang, 621000, China
| | - Lingxin Chen
- The Infection Department of Mianyang Central Hospital, Mianyang, 621000, China
| | - Guoxian Kou
- The Infection Department of Mianyang Central Hospital, Mianyang, 621000, China.
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Yu M, Li K, Zhou S, Wang H, Le M, Li C, Liu D, Tan Y. Endoscopic Removal of Sharp-Pointed Foreign Bodies with Both Sides Embedded into the Duodenal Wall in Adults: A Retrospective Cohort Study. Int J Gen Med 2021; 14:9361-9369. [PMID: 34908865 PMCID: PMC8664340 DOI: 10.2147/ijgm.s338643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/04/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose Sharp-pointed FBs with both sides embedded in the duodenal wall are rare. Compared with smooth edged FBs, sharp objects are more likely to be associated with significant adverse events, when penetrating the wall of the digestive tract. The clinical features of patients who experienced sharp-pointed FBs embedded in both sides of the duodenum were retrospectively analyzed, as were the efficacy and safety of endoscopic removal of these FBs. Patients and Methods This retrospective study included 21 adults with both sides of sharp-pointed FBs embedded into the duodenal wall who were admitted to the Second Xiangya Hospital in China between January 1, 1996, and May 31, 2021. Data associated with the endoscopic removal of these FBs were collected from the electronic medical record system (EMRS) of the hospital. Results The incidence rate of duodenal total FBs and FBs embedded in both sides was 8.87% and 1.03%, respectively. The success rate of endoscopic treatment was 100.00% in 124 patients without embedded duodenal FBs and 97.14% in 35 patients with one side embedded duodenal FBs. Of the 21 patients with FBs embedded in both sides of the duodenal wall, endoscopic removal was successful in 85.71% of patients, whereas 14.29% required surgery. FBs removed from these patients included toothpicks in 12; needles in 3; jujube pits in 2; and a chopstick, dentures, fish bones, and chicken bones in one each. Most of these 21 FBs were located in the bulb and descending duodenum, followed by the third part of duodenum. Conclusion Sharp-edged FBs with both sides embedded in the duodenal wall are rare. Endoscopic removal may be considered as a feasible, safe, and effective method of removing sharp-pointed FBs with both sides embedded in the duodenal wall. And if endoscopic removal is unsuccessful, surgical management can be a secondary option.
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Affiliation(s)
- Meihong Yu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, 410011, People's Republic of China
| | - Kaixuan Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Shishuang Zhou
- Department of Nursing Administration, Army Military Medical University, Chongqing, 400038, People's Republic of China
| | - Hanyu Wang
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, 410011, People's Republic of China
| | - Meixian Le
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, 410011, People's Republic of China
| | - Chen Li
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, 410011, People's Republic of China
| | - Deliang Liu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, 410011, People's Republic of China
| | - Yuyong Tan
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People's Republic of China.,Research Center of Digestive Disease, Central South University, Changsha, Hunan, 410011, People's Republic of China
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Li SY, Miao Y, Cheng L, Wang YF, Li ZQ, Liu YB, Zou TM, Shen J. Surgical treatment of delayed cervical infection and incomplete quadriplegia with fish-bone ingestion: A case report. World J Clin Cases 2021; 9:7535-7541. [PMID: 34616823 PMCID: PMC8464462 DOI: 10.12998/wjcc.v9.i25.7535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/20/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The most commonly ingested foreign body in Asians is fish bone. The vast majority of patients have obvious symptoms and can be timely diagnosed and treated. Cases of pyogenic cervical spondylitis and diskitis with retropharyngeal and epidural abscess resulting in incomplete quadriplegia due to foreign body ingestion have been rarely reported. The absence of pharyngeal or esophageal discomfort and negative computed tomography (CT) findings of fish bone have not been reported. We report the case of an elderly female patient with delayed cervical infection and incomplete quadriplegia who had a history of fish bone ingestion.
CASE SUMMARY A 73-year-old woman presented with right neck pain and weakness of four limbs for a week, and had a history of fish bone ingestion and negative findings on laryngoscopic examination one month previously. She did not complain of any pharyngeal or esophageal discomfort. Cervical magnetic resonance imaging showed C4/C5 spondylitis and diskitis along with retropharyngeal and ventral epidural abscesses. No sign of fish bone was detected on lateral cervical radiography and CT scans. The muscle strength of the patient’s right lower limb receded to grade 1 and other limbs to grade 2 suddenly on the 10th day of hospitalization. Emergency surgery was performed to drain the abscess and decompress the spinal cord by removing the anterior inflammatory necrotic tissue. Simultaneously, flexible esophagogastroduodenoscopy was carried out and a hole in the posterior pharyngeal wall was found. The motor weakness of the right lower limb improved to grade 3 and the other limbs to grade 4 within 2 d postoperatively.
CONCLUSION This rare case highlights the awareness of the posterior pharyngeal or esophageal wall perforation in patients with cervical pyogenic spondylitis along with a history of fish bone ingestion, even though local discomfort symptoms are absent and the radiological examinations are negative.
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Affiliation(s)
- Suo-Yuan Li
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Ye Miao
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Liang Cheng
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Ye-Feng Wang
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Zhi-Qiang Li
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Yu-Bo Liu
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Tian-Ming Zou
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Jun Shen
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
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Crain MA, Lakhani DA, Kuhnlein R, Balar AB, Neptune S, Parrish D, Shorter N, Adelanwa A, Nguyen TP, Hailemichael E. Small bowel obstruction from hollow foreign body ingestion: A case report and brief review of literature. Radiol Case Rep 2021; 16:1628-1632. [PMID: 33995754 PMCID: PMC8105595 DOI: 10.1016/j.radcr.2021.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/10/2021] [Accepted: 04/11/2021] [Indexed: 11/22/2022] Open
Abstract
While ingestion of a foreign body by children is common, diagnosis is often challenging, especially when the consumption by a young child is unwitnessed and presenting symptoms mimic other medical conditions. If the foreign body does not pass spontaneously, radiological imaging studies are typically performed, but visualization and identification of the ingested foreign object can be inconclusive, especially when an unidentified mass is radio translucent. Under this circumstance, physicians often have to go on a "fishing expedition", using exploratory endoscopy and/or surgery to identify and extract the object that became lodged. In this report we discuss a case of a 3 year-old boy who presented with abdominal pain and signs of bowel obstruction. Imaging revealed an ingested "radiolucent" foreign body, masqueraded as soft-tissue mass and enteric duplication cyst, delaying the diagnosis. Systematic shape and density reanalysis of CT and US imaging suggested a hollow object lodged at the terminal ileum. The patient underwent exploratory laparotomy with extraction of a hollow toy "fish". There is a dearth of literature regarding hollow ingested objects. This case report highlights the importance of systematic density and shape imaging analyses in order to identify and locate hollow ingested objects.
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Affiliation(s)
| | - Dhairya A. Lakhani
- Department of Radiology, West Virginia University, Morgantown, West Virginia
| | - Ryan Kuhnlein
- Department of Radiology, West Virginia University, Morgantown, West Virginia
| | - Aneri B Balar
- Department of Radiology, West Virginia University, Morgantown, West Virginia
| | - Susan Neptune
- Department of Surgery, West Virginia University, Morgantown, West Virginia
| | - Dan Parrish
- Department of Surgery, West Virginia University, Morgantown, West Virginia
| | - Nicholas Shorter
- Department of Surgery, West Virginia University, Morgantown, West Virginia
| | - Ayodele Adelanwa
- Department of Pathology, West Virginia University, Morgantown, West Virginia
| | - Thuan-Phuong Nguyen
- Department of Radiology, West Virginia University, Morgantown, West Virginia
| | - Eyassu Hailemichael
- Department of Radiology, West Virginia University, Morgantown, West Virginia
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