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Cook R, Zima L, Khazaal J, Williams J. Low-velocity penetrating brain injury: a review of the literature and illustrative case. Brain Inj 2024:1-7. [PMID: 38555515 DOI: 10.1080/02699052.2024.2336067] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/22/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Low-velocity penetrating brain injury (LVPBI) is a class of brain injury where a foreign object violates the skull and damages the brain. Such injuries are rare and consequently understudied. CASE As such, we report an illustrative case of a 29-year-old female with a dense, plastic spike penetrating her right orbit and into her midbrain. After assessment with a CT scan and angiography, the object was removed with careful attention to possible vascular injury. The patient had an uncomplicated post-operative course and received antibiotic and antiepileptic prophylaxis. She was discharged on post-operative day 5, experiencing only mild left-sided weakness. DISCUSSION Common concerns regarding LVPBI include infection, post-traumatic epilepsy, and vascular injury. A review of published LVPBI cases over the past 20 years demonstrated that most cases (55.2%) are due to accidents. Of patients undergoing surgery, 43.4% underwent a craniotomy, and 22.8% underwent a craniectomy. Despite the grave nature of LVPBI, only 13.5% of the patients died. Additionally, 6.5% of patients developed an infection over their clinical course. CONCLUSION In all, more reported cases further paint a picture of the current state of management and outcomes regarding LVPBI, paving the way for more cohesive guidelines to ensure the best possible patient outcomes.
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Affiliation(s)
- Richard Cook
- Department of Neurosurgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Laura Zima
- Department of Neurosurgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jawad Khazaal
- Department of Neurosurgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - John Williams
- Department of Neurosurgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas, USA
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Di Mitri M, Parente G, Bisanti C, Thomas E, Cravano SM, Cordola C, Vastano M, Collautti E, Di Carmine A, Maffi M, D’Antonio S, Libri M, Gargano T, Lima M. Ask Doctor Smartphone! An App to Help Physicians Manage Foreign Body Ingestions in Children. Diagnostics (Basel) 2023; 13:3285. [PMID: 37892106 PMCID: PMC10606892 DOI: 10.3390/diagnostics13203285] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/07/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Foreign body ingestion (FBI) represents the most common cause of emergent gastrointestinal endoscopy in children. FBI's management can be quite challenging for physicians because of the variability of the clinical presentation, and the decision tree becomes even more intricate because of patient-specific variables that must be considered in the pediatric age range (e.g., age of patients and neuropsychiatric disorders) in addition to the mere characteristics of the foreign body. We present an application for smartphones designed for pediatricians and pediatric surgeons based on the latest guidelines from the official pediatric societies. The app aims to help physicians manage FBI quickly and properly in children. MATERIALS AND METHODS The latest pediatric FBI management guidelines were reviewed and summarized. The flow chart we obtained guided the development of a smartphone application. A questionnaire was administered to all pediatric surgeon trainees at our institute to test the feasibility and helpfulness of the application. RESULTS An app for smartphones was obtained and shared for free on the Google Play Store and Apple Store. The app guides the physician step by step in the diagnostic process, analyzing all patient- and foreign body-specific characteristics. The app consultation ends with a suggestion of the most proper decision to make in terms of further radiological investigations and the indication and timing of endoscopy. A questionnaire administered to trainees proved the app to be useful and easy to use. CONCLUSION We developed an app able to help pediatricians and pediatric surgeons manage FBI in children, providing standardized and updated recommendations in a smart and easily available way.
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Affiliation(s)
- Marco Di Mitri
- Pediatric Surgery Department, IRCCS Sant’Orsola-Malpighi Polyclinic, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy; (G.P.); (C.B.); (E.T.); (S.M.C.); (C.C.); (M.V.); (E.C.); (A.D.C.); (M.M.); (S.D.); (M.L.); (T.G.); (M.L.)
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Freitag N, Möllenberg L, Wiemers A, Bosse HM, Kristin J, Vicencio A, Schramm D. Preference matters: New aspects on how foreign bodies should and could be removed from a child's airway. Pediatr Pulmonol 2023. [PMID: 37042606 DOI: 10.1002/ppul.26411] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/16/2023] [Accepted: 03/25/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Foreign body aspiration in children is a potentially life-threatening event that can be diagnosed and treated by airway endoscopy. We aimed to analyze the influence of the examiner's experience and preference on the choice of the technique and the resulting complication rate. METHODS In this international study, experts in the field documented their preferred and applied technique as well as the outcome of each case of foreign body removal. Personal data of the bronchoscopists and their medical center were collected via an online questionnaire separately from the case specifics. RESULTS A total of 399 foreign body removals were performed by 64 examiners. A total of 279 removals were performed using rigid endoscopy, and 120 procedures were performed by flexible. When a difficulty was expected, flexible endoscopy was used significantly more often (χ2 (1) = 11.06, p < 0.001). Complications occurred significantly less often when the bronchoscopist used their preferred technique (χ2 (1) = 6.41, p = 0.011), had more than 5 years of experience (χ2 (1) = 5.13, p = 0.023) or performed more than 100 removals (χ2 (2) = 11.51, p = 0.003). In medical centers, complication rates significantly decreased if more than 200 bronchoscopies were performed in children, compared to the centers that perform 50-200 bronchoscopies per year (χ2 (1) = 24.56, p < 0.001). CONCLUSION Preference and experience of a bronchoscopist and his/her medical center with flexible or rigid foreign body removal distinctively affect the outcome of the procedure and cannot be neglected in the discourse on the appropriate technique. This link also emphasizes the importance of a structured training program.
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Affiliation(s)
- Nadine Freitag
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Leon Möllenberg
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Anna Wiemers
- Ruhr University Bochum, Children's Hospital St. Josef-Hospital, Bochum, Germany
| | - Hans Martin Bosse
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Julia Kristin
- Department of Otorhinolaryngology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Alfin Vicencio
- Division of Pediatric Pulmonology, Department of Pediatrics, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dirk Schramm
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany
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Alsubaie H, Alghamdi S, Almalki A, Almansouri OS, Alsulami FA, Bafail SA. Extraction of a Foreign Body From the Middle Ear Following a Complicated Hearing Aid Fitting: A Case Report. Cureus 2023; 15:e36499. [PMID: 37090384 PMCID: PMC10119617 DOI: 10.7759/cureus.36499] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Ear molding is a safe way to evaluate the ear for hearing aid fitting. A very rare complication of ear molding is the entry of a foreign body into the middle ear. We report the case of a three-year-old boy who had a perforated left tympanic membrane and bilateral sensorineural hearing loss that required the use of hearing aids. During the ear molding procedure, the molding material was unintentionally introduced into his middle ear cavity, necessitating immediate surgery to remove it. Such patients with tympanic membrane perforation must be handled cautiously while an aural impression is taken via ear molding to prevent introducing a foreign body into the middle ear.
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Affiliation(s)
- Haya Alsubaie
- Otolaryngology, Head and Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
- Otolaryngology, Head and Neck Surgery, King Abdulaziz Medical City, Riyadh, SAU
| | - Saif Alghamdi
- Otolaryngology, Head and Neck Surgery, King Fahad Military Medical Complex, Jeddah, SAU
| | - Abdulaziz Almalki
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Omar S Almansouri
- Medicine and Surgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Fahad A Alsulami
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Sumayya A Bafail
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
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Yang Z, Qin S, Li X. Esophageal foreign body removal under holmium laser-assisted gastroscope: A case report. Front Surg 2023; 10:1094160. [PMID: 36733890 PMCID: PMC9886868 DOI: 10.3389/fsurg.2023.1094160] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
As a common clinical emergence, esophageal foreign body can lead to esophageal perforation followed by severe complications including aortic injury, mediastinal abscess and airway obstruction, leading to a high rate of mortality. Therefore, fast and effective diagnosis and treatment are of great necessity. In this case, holmium laser-assisted gastroscopy was adopted to remove the foreign body incarcerated in the esophagus, allowing patients to avoid traumatic and costly surgeries. It is a supplement to traditional methods of foreign body removal. The new combination tried in this report can bring development and innovation inspiration to the development of endoscopic technology.
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Muacevic A, Adler JR, Fry E, Tiesenga F. Removal of Polymer Clips From the Gallbladder Fossa in a Patient With Ehlers-Danlos Syndrome (EDS) to Treat Mast Cell Activation Syndrome (MCAS): A Case Report. Cureus 2023; 15:e33704. [PMID: 36788923 PMCID: PMC9922053 DOI: 10.7759/cureus.33704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 01/13/2023] Open
Abstract
Ehlers-Danlos syndrome (EDS) is a group of hereditary disorders characterized by fragility of connective tissue. Clinical manifestations of the disorder involve the skin, joints, blood vessels, and other internal organs. We report the case of a 29-year-old female suffering from EDS and mast cell activation syndrome (MCAS). Her history includes multiple orthopedic surgeries leading to the worsening of her symptoms. This was determined to be due to medical implants placed during her multiple procedures predisposing her to severe immunological reactions. This case report emphasizes the importance of meticulous surgical intervention when managing patients with EDS.
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Schramm D, Freitag N, Kötz K, Iglesias-Serrano I, Culebras-Amigo M, Koblizek V, Pérez-Tarazona S, Cases Viedma E, Srikanta JT, Durdik P, Darwiche K, Rubak S, Stafler P. Cryotherapy in the paediatric airway: Indications, success and safety. Respirology 2022; 27:966-974. [PMID: 36054726 DOI: 10.1111/resp.14353] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 08/15/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Cryotherapy in interventional bronchoscopy is a new treatment modality, which has recently been made available for the paediatric airway. Lack of experience and safety concerns have led to hesitant adaptation. The aim of this study was to assess indications, success rates and complications of airway cryotherapy in children. METHODS Bronchoscopists from medical centre performing cryotherapy in patients between 0 and 18 years were invited to participate in a prospective study based on an online questionnaire. Patient and participant data were collected between June 2020 and June 2021. RESULTS A total of 69 cryotherapy procedures were performed in 57 patients a for three main indications: Biopsy (30), restoration of airway patency (23) and foreign body aspiration (16). The overall success rate was 93%, the remaining 7% were performed for foreign body removal and required a switch of technique. Restoration of airway patency was successfully applied in various pathologies, including mucus plugs, bronchial casts and post traumatic stenosis. The diagnostic yield of transbronchial biopsies was 96%. No severe complications were encountered; one pneumothorax following a cryobiopsy required a chest drain for 48 h. No child was admitted to intensive care or died from a procedural complication. CONCLUSION In this largest paediatric case collection to date, cryotherapy was safe and carried a high success rate. Cryobiopsy compares favourably to the widely used forceps biopsy and could replace it in the future. Paediatric bronchoscopists are encouraged to add cryotherapy to their armamentarium of airway interventions.
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Affiliation(s)
- Dirk Schramm
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nadine Freitag
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Karsten Kötz
- Queen Silvias Children Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ignacio Iglesias-Serrano
- Unitat de Pneumologia Pediàtrica i Fibrosi Quística, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Vladimir Koblizek
- Department of Pneumology, University Hospital Hradec Kralove, Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czechia
| | | | - Enrique Cases Viedma
- Respiratory Endoscopy Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - J T Srikanta
- Pediatric Interventional Pulmonology, Allergy and Sleep Medicine, Aster CMI and RV Hospitals, Bengaluru, India
| | - Peter Durdik
- Pediatric Department, University Hospital Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Kaid Darwiche
- Department for Interventional Pneumology, Ruhrlandklinik-West German Lung Center, University Medicine Essen, Essen, Germany
| | - Sune Rubak
- Department of Pediatrics and Adolescents Medicine, Danish Center of Pediatric Pulmonology and Allergology, University Hospital of Aarhus, Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark
| | - Patrick Stafler
- Pediatric Pulmonology Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Uyar E, Sarıbaş F. Evaluating Depth and Width of Corneal Wounds Using Anterior Segment Optical Coherence Tomography After Foreign Body Removal. Semin Ophthalmol 2022; 37:774-779. [PMID: 35830289 DOI: 10.1080/08820538.2022.2100712] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To determine corneal foreign body (FB) location together with corneal wound depth and width by using anterior segment optical coherence tomography (AS-OCT) after uncomplicated FB removal. METHOD This prospective study was conducted with patients injured by a superficial metallic corneal FB. Under slit-lamp examination, after determining its location, the FB was removed with a 27-G needle. The depth and width of the corneal wound and the thinnest stromal thickness at the wound site were measured initially using AS-OCT. Measurements were repeated to assess the wound healing process at one week and at two months following FB removal. RESULTS Totally, 63 eyes of 63 patients were included in this study. The average age was 35.8 ± 11.0 years, and 96.8% of the patients were men. In terms of location of the FBs, 26 (41.3%) were in the central region, 21 (33.3%) were in the paracentral region, and 16 (25.4%) were in peripheral regions. The mean depth and width of the corneal wounds were 117.0 ± 42.5 µm and 332.9 ± 99.4 µm, respectively. The mean percentage of corneal wound depth was 18.9 ± 6.1%. In 20 patients who presented for follow-up, it was observed that the width of the wound increased and the thinnest stromal thickness at the wound site decreased over the two months. CONCLUSION The AS-OCT findings of the present study showed that the corneal FBs generally affected the anterior cornea with less than approximately 0.2 mm depth and 0.5 mm width. In addition, FBs were commonly located in the central and paracentral cornea.
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Affiliation(s)
- Enes Uyar
- Department of Ophthalmology, Aksaray Training and Research Hospital, Aksaray University, Aksaray, Turkey
| | - Ferhat Sarıbaş
- Department of Ophthalmology, Aksaray Training and Research Hospital, Aksaray University, Aksaray, Turkey
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Kim M, Park H, Kwon SK. Case of impacted subglottic metallic foreign body removal without tracheostomy through an endotracheal tube. Clin Case Rep 2022; 10:e05770. [PMID: 35521046 PMCID: PMC9066741 DOI: 10.1002/ccr3.5770] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 03/28/2022] [Indexed: 11/20/2022] Open
Abstract
A foreign body in the upper airway can cause serious morbidity and mortality, especially in pediatric patients. This case report describes an innovative way to remove an impacted foreign body distal to the vocal folds through an endotracheal tube without tracheostomy.
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Affiliation(s)
- Minju Kim
- Department of Otorhinolaryngology - Head and Neck Surgery Seoul National University Hospital Seoul National University College of Medicine Seoul Korea
| | - Haechan Park
- Department of Otorhinolaryngology - Head and Neck Surgery Seoul National University Hospital Seoul National University College of Medicine Seoul Korea
| | - Seong Keun Kwon
- Department of Otorhinolaryngology - Head and Neck Surgery Seoul National University Hospital Seoul National University College of Medicine Seoul Korea
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Zewdu D, Wondwosen M, Chufamo M, Eanga S, Aga A, Ewnte B, Hunie M, Teshome D. The practice of foreign body removal from the ear, nose, and upper esophageal in children in Ethiopia: A retrospective descriptive study. Laryngoscope Investig Otolaryngol 2021; 6:1316-1320. [PMID: 34938868 PMCID: PMC8665465 DOI: 10.1002/lio2.688] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/24/2021] [Accepted: 10/18/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Ear, nose, and upper esophageal foreign body (FB) impaction in children is a common emergency in-hospital service. There are no clear guidelines regarding the management of ingested FBs. This study aimed to determine the FB in terms of type, anatomic site, management outcome, and associated complications. METHODS Retrospective study of children with ear, nose, and upper esophageal FB managed under general anesthesia (GA) at operating room of Wolkite Hospital in the southern part of Ethiopia between January 2019 and February 2021. Data were collected from the medical chart of the patients using a prepared checklist. The parameters included were age, sex, FB anatomic site, type, management outcome, and associated complications related to FB or procedure modalities. RESULTS A total of 169 (31.4%) study subjects were required GA for the removal of FBs. The mean age was 4.45 ± 3.20 years. Under 5 years old children comprises 61.5% of total cases. The most common anatomic site of FB impaction was in the ear 97 (57.4%). The most commonly found type of FB was cereals or seeds, which constituted 102 (60.35%). The complication rate was 18.35%. Epistaxis was the commonest complication (6.51%) from the nose while canal abrasion (5.92%) was common from the ear. CONCLUSION Ear, nose, and upper esophageal FBs were found more frequently in younger children. The ear was the most common anatomic site of FB impaction followed by the nose and upper esophageal. The most common type of FB was cereals or seeds. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Dereje Zewdu
- Department of Anesthesia, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Mekete Wondwosen
- Department of Surgery, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Mulatu Chufamo
- Department of Surgery, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Shamill Eanga
- Department of Anesthesia, College of Medicine and Health ScienceWolkite UniversityWolkiteEthiopia
| | - Abdisa Aga
- Department of AnesthesiaHarar College of Health ScienceHararEthiopia
| | - Biniam Ewnte
- Department of Surgery, College of Medicine and Health ScienceDebre Tabor UniversityDebre TaborEthiopia
| | - Metages Hunie
- Department of Anesthesia, College of Health ScienceDebre Tabor UniversityDebre TaborEthiopia
| | - Diriba Teshome
- Department of Anesthesia, College of Health ScienceDebre Tabor UniversityDebre TaborEthiopia
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Kottferová L, Molnár L, Major P, Toporčák J, Mesárčová L, Kottferová J, Szarková A. Removal of foreign bodies from the proventriculus in a young golden eagle (Aquila chrysaetos). Acta Vet Hung 2021; 69:298-302. [PMID: 34520389 DOI: 10.1556/004.2021.00035] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 08/21/2021] [Indexed: 11/19/2022]
Abstract
This paper presents a clinical case report of a golden eagle (Aquila chrysaetos) with foreign bodies (stones) in its proventriculus. The case deals with the identification, management and removal of foreign objects identified in the gastrointestinal tract. A surgical removal by proventriculotomy under general anaesthesia was attempted. The surgery and the recovery were uneventful, and the follow-up after six months revealed no complications. To the best of our knowledge, there are no other reports of successful foreign body removal by proventriculotomy in the golden eagle.
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Affiliation(s)
- Lucia Kottferová
- 1 Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, Košice, Slovakia
| | - Ladislav Molnár
- 1 Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, Košice, Slovakia
| | - Peter Major
- 1 Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, Košice, Slovakia
| | - Juraj Toporčák
- 1 Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy, Komenského 73, Košice, Slovakia
| | - Lýdia Mesárčová
- 2 Department of Public Veterinary Medicine and Animal Welfare, University of Veterinary Medicine and Pharmacy, Košice, Slovakia
| | - Jana Kottferová
- 2 Department of Public Veterinary Medicine and Animal Welfare, University of Veterinary Medicine and Pharmacy, Košice, Slovakia
| | - Andrea Szarková
- 3 Small Animal Clinic, University of Veterinary Medicine and Pharmacy, Košice, Slovakia
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Cohen J, Ferm S, Schwarzbaum D, Tsistrakis S, Hussain S, Kim SH. Novel Approach to Endoscopic Foreign Body Retrieval From the Gastric Body. J Investig Med High Impact Case Rep 2021; 9:23247096211040631. [PMID: 34420403 PMCID: PMC8385581 DOI: 10.1177/23247096211040631] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Foreign body (FB) ingestion is a common occurrence in the United States with a reported incidence of 120 per 1 million people, accounting for up to 1500 fatalities annually. The majority of FB ingestions will pass through the gastrointestinal tract spontaneously, while in 10% to 20% of patients, intervention will be necessary. A variety of endoscopic devices can be utilized to facilitate FB removal from the gastrointestinal tract, including snares, retrieval nets, and grasping forceps. We report the case of a 58-year-old female who required utilization of endoscopic scissors for FB removal in the setting of multiple failed attempts with traditional methods. This case highlights a novel approach to gastric FB removal utilizing endoscopic scissor forceps, which should be considered in select cases to further improve the efficacy of endoscopic FB removal and reduce the need for surgical intervention.
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Affiliation(s)
- Jason Cohen
- New York-Presbyterian Queens, Flushing, NY, USA
| | - Samson Ferm
- New York-Presbyterian Queens, Flushing, NY, USA
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Abstract
Stingrays stings are becoming an increasingly common marine injury. Stingray spine extraction is a complicated maneuver without a precise method: we present here a novel approach to safely remove a penetrating stingray sting. This procedure is easy and does not require specialized medical devices.
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Affiliation(s)
- Giovanni Cappa
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo University Hospital, University of Pavia, Pavia, Italy
| | - Bruno Barcella
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo University Hospital, University of Pavia, Pavia, Italy
| | - Pietro Pettenazza
- Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, IRCCS Policlinico San Matteo University Hospital, University of Pavia, Pavia, Italy
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Wang W, Schneider GT, Strohl A. The Utility of the Maxillary Heuwieser for Oropharyngeal Foreign Body Removal Under Nebulized Local Anesthesia: A Case Series. Ear Nose Throat J 2020; 100:691S-693S. [PMID: 32050771 DOI: 10.1177/0145561320906329] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We describe a novel and safe use of existing instrumentation in the removal of select foreign bodies in the upper aerodigestive tract to minimize health-care costs. A retrospective review of 4 cases involving visualized upper aerodigestive tract foreign bodies were identified via flexible laryngoscopy and extracted under local anesthesia from 2016 to 2018. All 4 patients were not in any airway distress and underwent successful removal of the foreign body, which included 2 fishbones, a sewing pin, and a wire bristle with a maxillary Heuwieser or giraffe instrument under flexible laryngoscopy visualizing using local anesthesia without complications. No foreign bodies were dislodged. The use of a maxillary Heuwieser and flexible laryngoscopy visualization is safe, allows for removal of otherwise difficult to reach foreign bodies at the bedside, improving patient comfort, obviates the need for general anesthesia to the patient, and minimizes health-care costs.
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Affiliation(s)
- Weitao Wang
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, TX, USA
| | - Glenn Todd Schneider
- Department of Otolaryngology Head and Neck Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Alexis Strohl
- Department of Otolaryngology Head and Neck Surgery, University of Rochester Medical Center, Rochester, NY, USA
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15
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Khayat M, Khayat A, Chick JFB, Healey TL, Srinivasa RN. Percutaneous Interventional Radiology-Operated Endoscopy for Foreign Body Removal. Tech Vasc Interv Radiol 2019; 22:149-153. [PMID: 31623755 DOI: 10.1053/j.tvir.2019.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Image-guided retrieval of endovascular devices such as inferior vena cava filters, guidewires, and stents is well reported, though there is a paucity of published reports on biliary, genitourinary, or gastrointestinal foreign body retrieval utilizing percutaneous endoscopy, particularly when it is performed solely by interventional radiologists. In cases of failed traditional endoscopic techniques or to evade more invasive surgical options, percutaneous endoscopy can be an adjunctive tool employed by interventional radiologists to extract foreign bodies. In this article, clinical evaluation, perioperative management, and procedural techniques for biliary, genitourinary, and gastrointestinal endoscopy for foreign body retrieval are reviewed.
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Affiliation(s)
- Mamdouh Khayat
- Department of Radiology, Division of Vascular and Interventional Radiology, The Ohio State University Wexner Medical Center, Columbus, OH.
| | - Adam Khayat
- Department of Biology, University of Louisville, Louisville, KY
| | - Jeffrey Forris Beecham Chick
- Division of Interventional Radiology, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195
| | - Travis L Healey
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Ravi N Srinivasa
- Department of Radiology, Division of Vascular and Interventional Radiology, UCLA Medical Center, Los Angeles, CA
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Abstract
INTRODUCTION Rigid bronchoscopy is an invaluable tool for the management of airway disorders and an essential skill for an interventional pulmonologist. Since its introduction in the late 19th century, it has remained an important technique for the management of central airway obstruction, foreign body aspiration and massive hemoptysis. Areas covered: This article will review the history, indications, contraindication, technique and complications of rigid bronchoscopy. We will also briefly discuss the methods of anesthesia and ventilation and finally our perspective on the future of rigid bronchoscopy. Expert commentary: Although the rise of flexible bronchoscopy in the 1960s led to a decline in the use of rigid bronchoscopy, the last two decades have witnessed resurgence in its popularity. We anticipate that it will remain an important tool used by interventional pulmonologists for decades to come. We suggest that interventional pulmonologists must have training and develop expertise in this technique.
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Affiliation(s)
- Hitesh Batra
- a Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine , Johns Hopkins Hospital , Baltimore , MD , USA
| | - Lonny Yarmus
- a Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine , Johns Hopkins Hospital , Baltimore , MD , USA
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17
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Schramm D, Ling K, Schuster A, Nicolai T. Foreign body removal in children: Recommendations versus real life-A survey of current clinical management in Germany. Pediatr Pulmonol 2017; 52:656-661. [PMID: 27648823 DOI: 10.1002/ppul.23609] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/18/2016] [Accepted: 09/06/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Task forces of the European Respiratory Society (ERS, 2003) and the American Thoracic Society (ATS, 2015) both recommend rigid bronchoscopy for foreign body removal in children. However, there is an increasing number of publications recommending flexible bronchoscopy as primary method for foreign body removal in children. METHODS We therefore initiated a nationwide survey, investigating the routinely used method of foreign body removal in children in different centers in Germany. RESULTS In total, 259 centers took part in the survey. Twenty percent used flexible bronchoscopy as primary method of choice for foreign body removal. Of note, only 40% of the respondents reported that they had attended formal training courses in flexible bronchoscopy, 15% in rigid bronchoscopy, and 42% had never attended a formal training. Twenty-five percent indicated that they had already encountered an emergency situation during or after foreign body removal, requiring intensive care. CONCLUSION Published data shows that rigid bronchoscopy involves fewer complications and is more successful in foreign body removal in children. It is consequently questionable, why 20% of the medical centers report a preference for the flexible method. One reason might be the poor availability of rigid bronchoscopy and the difficulty gaining sufficient expertise in rigid bronchoscopy in Germany. Pediatr Pulmonol. 2017;52:656-661. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Dirk Schramm
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Kerstin Ling
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Antje Schuster
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Thomas Nicolai
- Department of Pediatrics, Ludwig-Maximilians-University of Munich, Munich, Germany
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18
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Belgrano V, Bagge RO, Scordamaglia C, Scordamaglia R. Extraction of a foreign body in the liver using single incision laparoscopic surgery: a new application for minimally invasive surgical procedures. Wideochir Inne Tech Maloinwazyjne 2015; 10:129-32. [PMID: 25960804 DOI: 10.5114/wiitm.2015.48732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/24/2014] [Accepted: 12/22/2014] [Indexed: 11/17/2022] Open
Abstract
Ingestion of foreign bodies is a common medical problem frequently observed in children, psychiatric patients and prisoners. Various cases have been found in the medical literature, with different diagnostic and therapeutic approaches. We report a case of a 41-year-old male inmate, hospitalized for right upper quadrant pain of the abdomen due to the ingestion of two syringe needles two weeks previously. We describe the diagnostic procedure and the removal of one of the two needles that had migrated into the liver parenchyma, using a single-incision laparoscopic surgical technique. The operation was carried out safely through a 2.5 cm transverse incision below the umbilicus. The dissection and the removal of the foreign body were easily conducted under direct visualization using a minimally invasive surgical technique. Our case report demonstrates the efficacy and the security of the laparoscopic treatment in such a challenging area, employing a single port access only.
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19
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Williams JR, Aghion DM, Doberstein CE, Cosgrove GR, Asaad WF. Penetrating brain injury after suicide attempt with speargun: case study and review of literature. Front Neurol 2014; 5:113. [PMID: 25071701 PMCID: PMC4083241 DOI: 10.3389/fneur.2014.00113] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/16/2014] [Indexed: 11/16/2022] Open
Abstract
Penetrating cranial injury by mechanisms other than gunshots are exceedingly rare, and so strategies and guidelines for the management of PBI are largely informed by data from higher-velocity penetrating injuries. Here, we present a case of penetrating brain injury by the low-velocity mechanism of a harpoon from an underwater fishing speargun in an attempted suicide by a 56-year-old Caucasian male. The case raised a number of interesting points in management of low-velocity penetrating brain injury (LVPBI), including benefit in delaying foreign body removal to allow for tamponade; the importance of history-taking in establishing the social/legal significance of the events surrounding the injury; the use of cerebral angiogram in all cases of PBI; advantages of using dual-energy CT to reduce artifact when available; and antibiotic prophylaxis in the context of idiosyncratic histories of usage of penetrating objects before coming in contact with the intracranial environment. We present here the management of the case in full along with an extended discussion and review of existing literature regarding key points in management of LVPBI vs. higher-velocity forms of intracranial injury.
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Affiliation(s)
- John R Williams
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA
| | - Daniel M Aghion
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA
| | - Curtis E Doberstein
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA
| | - G Rees Cosgrove
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA ; Department of Clinical Neuroscience, Warren Alpert School of Medicine, Brown University , Providence, RI , USA
| | - Wael F Asaad
- Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Department of Neurosurgery, Rhode Island Hospital , Providence, RI , USA ; Department of Clinical Neuroscience, Warren Alpert School of Medicine, Brown University , Providence, RI , USA ; Brown Institute for Brain Sciences , Providence, RI , USA
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20
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Friedrich RE, Zustin J. Paraffinoma of lips and oral mucosa: Case report and brief review of the literature. GMS Interdiscip Plast Reconstr Surg DGPW 2014; 3:Doc05. [PMID: 26504716 PMCID: PMC4582499 DOI: 10.3205/iprs000046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Interstitial application of paraffin in plastic and reconstructive surgery is obsolete due to the development of permanent and extensive foreign body granulomas at the site of application. These granulomas can cause severe physical impairment and develop their own prognostic worth. Furthermore, the disperse oil droplets are not a locally stable suspension. Therefore, the desired aesthetic aspect can get lost in the course of a potential dislocation of the suspension. In addition, the interstitial confluence of non-resorbable droplets to larger oil drops causes palpable and sometimes visible indurations of the skin, the correlate of chronic inflammation. This case report describes the efforts undertaken to release the patient at least temporarily from her paraffin granulomas and to improve her appearance. The relevant literature is briefly discussed. Furthermore, we present some immunohistochemical findings to specify the foreign body reaction associated with paraffin injections into connective tissues.
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Affiliation(s)
- Reinhard E Friedrich
- Oral and Cranio-Maxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Germany
| | - Jozef Zustin
- Gerhard-Domagk-Institute of Pathology, Westfälische Wilhelms University, Münster, Germany
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21
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Shariff MK, Oppong K, Thompson N. Ingested foreign body, to remove or not to remove. Gut 2006; 55:1103, 1155. [PMID: 16849346 PMCID: PMC1856294 DOI: 10.1136/gut.2005.083543] [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] [Indexed: 12/08/2022]
Affiliation(s)
- M K Shariff
- Gastroenterology and Liver Unit, Freeman Hospital, Newcastle upon Tyne, UK
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