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Qin L, Shi H, Zhang X, Chen P, Liu X, Wang J, Qin B. Endoscopic removal of esophageal foreign body embedded in muscularis propria. Endoscopy 2024; 56:E89-E90. [PMID: 38290708 PMCID: PMC10827518 DOI: 10.1055/a-2239-3296] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Lingzhi Qin
- Department of Gastroenterology, Xiʼan Jiaotong University Second Affiliated Hospital, Xiʼan, China
| | - Haitao Shi
- Department of Gastroenterology, Xiʼan Jiaotong University Second Affiliated Hospital, Xiʼan, China
| | - Xue Zhang
- Department of Gastroenterology, Xiʼan Jiaotong University Second Affiliated Hospital, Xiʼan, China
| | - Peiqi Chen
- Department of Gastroenterology, Xiʼan Jiaotong University Second Affiliated Hospital, Xiʼan, China
| | - Xin Liu
- Department of Gastroenterology, Xiʼan Jiaotong University Second Affiliated Hospital, Xiʼan, China
| | - Jinhai Wang
- Department of Gastroenterology, Xiʼan Jiaotong University Second Affiliated Hospital, Xiʼan, China
| | - Bin Qin
- Department of Gastroenterology, Xiʼan Jiaotong University Second Affiliated Hospital, Xiʼan, China
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Tao X, Zhao X, Liu H, Wang J, Tian C, Liu L, Ding Y, Chen X, Liu Y. Automatic Recognition of Concealed Fish Bones under Laryngoscopy: A Practical AI Model Based on YOLO-V5. Laryngoscope 2024; 134:2162-2169. [PMID: 37983879 DOI: 10.1002/lary.31175] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/27/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Fish bone impaction is one of the most common problems encountered in otolaryngology emergencies. Due to their small and transparent nature, as well as the complexity of pharyngeal anatomy, identifying fish bones efficiently under laryngoscopy requires substantial clinical experience. This study aims to create an AI model to assist clinicians in detecting pharyngeal fish bones more efficiently under laryngoscopy. METHODS Totally 3133 laryngoscopic images related to fish bones were collected for model training and validation. The images in the training dataset were trained using the YOLO-V5 algorithm model. After training, the model was validated and its performance was evaluated using a test dataset. The model's predictions were compared to those of human experts. Seven laryngoscopic videos related to fish bone were used to validate real-time target detection by the model. RESULTS The model trained in YOLO-V5 demonstrated good generalization and performance, with an average precision of 0.857 when the intersection over union (IOU) threshold was set to 0.5. The precision, recall rate, and F1 scores of the model are 0.909, 0.818, and 0.87, respectively. The overall accuracy of the model in the validation set was 0.821, comparable to that of ENT specialists. The model processed each image in 0.012 s, significantly faster than human processing (p < 0.001). Furthermore, the model exhibited outstanding performance in video recognition. CONCLUSION Our AI model based on YOLO-V5 effectively identifies and localizes fish bone foreign bodies in static laryngoscopic images and dynamic videos. It shows great potential for clinical application. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2162-2169, 2024.
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Affiliation(s)
- Xiaoyao Tao
- Otorhinolaryngology Head and Neck Surgery Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xu Zhao
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Hairui Liu
- School of Information Engineering, China University of Geosciences, Beijing, China
| | - Jinqiao Wang
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Chunhui Tian
- Otolaryngology-Head and Neck Surgery Department, Suzhou Hospital of Anhui Medical University, Suzhou, China
| | - Longsheng Liu
- Otolaryngology-Head and Neck Surgery Department, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yujie Ding
- Otolaryngology-Head and Neck Surgery Department, Feixi County People's Hospital, Hefei, China
| | - Xue Chen
- Otolaryngology-Head and Neck Surgery Department, Feidong County People's Hospital, Hefei, China
| | - Yehai Liu
- Otorhinolaryngology Head and Neck Surgery Department, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Kurisaki K, Soyama A, Hamauzu S, Yamada M, Yamaguchi S, Matsuguma K, Kerkhof E, Fukuda T, Toya R, Eguchi S. Clinical Validation of Computer-Aided Diagnosis Software for Preventing Retained Surgical Sponges. J Am Coll Surg 2024; 238:856-860. [PMID: 38258847 DOI: 10.1097/xcs.0000000000001012] [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] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND We previously reported the successful development of a computer-aided diagnosis (CAD) system for preventing retained surgical sponges with deep learning using training data, including composite and simulated radiographs. In this study, we evaluated the efficacy of the CAD system in a clinical setting. STUDY DESIGN A total of 1,053 postoperative radiographs obtained from patients 20 years of age or older who underwent surgery were evaluated. We implemented a foreign object detection application software on the portable radiographic device used in the operating room to detect retained surgical sponges. The results of the CAD system diagnosis were prospectively collected. RESULTS Among the 1,053 images, the CAD system detected possible retained surgical items in 150 images. Specificity was 85.8%, which is similar to the data obtained during the development of the software. CONCLUSIONS The validation of a CAD system using deep learning in a clinical setting showed similar efficacy as during the development of the system. These results suggest that the CAD system can contribute to the establishment of a more effective protocol than the current standard practice for preventing the retention of surgical items.
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Affiliation(s)
- Ken Kurisaki
- From the Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Japan (Kurisaki, Soyama, Yamaguchi, Matsuguma, Eguchi)
| | - Akihiko Soyama
- From the Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Japan (Kurisaki, Soyama, Yamaguchi, Matsuguma, Eguchi)
| | - Shin Hamauzu
- Imaging Technology Center, Research and Development Management Headquarters, FUJIFILM Corporation, Tokyo, Japan (Hamauzu, Yamada)
| | - Masahiko Yamada
- Imaging Technology Center, Research and Development Management Headquarters, FUJIFILM Corporation, Tokyo, Japan (Hamauzu, Yamada)
| | - Shun Yamaguchi
- From the Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Japan (Kurisaki, Soyama, Yamaguchi, Matsuguma, Eguchi)
| | - Kunihito Matsuguma
- From the Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Japan (Kurisaki, Soyama, Yamaguchi, Matsuguma, Eguchi)
| | - Enzo Kerkhof
- Educational Program Technical Medicine, Leiden University Medical Center, Delft University of Technology and Erasmus MC Rotterdam, Rotterdam, The Netherlands (Kerkhof)
| | - Toru Fukuda
- From the Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Japan (Kurisaki, Soyama, Yamaguchi, Matsuguma, Eguchi)
- Imaging Technology Center, Research and Development Management Headquarters, FUJIFILM Corporation, Tokyo, Japan (Hamauzu, Yamada)
- Educational Program Technical Medicine, Leiden University Medical Center, Delft University of Technology and Erasmus MC Rotterdam, Rotterdam, The Netherlands (Kerkhof)
- Department of Radiology, Nagasaki University Hospital, Nagasaki City, Japan (Toya)
| | - Ryo Toya
- Department of Radiology, Nagasaki University Hospital, Nagasaki City, Japan (Toya)
| | - Susumu Eguchi
- From the Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Japan (Kurisaki, Soyama, Yamaguchi, Matsuguma, Eguchi)
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Sun X, Ren J, Li B, Liu S, Zou J, Chen F, Wang H. Remove an Unusual Laryngeal Foreign Body with a Modified Endoscopic Injection Needle. Laryngoscope 2024; 134:2338-2340. [PMID: 37909667 DOI: 10.1002/lary.31121] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023]
Abstract
Foreign body (FB) aspiration requiring prompt intervention to prevent severe complications. The endoscopic injection needle, commonly employed for intramucosal injections in the gastrointestinal tract and respiratory tract, while with no previous reports of used for FB extraction. Here we report a case of a pea impacted in the laryngeal ventricle of an adult patient, which became lodged in her right laryngeal ventricle. Conventional methods, such as flexible forceps and baskets, were deemed unsuitable for retrieving this fragile and mushy FB. Therefore, we introduce a novel technique using a modified endoscopic injection needle, which proved successful in removing the foreign body. Laryngoscope, 134:2338-2340, 2024.
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Affiliation(s)
- Xiaoru Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Ren
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Li
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Shixi Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Zou
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Haiyang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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Hong PY, Wang L, Du YP, Wang M, Chen YY, Huang MH, Zhang XB. Clinical characteristics and removal approaches of tracheal and bronchial foreign bodies in elders. Sci Rep 2024; 14:9493. [PMID: 38664527 DOI: 10.1038/s41598-024-60307-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/21/2024] [Indexed: 04/28/2024] Open
Abstract
The symptoms of tracheobronchial foreign body in the elderly are not typical, so they are often missed or misdiagnosed. This study aims to depict the clinical characteristics of tracheobronchial foreign body inhalation in the elderly. We retrospectively analysed the clinical data of elder patients (age ≥ 65 years) diagnosed with tracheal and bronchial foreign bodies. The data included age, sex, clinical symptoms, type and location of foreign bodies, prehospital duration, Chest CT, bronchoscopic findings, and frequencies and tools for removing these elderly patients' tracheal and bronchial foreign bodies. All patients were followed up for a half year. Fifty-nine cases were included, of which only 32.2% had a definite aspiration history. Disease duration > 30 days accounted for 27.1% of the patients. 27.1% of the patients had a history of stroke, and 23.8% had Alzheimer's Disease. Regarding clinical symptoms, patients mainly experience cough and expectoration. The most common CT findings were abnormal density shadow (37.3%) and pulmonary infiltration (22.0%). Under bronchoscopy, purulent secretions were observed in 52.5% of patients, and granulation tissue hyperplasia was observed in 45.8%. Food (55.9%) was the most common foreign object, including seafood shells (5.1%), bones (20.3%), dentures (18.6%), and tablets (20.3%). The success rate of foreign body removal under a bronchoscope was 96.7%, 28.8% of the foreign bodies were on the left and 69.5% on the right. 5.1% of the elderly patients required rigid bronchoscopy, and 6.8% required two bronchoscopies. In elderly cohorts, tracheal foreign bodies are obscured by nonspecific clinical presentations and a paucity of aspiration history, challenging timely diagnosis. Predominantly constituted by food particles, with a notable predilection for the left bronchial tree, these cases demand skilled bronchoscopic management, occasionally requiring sophisticated approaches for successful extraction.
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Affiliation(s)
- Ping-Yang Hong
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, Fujian, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Key Clinical Specialty of Fujian Province, Fuzhou, China
| | - Ling Wang
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, Fujian, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Key Clinical Specialty of Fujian Province, Fuzhou, China
| | - Yan-Ping Du
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, Fujian, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Key Clinical Specialty of Fujian Province, Fuzhou, China
| | - Miao Wang
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, Fujian, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Key Clinical Specialty of Fujian Province, Fuzhou, China
| | - Yi-Yuan Chen
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, Fujian, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Key Clinical Specialty of Fujian Province, Fuzhou, China
| | - Mao-Hong Huang
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, Fujian, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Key Clinical Specialty of Fujian Province, Fuzhou, China
| | - Xiao-Bin Zhang
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, Fujian, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Key Clinical Specialty of Fujian Province, Fuzhou, China.
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Gontier JCM, Wienandts L, Endermann S. Unintentional Plastic Blister Ingestion Leading to Intestinal Perforation: A Report of Two Cases. Am J Case Rep 2024; 25:e943514. [PMID: 38622861 PMCID: PMC11034392 DOI: 10.12659/ajcr.943514] [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: 12/15/2023] [Revised: 03/01/2024] [Accepted: 02/15/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Unintentional medication-blister ingestion is rare but frequently leads to intestinal perforation. The diagnosis of intestinal perforation following blister ingestion is often delayed because of an unreliable history and nonspecific clinical presentation. The purpose of this case report is to raise awareness about a rare but difficult diagnosis and its importance in avoiding potentially fatal events. CASE REPORT Herein, we describe successful cases of surgical and endoscopic removal after blister ingestion. The first case was that of a polymorbid 75-year-old man who presented with acute onset of abdominal pain in the right upper quadrant and epigastric regions. No indication of the cause was observed on initial computed tomography (CT). The patient developed an acute abdomen, and emergency laparotomy was performed, during which 2 small perforations were observed in the terminal ileum, and an empty tablet blister was retrieved. The second patient was a 55-year-old man who presented with a considerable lack of awareness. On the initial CT, a subdural hematoma, aspiration, and an unidentified foreign body in the stomach were observed. Gastroscopy was performed after emergency craniotomy. In addition to the initial foreign body, a second object, which had gone unnoticed on the initial CT, was found and removed from the esophagus. CONCLUSIONS With an increased risk of perforation and difficult clinical and radiological diagnoses, prophylactic measures and special awareness of high-risk patients are particularly important.
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Affiliation(s)
- Juli Celina Medina Gontier
- Clinic for General, Visceral, Endocrine, and Transplantation Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Lea Wienandts
- Clinic for General Internal Medicine, General Practitioner Medicine, and Emergency Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Susann Endermann
- Clinic for Anesthesiology, Operative Intensive Care Medicine, Rescue, and Pain Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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Zhang R, Chen Z, Li C. Right Coronary Artery Occlusion Due to Foreign Body From Left Chest Traumatic Injury. JACC Cardiovasc Interv 2024; 17:940-941. [PMID: 38599700 DOI: 10.1016/j.jcin.2024.01.303] [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: 12/23/2023] [Accepted: 01/02/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Ran Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhongxiu Chen
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Chen Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
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Oftring ZS, Mehrtens DM, Mollin J, Hamelmann E, Gaus S. Chronic stridor in a toddler after ingestion of a discharged button battery: a case report. BMC Pediatr 2024; 24:246. [PMID: 38582899 PMCID: PMC10998317 DOI: 10.1186/s12887-024-04730-1] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/30/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Button battery (BB) ingestions (BBI) are increasingly prevalent in children and constitute a significant, potentially life-threatening health hazard, and thus a pediatric emergency. Ingested BBs are usually charged and can cause severe symptom within 2 h. Discharged BBs ingestion is very rare and protracted symptom trajectories complicate diagnosis. Timely imaging is all the more important. Discharged BBs pose specific hazards, such as impaction, and necessitate additional interventions. CASE PRESENTATION We present the case of a previously healthy 19-month-old girl who was admitted to our pediatric university clinic in Germany for assessment of a three-month history of intermittent, mainly inspiratory stridor, snoring and feeding problems (swallowing, crying at the sight of food). The child's physical examination and vital signs were normal. Common infectious causes, such as bronchitis, were ruled out by normal lab results including normal infection parameters, negative serology for common respiratory viruses, and normal blood gas analysis, the absence of fever or pathological auscultation findings. The patient's history contained no evidence of an ingestion or aspiration event, no other red flags (e.g., traveling, contact to TBC). Considering this and with bronchoscopy being the gold standard for foreign body (FB) detection, an x-ray was initially deferred. A diagnostic bronchoscopy, performed to check for airway pathologies, revealed normal mucosal and anatomic findings, but a non-pulsatile bulge in the trachea. Subsequent esophagoscopy showed an undefined FB, lodged in the upper third of the otherwise intact esophagus. The FB was identified as a BB by a chest X-ray. Retrieval of the battery proved extremely difficult due to its wedged position and prolonged ingestion and required a two-stage procedure with consultation of Ear Nose Throat colleagues. Recurring stenosis and regurgitation required one-time esophageal bougienage during follow-up examinations. Since then, the child has been asymptomatic in the biannual endoscopic controls and is thriving satisfactorily. CONCLUSION This case describes the rare and unusual case of a long-term ingested, discharged BB. It underscores the need for heightened vigilance among healthcare providers regarding the potential hazards posed by discharged BBIs in otherwise healthy children with newly, unexplained stridor and feeding problems. This case emphasizes the critical role of early diagnostic imaging and interdisciplinary interventions in ensuring timely management and preventing long-term complications associated even to discharged BBs.
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Affiliation(s)
- Zoe S Oftring
- Department of Paediatrics, University Clinic Giessen & Marburg, Marburg, Germany
- Philipps University Marburg and University Clinic Giessen & Marburg, Institute of Digital Medicine, Marburg, Germany
- Department of Paediatrics, Bielefeld University, University Hospital OWL, Children's Center Bethel, Bielefeld, Germany
| | - Doortje M Mehrtens
- Department of Paediatrics, Bielefeld University, University Hospital OWL, Children's Center Bethel, Bielefeld, Germany
| | - Julian Mollin
- Department of Paediatrics, Bielefeld University, University Hospital OWL, Children's Center Bethel, Bielefeld, Germany
- Clinic Westbrandenburg GmbH, Children's Hospital, Potsdam, Germany
| | - Eckard Hamelmann
- Department of Paediatrics, Bielefeld University, University Hospital OWL, Children's Center Bethel, Bielefeld, Germany
| | - Sebastian Gaus
- Pediatric Emergency Department, Bielefeld University, University Hospital OWL, Children's Center Bethel, Bielefeld, Germany.
- Notaufnahme Kinderzentrum Bethel (NoKi), Evangelisches Klinikum Bethel (EvKB), Universitätsklinik für Kinder-und Jugendmedizin, Grenzweg 10, Bielefeld, 33617, Germany.
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Affiliation(s)
| | - Vijay Patel
- Rady Children's Hospital-San Diego, San Diego, CA
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Hisatomi M, Takeshita Y, Yanagi Y, Okada S, Fujikura M, Yoshida S, Kawazu T, Asaumi J. Imaging characteristics of incidentally detected cosmetic surgery-derived foreign bodies on CT images in the maxillofacial region. Oral Radiol 2024; 40:277-284. [PMID: 38252389 DOI: 10.1007/s11282-023-00734-2] [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: 10/06/2023] [Accepted: 12/10/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVES This study examined the imaging characteristics of cosmetic surgery-derived foreign bodies in the maxillofacial region through a retrospective review of cosmetic material foreign bodies incidentally detected on computed tomography (CT) images in routine clinical practice. METHODS We retrospectively investigated cases of cosmetic surgery-derived foreign bodies other than dental materials in the maxillofacial region, using 5 years of CT image data stored on an imaging server. The imaging findings of these foreign bodies were investigated, along with patient age, patient sex, whether the foreign bodies were associated with the disease targeted by the CT scan, and the availability of cosmetic surgery information prior to examination. RESULTS Foreign bodies were more common in women (19/21 cases), and affected patients displayed a wide age range (20-84 years). Four types of cosmetic surgery-derived foreign bodies in the maxillofacial region were detected by CT examination: nasal prostheses (nasal region), lifting sutures and injectable facial fillers (both in the buccal region), and silicone chin implants (chin region). CONCLUSIONS A cosmetic surgery-derived foreign body should be suspected when a foreign body is identified without a dental source of infection. In addition, cosmetic surgery-derived foreign bodies may be present in numerous patients, regardless of age or sex.
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Affiliation(s)
- Miki Hisatomi
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yoshinobu Yanagi
- Department of Dental Informatics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Shunsuke Okada
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Mamiko Fujikura
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Suzuka Yoshida
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Toshiyuki Kawazu
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Junichi Asaumi
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Cimenoglu B, Dogruyol T, Ozdemir A, Buz M, Ece D, Comert SS, Demirhan R. Foreign Body Reaction Mimicking Lymph Node Metastasis is Not Rare After Lung Cancer Resection. Thorac Cardiovasc Surg 2024; 72:235-241. [PMID: 37640061 DOI: 10.1055/a-2161-0690] [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] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Mediastinal lymphadenopathies with high 18-fluorodeoxyglucose uptake in patients previously operated on for lung cancer are alarming for recurrence and necessitate invasive diagnostic procedures. Peroperative placement of oxidized cellulose to control minor bleeding may lead to a metastasis-like image through a foreign body reaction within the dissected mediastinal lymph node field at postoperative examinations. In this study, we investigated clinicopathological features and the frequency of foreign body reaction mimicking mediastinal lymph node metastasis. METHODS Patients who underwent surgery for lung cancer between January 2016 and August 2021 and who were subsequently evaluated for mediastinal recurrence with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were included. Patients were grouped according to the results of EBUS-TBNA as metastasis, foreign body, and reactive. Clinicopathological features of these patients were compared and characteristics of patients in the foreign body group were scrutinized. RESULTS EBUS-TBNA was performed on a total of 34 patients during their postoperative follow-up due to suspicion of mediastinal recurrence. EBUS-TBNA pathological workup revealed metastasis in 18 (52.9%), foreign body reaction in 10 (29.4%) and reactive lymph nodes in 6 (17.6%) patients. Mean maximum standardized uptake value (SUVMax) for metastasis group and foreign body group were 9.39 ± 4.69 and 5.48 ± 2.54, respectively (p = 0.022). Time interval between the operation and EBUS-TBNA for the metastasis group was 23.72 ± 10.48 months, while it was 14.90 ± 12.51 months in the foreign body group (p = 0.015). CONCLUSION Foreign body reaction mimicking mediastinal lymph node metastasis is not uncommon. Iatrogenic cause of mediastinal lymphadenopathy is related to earlier presentation and lower SUVMax compared with metastatic lymphadenopathy.
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Affiliation(s)
- Berk Cimenoglu
- Thoracic Surgery Department, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Talha Dogruyol
- Thoracic Surgery Department, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Attila Ozdemir
- Thoracic Surgery Department, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Mesut Buz
- Thoracic Surgery Department, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Dilek Ece
- Pathology Department, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Sevda Sener Comert
- Pneumology Department, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Recep Demirhan
- Thoracic Surgery Department, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
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12
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Qiao Z, Yin G, Zhu J. New technique for the endoscopic removal of long foreign bodies. Rev Esp Enferm Dig 2024; 116:227-228. [PMID: 37170531 DOI: 10.17235/reed.2023.9398/2022] [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] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Removing long foreign bodies (LFBs) is a challenge due to the risk of perforation is high, especially in anatomically narrow or acute angulations areas. Here we report a new technique for removing LFBs under endoscope.
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Affiliation(s)
- Zhenguo Qiao
- Gastroenterology, Suzhou Ninth People's Hospital, China
| | - Guojian Yin
- Gastroenterology, The Second Affiliated Hospital of Soochow University
| | - Jianghong Zhu
- Gastroenterology, The Second Affiliated Hospital of Soochow University
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13
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14
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De Raeymaeker X, Van Cauwenbergh S, Houben B, Karimi A, Sergeant G, Appeltans B. Magnets and children: a dangerous combination. Acta Chir Belg 2024; 124:156-159. [PMID: 37259806 DOI: 10.1080/00015458.2023.2219086] [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: 11/14/2022] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Accidental ingestion of foreign bodies is a common problem in children. Fortunately, the gastrointestinal tract is quite resilient to foreign bodies. On the other hand, the ingestion of magnets can result in enormous morbidity. Because of their natural tendency to firmly adhere they can cause intestinal obstruction, pressure necrosis, fistula formation or perforation. With this case report, we aim to raise awareness of the risks that these magnets pose to children. METHODS We describe a case of intestinal perforation caused by the separate ingestion of multiple magnets from a children's toy (buckyballs, Neodymium spheres) by a two-year-old boy. A search in the Pubmed database showed some publications and varied management guidelines. RESULTS The boy was treated with an exploratory laparoscopy converted to a mini-laparotomy. We removed the four magnets through separate enterotomies. Postoperative recovery was uneventful. The boy was discharged on a postoperative day five and had no complications at three months follow-ups. CONCLUSION Accidental ingestion of multiple magnets is rare but can create a life-threatening situation in children. If the magnets are still in the stomach, endoscopic retrieval is needed. If they are beyond the stomach, in asymptomatic cases close clinical and radiographic vigilance is mandatory. When symptomatic we advise urgent removal. If treated on time, the surgical outcome is good and fast recovery is expected.
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Affiliation(s)
- X De Raeymaeker
- Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium
| | | | - B Houben
- Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium
| | - A Karimi
- Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium
| | - G Sergeant
- Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium
| | - B Appeltans
- Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium
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15
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Li S, Hu J, Geng W, Shi Y, Shi J, Sun S, Wang G. EUS-guided direct removal of a foreign body embedded in the stomach after failure of endoscopic submucosal dissection (with video). Gastrointest Endosc 2024; 99:645-646. [PMID: 37820931 DOI: 10.1016/j.gie.2023.10.029] [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] [Received: 05/10/2023] [Revised: 06/12/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Shiwei Li
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jinlong Hu
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wenjing Geng
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yubo Shi
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiaxin Shi
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Siyu Sun
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guoxin Wang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China
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16
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Torsello M, Sicuranza L, Meucci D, Salvati A, Tropiano ML, Santarsiero S, Calabrese C, D'Onghia A, Trozzi M. Foreign body aspiration in children: our pediatric tertiary care experience. Pediatr Surg Int 2024; 40:93. [PMID: 38551664 DOI: 10.1007/s00383-024-05679-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Inhalation of a foreign body is a real emergency in pediatric age and requires prompt diagnosis and treatment to reduce mortality. The objective of this study is to analyze clinical and radiological details, types, and localization of foreign bodies in patients conducted or to our hospital with suspected inhalation. METHODS We conducted a retrospective analysis of all cases of foreign body inhalation admitted to our Pediatric Emergency Room between January 2009 and June 2022. RESULTS 171 patients were included in the study. In 83 patients, the FB was detected. The mean age of presentation was 2.3 years (SD: ± 2). Cough (73%) and unilateral reduced breath sound (51%) were the most common clinical symptom and clinical sign. The most frequent localization was the right main bronchus (43%). The foreign bodies retrieved were vegetable (83%), of which peanut was the most common. Chest radiographs were normal in 25%. The mean duration of hospitalization was 5 days (± 2.9). Complications such as pneumothorax were seen in two cases. CONCLUSIONS Foreign body inhalation represents a true pediatric emergency and still a challenge in clinical practice. The best way to manage it is an early diagnosis and removal by fully trained staff.
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Affiliation(s)
- Miriam Torsello
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy.
| | - Luana Sicuranza
- Department of Surgery, Otorhinolaryngology Unit, University of Cagliari, Cagliari, Italy
| | - Duino Meucci
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy
| | - Antonio Salvati
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy
| | - Maria Luisa Tropiano
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy
| | - Sara Santarsiero
- Department of Otorhinolaryngology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Cinzia Calabrese
- Otolaryngology Department, Verona University Hospital, Verona, Italy
| | - Alessandra D'Onghia
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marilena Trozzi
- Airway Surgery Unit, Department of Surgical Specialties, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, 00165, Rome, Italy
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17
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Rosales-Castillo A, Bustos-Merlo A, Tornero-Divieso ML. [Abdominal gossypiboma as a cause of constitutional syndrome]. Med Clin (Barc) 2024; 162:258. [PMID: 37996334 DOI: 10.1016/j.medcli.2023.08.012] [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: 07/12/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 11/25/2023]
Affiliation(s)
| | - Antonio Bustos-Merlo
- Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, España
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18
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Brown B, Al-Zubeidi D. Endoscopy findings in an unusually well patient with a chronic retained button battery. J Pediatr Gastroenterol Nutr 2024; 78:745-746. [PMID: 38299302 DOI: 10.1002/jpn3.12149] [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: 05/04/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024]
Affiliation(s)
- Brandon Brown
- University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Dina Al-Zubeidi
- University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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19
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Li D, Yang N, Dong J, Wang J, Cui X, Yu H, Liu Y. Comparison of rigid bronchoscopy and flexible bronchoscopy for the management of foreign body aspiration in children. Am J Otolaryngol 2024; 45:104092. [PMID: 38043300 DOI: 10.1016/j.amjoto.2023.104092] [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: 05/29/2023] [Revised: 10/08/2023] [Accepted: 10/12/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To compare clinical outcomes of flexible and rigid bronchoscopies for the management of foreign body aspiration (FBA) in different airway locations, especially in unilateral main bronchus, in children, so as to provide some suggestions to assist clinical decisions. METHODS The medical records of children diagnosed with FBA in Qingdao Women and Children's Hospital Affiliated to Qingdao University from January 2020 to June 2022 were retrospectively reviewed. The following information was collected: demographics, radiological findings, endoscopic findings, foreign body locations, duration of operation, operation cost, and intraoperative and postoperative complications. RESULTS 182 children were included in the study with the median age of 1.3 years (interquatile range, 1.0-1.8). Among whom, 124 cases (68.1 %) were male and 58 cases (31.9 %) were female. 11 cases (6.0 %) had the foreign bodies located in the trachea (larynx to carina), 3 cases (1.6 %) located in the trachea and lower bronchus, 1 case (0.5 %) located in bilateral main bronchus, 135 cases (74.2 %) located in unilateral main bronchus, 4 cases (2.2 %) located in main and lobar bronchus, and 28 cases (15.4 %) located in the lobar or segmental bronchus. Among all the included children, 84 cases (46.2 %) received rigid bronchoscopy (RB) and 98 cases (53.8 %) received flexible bronchoscopy (FB). 131 cases with the foreign bodies located in unilateral main bronchus received one type of bronchoscopy (RB or FB). They were divided into two groups according to the location of foreign body relative to the midpoint of main bronchus, the proximal bronchus group and the distal bronchus group. In the proximal bronchus group, duration of operation using RB and FB was 15 (12.5-27.5) min and 15 (14.5-30.0) min, respectively (Z = 0.000, P = 1.000). The intraoperative and postoperative complication rate using RB and FB was 15.4 % and 9.1 %, respectively (χ2 = 0.008, P = 0.927). Operation cost of FB was significantly higher than that of RB (t = -13.396, P = 0.000). In the distal bronchus group, duration of operation using RB was 20 (13.5-25.0) min, which was drastically shorter than that of FB (25 (20.0-35.0) min) (Z = -2.947, P=0.003). Operation cost of FB was still found to be significantly higher than RB (t = -20.456, P=0.000). No significant difference was found in complication rate of RB (14.3%) compared to FB (8.3%) (χ2=0.251, P=0.616). CONCLUSIONS When foreign bodies are lodged in unilateral main bronchus, RB could be chosen as the first-choice procedure with advantages in duration of operation and operation cost, especially for patients in China. Regardless of duration of operation and operation cost, FB is also a safe and efficient therapeutic procedure to remove inhaled foreign bodies in children, except for those located in the trachea and asphyxiating foreign bodies.
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Affiliation(s)
- Da Li
- Qingdao Women and Children's Hospital, China
| | - Nana Yang
- Qingdao Women and Children's Hospital, China
| | - Jinye Dong
- Qingdao Women and Children's Hospital, China
| | - Jinju Wang
- Qingdao Women and Children's Hospital, China
| | - Xin Cui
- Qingdao Women and Children's Hospital, China.
| | - Hailing Yu
- Qingdao Women and Children's Hospital, China
| | - Yuxin Liu
- Qingdao Women and Children's Hospital, China
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20
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Luo DH, Fang LN, Mao XL, Ye LP, Wang J. Endoscopic Submucosal Excavation of Submucosal Foreign Bodies in the Sigmoid Colon. Dig Dis Sci 2024; 69:650-652. [PMID: 38190071 DOI: 10.1007/s10620-023-08227-2] [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: 11/02/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Ding-Hai Luo
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Li-Na Fang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Xin-Li Mao
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Li-Ping Ye
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Jun Wang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
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21
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Salman Önemli C. ROLE OF THE VIDEO LARYNGOSCOPE IN REMOVAL OF AN INTRAOPERATIVE IATROGENIC ESOPHAGEAL FOREIGN OBJECT. Gastroenterol Nurs 2024; 47:148-151. [PMID: 38567858 DOI: 10.1097/sga.0000000000000762] [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] [Received: 01/09/2023] [Accepted: 05/23/2023] [Indexed: 04/05/2024] Open
Affiliation(s)
- Canan Salman Önemli
- Canan Salman Önemli, MD, is an anesthesiology and reanimation specialist, Department of Anesthesiology and Reanimation, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
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22
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Yao L, Zheng B. Laparoscopic cholecystectomy-caused foreign bodies in the stomach. Asian J Surg 2024; 47:1406-1407. [PMID: 38036346 DOI: 10.1016/j.asjsur.2023.11.102] [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: 10/18/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Lihua Yao
- Department of General Surgery, The First People's Hospital of Guangyuan City, Guangyuan, China
| | - Bingfeng Zheng
- Department of General Surgery, The First People's Hospital of Guangyuan City, Guangyuan, China.
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23
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Mao Q, Lv Z, Han Q, Zhang W. Value of multiplanar reconstruction in multi-slice computed tomography for the detection of foreign body in the pulmonary artery: a case report. J Int Med Res 2024; 52:3000605241237890. [PMID: 38497130 PMCID: PMC10946078 DOI: 10.1177/03000605241237890] [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: 10/29/2023] [Accepted: 02/21/2024] [Indexed: 03/19/2024] Open
Abstract
Multi-slice computed tomography (MSCT) is the primary method for the detection and visualization of foreign bodies in the pulmonary artery because it provides high sensitivity and accuracy. It is very difficult to diagnose a patient with a non-iatrogenic pulmonary artery foreign body who does not have a history of a penetrating trauma. This case report describes a 36-year-old male that presented with coughing and haemoptysis. Based on conventional coronal and cross-sectional CT, the foreign body was misdiagnosed as pulmonary tuberculosis and pulmonary artery thrombosis. During treatment of the bronchial artery embolization and anti-tuberculosis therapy, the patient continued to experience haemoptysis. After further analysis of the pulmonary artery CT angiography images and curved multiplane reconstruction, an approximately 6-cm long toothpick was identified in the pulmonary artery with an unclear entry route. After surgery to remove the toothpick, symptoms of coughing and haemoptysis were resolved. This current case demonstrated that multiplane reconstruction in MSCT can improve the detection and visualization of pulmonary artery foreign bodies, which can aid in the diagnosis of pulmonary artery diseases of unknown cause.
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Affiliation(s)
- Qinxiang Mao
- Department of Radiology, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi Zhuang Autonomous Region, China
| | - Zheng Lv
- Department of Radiology, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi Zhuang Autonomous Region, China
| | - Qiuli Han
- Department of Radiology, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi Zhuang Autonomous Region, China
| | - Wei Zhang
- Department of Radiology, Liuzhou People’s Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi Zhuang Autonomous Region, China
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24
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Saito M, Nakamura H, Tsuji R, Asano N, Ota K, Niimi K, Ogawa H, Torikai K, Takano H, Toda K. [Endovascular Repair of Aortic Injury Caused by Esophageal Foreign Body:Report of a Case]. Kyobu Geka 2024; 77:217-221. [PMID: 38465495] [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: 03/12/2024]
Abstract
A 51-year-old man visited to our hospital because of chest discomfort and hematemesis. He was diagnosed with Mallory-Weiss syndrome and followed in outpatient clinic. One week later, he visited our hospital again for fever and discomfort. Chest computed tomography (CT) showed a foreign body perforated in the mediastinum in the upper esophagus, and he was urgently hospitalized for surgical removal of esophageal foreign body. Before surgery he vomited the esophageal foreign body with a lot of blood. Hematemesis was stopped spontaneously and contrast-enhanced CT revealed a pseudoaneurysm in the distal aortic arch, so thoracic endovascular aortic repair (TEVAR) was performed to prevent rupture. Esophageal endoscopy found that the site of esophageal injury healed spontaneously, so the patient was followed conservatively with antibiotics. He was discharged on postoperative day 18 uneventfully. TEVAR was an effective treatment for aortic injury caused by esophageal foreign body in our case.
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Affiliation(s)
- Masahito Saito
- Department of Cardiovascular Surgery Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
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Kara K, Ozdemir C, Tural Onur S, Satici C, Tokgoz Akyil F, Nedime Sokucu S. Late Diagnosis of Foreign Body Aspiration in Adults: Case Series and Review of the Literature. Respir Care 2024; 69:317-324. [PMID: 37935526 PMCID: PMC10984597 DOI: 10.4187/respcare.10723] [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: 11/09/2023]
Abstract
BACKGROUND Tracheobronchial foreign body (FB) aspiration (FBA) is a life-threatening emergency mostly observed in childhood and advanced age. With early diagnosis, the FB can be removed using bronchoscopic methods without causing irreversible damage. METHODS This was a single-center, retrospective observational study. Subjects diagnosed with FBA via either bronchoscopic methods and/or radiological findings, having no medical history of aspirated FB, and who were detected to have aspirated FB for longer than 30 days were included in the study. Medical records and radiological and bronchoscopic findings of the subjects were investigated from the hospital information database system. RESULTS Of the 255 patients with FBA, 17.6% (N = 45) were diagnosed late. The mean age was 53 y; 28% were female, and 60% of the subjects had a history of ever smoking. The estimated residence time of the FB in the bronchial system was 22.8 months. The most common complaints were cough and shortness of breath. Forty-two percent of the aspirated FBs were organic material. FB artifact could be observed in 6.7% of posteroanterior chest radiographs and 65% of thorax computed tomography (CT) scans. Rigid bronchoscopy had been primarily preferred as therapeutic interventional procedure. It was also found that the artifact most frequently resided in the right bronchial system and was most commonly found in the right lower lobe, while granulation tissue was formed in 85% of the subjects. CONCLUSIONS The findings of the present study demonstrate that subjects tended to forget the FBA, leading to insidious respiratory system symptoms, with recurrent infections. In cases with an endobronchial mass lesion image on thorax CT, clinicians should consider the possibility of FBA. Delayed diagnosis of both organic and inorganic FB may cause granulation tissue.
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Affiliation(s)
- Kaan Kara
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey.
| | - Cengiz Ozdemir
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Seda Tural Onur
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Celal Satici
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Fatma Tokgoz Akyil
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Sinem Nedime Sokucu
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
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Inoue K, Yabe S, Kashiwabara S, Itaya Y, Era S, Kikuchi A, Takai Y. A pregnant woman with long-standing, retained intraabdominal glass shards who gave birth to a live infant with no complications: a case report. J Med Case Rep 2024; 18:74. [PMID: 38402220 PMCID: PMC10894482 DOI: 10.1186/s13256-024-04392-8] [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: 12/22/2023] [Accepted: 01/17/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Most cases of traumatic injury during pregnancy involve blunt trauma, with penetrating trauma being uncommonly rare. In glass shard injuries, fragments often penetrate deeply, and multiple injuries may occur simultaneously; attention must be paid to the possibility of organ injury from the residual fragments. However, no case of this occurring during pregnancy has been reported yet. CASE PRESENTATION We present the case of a 34-year-old pregnant Cameroonian woman who retained intraabdominal glass shards following a penetrating injury at 13 weeks gestation and not diagnosed until 22 weeks gestation. Notably, this patient continued the pregnancy without complications and gave birth via cesarean section at 36 weeks gestation. CONCLUSION In pregnant women sustaining a penetrating glass trauma during pregnancy, careful attention should be paid to the fragments; in that case, computed tomography is a useful modality for accurately visualizing any remaining fragments in the body. Essentially, the foreign bodies in glass shard injuries during pregnancy should be removed immediately, but conservative management for term delivery is an important choice for patients at risk for preterm delivery.
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Affiliation(s)
- Kenta Inoue
- Division of Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
| | - Shinichiro Yabe
- Division of Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Soichiro Kashiwabara
- Division of Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Yukiko Itaya
- Division of Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Sumiko Era
- Division of Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Akihiko Kikuchi
- Division of Maternal and Fetal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Chowdhary S, Veerappan M, Peter J, Kurien R. Post-traumatic transocular retained foreign body in the infratemporal fossa: a near miss. BMJ Case Rep 2024; 17:e258075. [PMID: 38378590 PMCID: PMC10882362 DOI: 10.1136/bcr-2023-258075] [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: 02/22/2024] Open
Abstract
The infratemporal fossa is an uncommon site for lodgement of foreign bodies. Fast-moving projectiles and displaced teeth may get impacted and have been described in the literature. However, foreign body lodgement in the retromaxillary space after transorbital passage is rare. The trajectory of the foreign bodies in such cases is difficult to predict and may not be suspected in the absence of overt clinical features. The authors present a case of a wooden splinter lodged within the infratemporal fossa after the patient sustained a lid injury with an orbital floor fracture. Imaging was equivocal; hence, endoscopic surgical exploration was undertaken, revealing the foreign body. A high index of clinical suspicion and rapid intervention is needed since unsuspected foreign bodies may cause further visual, infective or neurovascular complications. Approaches should be tailored on a case-by-case basis.
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Affiliation(s)
- Stuti Chowdhary
- Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | | | - Jayanthi Peter
- Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | - Regi Kurien
- Christian Medical College Vellore, Vellore, Tamil Nadu, India
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Chrysikos MN, Konstantinidis S, Katsourakis A, Samara P, Sarakatsanos A, Karakasis N, Fotiadis K, Chatzis I, Vrampa D, Papalakis A. A 56-Year-Old Woman Presenting 19 Years After Pubic Bone Fracture with a Surgical Screw Foreign Body in the Bladder. Am J Case Rep 2024; 25:e942059. [PMID: 38369745 PMCID: PMC10883390 DOI: 10.12659/ajcr.942059] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND Non-calculus foreign bodies in the bladder are rare and are usually introduced via the urethra. Reports of the migration of metallic foreign bodies from previous surgery are uncommon and mainly associated with surgical screws used for the internal fixation of pubic bone fracture and total hip replacement. This report is of a 56-year-old woman presenting with a surgical screw foreign body in the bladder 19 years after open surgical reduction and internal plate and screw fixation of traumatic fracture of the pubic bone. CASE REPORT A 56-year-old woman visited a urologist because of gross hematuria. She mentioned a mild pelvic pain and multiple lower urinary tract infections over the past 2 years, with no other symptoms. From the previous history, she had undergone an open reduction and internal fixation of the pelvic ring, with surgical plates and screws following pubic bone's fracture, due to an accident 19 years earlier. Cystoscopy identified the presence of a screw head protruding into the bladder wall. The screw was extracted via open surgery, and the patient was discharged 2 days later. CONCLUSIONS While intravesical foreign bodies are rarely seen in Emergency Departments, clinicians should maintain a level of suspicion in certain cases. The purpose of this case report is to present the unlikely and delayed complication of internal pubic bone fixation resulting in the migration of a fixation screw to the bladder. It also highlights the importance of imaging in diagnosis and localization of the foreign body in the bladder.
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Affiliation(s)
- Michael N Chrysikos
- Department of General Surgery, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Sergios Konstantinidis
- Department of General Surgery, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Anastasios Katsourakis
- Department of General Surgery, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Parthena Samara
- Department of General Surgery, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Alexandros Sarakatsanos
- Department of General Surgery, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Nikolaos Karakasis
- Department of Urology, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Konstantinos Fotiadis
- Department of Urology, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Iosif Chatzis
- Department of General Surgery, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
| | - Dimitra Vrampa
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Apostolos Papalakis
- Department of General Surgery, General Hospital of Thessaloniki "Agios Dimitrios", Thessaloniki, Greece
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Liu L, Ma DJ, Qin YZ, Liu H. Intrapulmonary migration of a fractured acupuncture needle: a case report. J Cardiothorac Surg 2024; 19:101. [PMID: 38374106 PMCID: PMC10877888 DOI: 10.1186/s13019-024-02502-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/14/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Acupuncture, a traditional Chinese medical treatment, has been gaining popularity over the years. However, it also presents certain risks. We report a case of a patient who discovered a foreign body in their lung several years after undergoing acupuncture. CASE PRESENTATION A middle-aged woman presented to our hospital with chest pain. An X-ray revealed a needle-like foreign body in the middle lobe of her right lung. The patient had previously undergone acupuncture treatment for local pain in her lower back and lower extremities many years prior. Based on the imaging findings and her medical history, we hypothesized that the foreign body in her lung was a result of a dislodged acupuncture needle. Through preoperative 3-dimensional reconstruction and indocyanine green localization, we were able to locate the foreign body in the lateral segment of the right middle lobe. We successfully removed the foreign body via wedge resection, and the patient made a smooth recovery post-surgery. CONCLUSION Acupuncturists and surgeons should remain vigilant about the potential risks associated with acupuncture.
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Affiliation(s)
- Lei Liu
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking, 100730, P.R. China
| | - Dong-Jie Ma
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking, 100730, P.R. China
| | - Ying-Zhi Qin
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking, 100730, P.R. China
| | - Hongsheng Liu
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking, 100730, P.R. China.
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Shiraki Y, Takahashi T, Ogi M, Horii A. Changes in CT values of wood in the body: pitfalls in detecting a wooden foreign body. BMJ Case Rep 2024; 17:e259348. [PMID: 38320817 PMCID: PMC10859975 DOI: 10.1136/bcr-2023-259348] [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: 02/15/2024] Open
Affiliation(s)
- Yuya Shiraki
- Otolaryngology, Niigata University Faculty of Medicine Graduate School of Medical and Dental Science, Niigata, Japan
| | - Takeshi Takahashi
- Otolaryngology, Niigata University Faculty of Medicine Graduate School of Medical and Dental Science, Niigata, Japan
| | - Manabu Ogi
- Otolaryngology, Niigata prefectural central hospital, Joetsu, Japan
| | - Arata Horii
- Otolaryngology, Niigata University Faculty of Medicine Graduate School of Medical and Dental Science, Niigata, Japan
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Lehtinen M, Nykänen A, Raivio P. No cupid, just an arrow: a penetrating injury into the interventricular septum. J Cardiothorac Surg 2024; 19:48. [PMID: 38310275 PMCID: PMC10838426 DOI: 10.1186/s13019-024-02512-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/28/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND Penetrating cardiac injuries are rare but often fatal, with 16-55% mortality. We report a patient who suffered a non-fatal occupational cardiac injury. CASE PRESENTATION A 47-year-old man was operating an ironworker machine. A thin 3-cm metal fragment catapulted from the machine piercing the chest wall and the right ventricular outflow tract (RVOT), burrowing into the interventricular septum (IVS). The patient remained hemodynamically stable and walked to the nearest hospital. ECG-gated computed tomography revealed the exact location of the fragment within the IVS, allowing for detailed preoperative planning. The fragment was removed through a sternotomy and an incision through the RVOT. The postoperative course was uneventful. CONCLUSIONS This case underscores the value of detailed preoperative imaging and the wide spectrum of clinical scenarios of penetrating cardiac injuries.
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Affiliation(s)
- Miia Lehtinen
- Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Hospital, Haartmaninkatu 4, Helsinki, 00290, Finland.
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Antti Nykänen
- Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Hospital, Haartmaninkatu 4, Helsinki, 00290, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Peter Raivio
- Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Hospital, Haartmaninkatu 4, Helsinki, 00290, Finland
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Joseph M, Nguyen N, Wiersch J, Mark JA. Endoscopic Ultrasound-Guided Removal of an Unusual Paraesophageal Foreign Body Through the Esophageal Wall. Am J Gastroenterol 2024; 119:244. [PMID: 37815207 DOI: 10.14309/ajg.0000000000002556] [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] [Received: 09/11/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Michael Joseph
- Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Nathalie Nguyen
- Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA
| | - John Wiersch
- Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Jacob A Mark
- Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA
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Sum SCM, Hort A, Tsakanov S. A unique operative approach to a retained gastrointestinal foreign body. ANZ J Surg 2024; 94:250-251. [PMID: 37803489 DOI: 10.1111/ans.18712] [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: 08/17/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/08/2023]
Affiliation(s)
| | - Amy Hort
- Department of Surgery, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Sergei Tsakanov
- General Surgery Auburn Hospital and Canterbury Hospital, Sydney, New South Wales, Australia
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Tharwat M, El-Ghareeb WR, Almundarij TI. Depraved appetite in dromedary camels: Clinical, ultrasonographic, and postmortem findings. Open Vet J 2024; 14:652-663. [PMID: 38549572 PMCID: PMC10970125 DOI: 10.5455/ovj.2024.v14.i2.5] [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] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/16/2024] [Indexed: 04/02/2024] Open
Abstract
Background Camels are subjected to a wide variety of nutritional deficiencies as they are largely dependent upon grazing desert plants. As a consequence, the syndrome of pica or depraved appetite is occasionally seen in dromedary camels. The condition is manifested as chewing or eating abnormal things such as wood, dirt, bones, stones, clothes, plastics, mud, sand, or other inanimate objects. Aim This study was designed to investigate the clinical, ultrasonographic, and postmortem findings in dromedary camels with pica or depraved appetite. Methods Twenty-five camels of 5 days to 15 years were examined. Owner complaints included depraved appetite, loss of body condition, regurgitation of stomach content, and partial or complete absence of feces. Symptoms described were present for a period varying between 3 days, up to 12 months. The stomach compartments and small and large intestines were scanned using ultrasonography from the right and left sides of the abdomen. Necropsy was carried out on six female and three male camels where the thoracic and abdominal organs were examined with special attention to the digestive system. Results The affected animals had a history of gradual loss of body conditions, eating foreign objects, decreased or total absence of feces, and regurgitation of stomach content. Using ultrasound, the foreign body was imaged occluding completely or partially the intestines. Foreign bodies within the rumen could not be visualized with ultrasound. In cases where the rumen is impacted by sand, small pin-points revealing acoustic enhancement were imaged. Foreign bodies were removed from the rumen at exploratory rumenotomy (n = 11), laparotomy (n = 3), or at necropsy (n = 8) in the form of plastics, cloths, sand, mud, wool balls, robes, glasses, or even metallic objects which may be blunt or sharp. Sixteen (64%) of the camels were recovered while the remaining 9 (36%) did not survive. Conclusion The syndrome of pica or depraved appetite is an important condition in dromedary resulting in the ingestion of objects other than normal feed. Substantial economic losses are expected as a result of this syndrome. Ultrasonography of the digestive system may help the clinician in some cases to localize of occluding foreign bodies in the intestines, while in the transabdominal scanning of the stomach is valuable only in cases of sand impaction.
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Affiliation(s)
- Mohamed Tharwat
- Department of Clinical Sciences, College of Veterinary Medicine, Qassim University, Buraidah, Saudi Arabia
- Department of Animal Medicine, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Waleed R. El-Ghareeb
- Department of Public Health, College of Veterinary Medicine, King Faisal University, Hofuf, Saudi Arabia
| | - Tariq I. Almundarij
- Department of Biomedical Sciences, College of Veterinary Medicine, Qassim University, Buraidah, Saudi Arabia
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Li X, Fu B, Chen F, Wang P. Ultrasound-assisted surgical removal of woody foreign bodies. Wien Klin Wochenschr 2024; 136:122-123. [PMID: 37610528 DOI: 10.1007/s00508-023-02256-7] [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: 05/22/2023] [Accepted: 07/18/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Xingping Li
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, The First Affiliated Hospital of Tianjin University of Traditional Chinese medicine, 314 Anshan West Road, 300381, Tianjian, China
- Tianjin University of Traditional Chinese medicine, 301617, Tianjian, China
| | - Bifeng Fu
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, The First Affiliated Hospital of Tianjin University of Traditional Chinese medicine, 314 Anshan West Road, 300381, Tianjian, China
| | - Fuyan Chen
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, The First Affiliated Hospital of Tianjin University of Traditional Chinese medicine, 314 Anshan West Road, 300381, Tianjian, China.
| | - Ping Wang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, The First Affiliated Hospital of Tianjin University of Traditional Chinese medicine, 314 Anshan West Road, 300381, Tianjian, China.
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Wang SD, Cao TT, Wang Z. A simple cap-assistant method to removal fishbone embedded in the cervical esophageal wall. Clin Res Hepatol Gastroenterol 2024; 48:102281. [PMID: 38216048 DOI: 10.1016/j.clinre.2024.102281] [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] [Received: 12/09/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Affiliation(s)
- Si-Di Wang
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China; West China School of Medicine, Sichuan, University, Chengdu, China
| | - Ting-Ting Cao
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China
| | - Zhu Wang
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China.
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Arpa A, Ozturk PA, Sanrı O, Yilmaz A. Pediatric case of a penetrating lumbar spinal injury. Childs Nerv Syst 2024; 40:593-596. [PMID: 37855878 DOI: 10.1007/s00381-023-06180-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Penetrating spinal injuries are generally extremely rare and are seldom encountered in pediatric patients. The non-compliance of pediatric patients with physical examination can sometimes delay diagnosis and treatment. Here, we present a case of a child who had a fall and suffered penetrating spinal trauma due to a small glass fragment. CASE REPORT A penetrating foreign body was detected in the lumbar spinal region of a 2-year-old patient with complaints of increased restlessness on physical activity followed by difficulty in walking. The patient was operated on and followed up without any complications in the perioperative and late postoperative periods. CONCLUSION A detailed physical examination is necessitated in the pediatric age group because of insufficient anamnesis. The high number of patients per physician, especially in societies having a low socioeconomic standard, prevents detailed examinations, and unnecessary examinations may cause delays in diagnosis. However, one must note that the skin findings of pediatric patients can be very helpful, especially in pediatric neurosurgery, and examination should not be neglected.
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Affiliation(s)
- Abdurrahman Arpa
- Department of Neurosurgery, Dicle University Medical Faculty, Diyarbakir, Turkey
| | - Pinar Aydın Ozturk
- Department of Neurosurgery, Dicle University Medical Faculty, Diyarbakir, Turkey.
| | - Omer Sanrı
- Department of Neurosurgery, Şırnak Public Hospital, Sirnak, Turkey
| | - Adil Yilmaz
- Department of Neurology, Private Batı Hospital, Diyarbakir, Turkey
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Lowe E, Soylu E, Deekonda P, Gajaweera H, Ioannidis D, Walker W, Amonoo-Kuofi K. Principal diagnostic features of paediatric foreign body aspiration. Int J Pediatr Otorhinolaryngol 2024; 177:111846. [PMID: 38176114 DOI: 10.1016/j.ijporl.2023.111846] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES The aim of this study is to identify the most common and important features within the presenting history, clinical examination and chest radiograph that are associated with foreign body (FB) aspiration in the paediatric population, to support rationalised decision making in regards to proceeding with diagnostic bronchoscopy. METHODS A retrospective notes review was conducted of 70 patients over a 12-year period at our tertiary referral centre. Their presenting history, clinical and radiographic signs were documented and univariate logistic regression model used to calculate odds ratios. RESULTS The main features identified within our cohort with a positive FB finding at bronchoscopy were history of a cough (OR 5.1, p = 0.008) and radiographic evidence of hyperinflation or air trapping (OR 7.1, p = 0.016). Zero patients with a FB presented with only a positive history in the absence of other clinical or radiological signs. History of a witnessed choking episode neither increased or decreased the likelihood of as aspirated FB (OR 1, p = 0.967). CONCLUSIONS We have identified two principal features, as described above, which are associated with paediatric FB aspiration. Reliance on a positive clinical history alone, but specifically the history of a witnessed choking episode, did not support the presence of a FB and other associated signs need to be considered in deciding to proceed to bronchoscopy.
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Affiliation(s)
- Emily Lowe
- ENT Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, S016 6YD, United Kingdom.
| | - Erdinc Soylu
- ENT Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, S016 6YD, United Kingdom.
| | - Praveena Deekonda
- ENT Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, S016 6YD, United Kingdom.
| | - Hasitha Gajaweera
- Paediatric Respiratory Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, United Kingdom.
| | - Dimitrios Ioannidis
- ENT Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, S016 6YD, United Kingdom.
| | - Woolf Walker
- Paediatric Respiratory Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, United Kingdom.
| | - Kwamena Amonoo-Kuofi
- ENT Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, S016 6YD, United Kingdom.
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Li Q, Jiang Z, Yuan M, Xu C, Zeng L. A foreign body that has been left for 20 years causes a pseudoaneurysm of the middle cerebral artery: a case report. J Med Case Rep 2024; 18:39. [PMID: 38297354 PMCID: PMC10832239 DOI: 10.1186/s13256-023-04334-w] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/22/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND We report a patient with extensive subarachnoid hemorrhage caused by the rupture of a middle cerebral artery pseudoaneurysm from a foreign body that had been left for two decades. CASE PRESENTATION A 74-year-old male patient from Han nationality was admitted to the emergency department of our hospital with impaired consciousness for 1 hour. Cranial computed tomography examination indicated a massive subarachnoid hemorrhage with intraventricular blood accumulation, and a high-density short strip dense shadow was seen in the M1 segment of the right middle cerebral artery, considering the possibility of a foreign body. Subsequently, a cerebral angiography was suggested; the foreign body was seen through the right middle cerebral artery, and the aneurysm was seen in the lower wall, so a pseudoaneurysm was considered. The emergent surgical intervention involved the clipping of the pseudoaneurysm and intracranial extraction of the foreign body. Unfortunately,the patient ultimately expired due to severe pulmonary infection. CONCLUSION Intracranial pseudoaneurysm caused by foreign body has been rarely reported previously, and microsurgical treatment of an intracranial pseudoaneurysm caused by a foreign body is a good choice.
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Affiliation(s)
- Qiang Li
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Zhengfang Jiang
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
- Department of Neurosurgery, Sichuan Mianyang 404 Hospital, Mianyang, 621000, China.
| | - Miao Yuan
- Department of Neurosurgery, Sichuan Mianyang 404 Hospital, Mianyang, 621000, China
| | - Chenglang Xu
- Department of Neurosurgery, Sichuan Mianyang 404 Hospital, Mianyang, 621000, China
| | - Lingyong Zeng
- Department of Neurosurgery, Sichuan Mianyang 404 Hospital, Mianyang, 621000, China
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Schicchi A, Lonati D, Papotto A, Ippolito A, Piana S, Grasso S. Ingestion of heated tobacco sticks containing a micro-blade by children: the importance of performing a radiograph. Clin Toxicol (Phila) 2024; 62:129-130. [PMID: 38477964 DOI: 10.1080/15563650.2024.2308018] [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: 10/05/2023] [Accepted: 01/16/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Some tobacco sticks, such as TEREA™ heat sticks for IQOS ILUMA™, contain a blade. Both the nicotine part of the device and the micro-blade can be ingested by children. CASE SUMMARIES We report two children, an 18-month-old boy and a 10-month-old girl, who ingested a heat stick containing a micro-blade. IMAGES Radiography revealed the micro-blade to be in the child's mouth in the first case and the stomach in the second. Endoscopy was performed on the second child, confirming the presence of the blade in the stomach. CONCLUSION We recommend performing a radiograph on all children who ingest tobacco sticks containing a micro-blade. If a metallic object is present, we recommend endoscopic removal to avoid traumatic lesions from the sharp edges.
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Affiliation(s)
- Azzurra Schicchi
- Pavia Poison Centre, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
- Experimental Medicine PhD Program, University of Pavia, Pavia, Italy
| | - Davide Lonati
- Pavia Poison Centre, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Anna Papotto
- Pediatric Emergency Department, ARNAS Garibaldi Catania Nesima Hospital, Catania, Italy
| | | | - Sebastiano Piana
- Unit of Diagnostic and Interventional Radiology, ARNAS Garibaldi Catania, Nesima Hospital, Catania, Italy
| | - Santo Grasso
- Department of Gastroenterology, Cannizzaro Hospital, Catania, Italy
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Irumba C, Baragaine J, Obore S, Mwanje H, Nteziyaremye J. An intricate vagina penetrating injury with a 22 cm cassava stick in situ for 6 months: a case report. J Med Case Rep 2024; 18:30. [PMID: 38267997 PMCID: PMC10809435 DOI: 10.1186/s13256-023-04339-5] [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: 11/03/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Trauma remains one of the major causes of morbidity and mortality and a threat to attainment of sustainable development goal 11. Genital urinary trauma is reported in about 10% of patients presenting with trauma worldwide, and in about 6.6% of patients in Sub-Saharan Africa. If not careful enough, one may miss the foreign body in the vagina and this may be associated with morbidity, and although rare, mortality. CASE PRESENTATION We report a case of a 7-year-old Black Ugandan that had suffered vagina trauma 6 months prior to presentation at our facility and presented with chronic vagina pus discharge for 6 months. Prior examinations had failed to recognize the foreign body and so did the two abdominal pelvic ultrasound scans. During examination under anesthesia, we were able to locate the cassava stick that had caused penetrating vagina injury and we were able to dislodge it. It was a blunt cassava stick with length of 22 cm and diameter of 2 cm. Although it had gone through the peritoneal cavity, we did not do a laparotomy. CONCLUSION This case emphasizes the need for a thorough vaginal exam including the need to do it under anesthesia with good lighting even when ultrasound scan findings are normal. It presents an opportunity for one to manage penetrating peritoneal injury without a laparotomy in highly selected cases. Gynecologists should be keen as well to rule out child molestation.
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Affiliation(s)
- Charles Irumba
- Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Justus Baragaine
- Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Susan Obore
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Haruna Mwanje
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Julius Nteziyaremye
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
- Department of Obstetrics and Gynaecology, Mbale Regional Referral Hospital, Mbale, Uganda.
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Mckinnon K, Jardine C, Barclay G, Thrippleton MJ, Abel S, Wardlaw JM, Bastin ME, Whalley HC, Richardson H, Boardman JP. An unexpected ferromagnetic foreign body in a paediatric research participant undergoing 3T MRI. BMJ Case Rep 2024; 17:e258969. [PMID: 38272527 PMCID: PMC10826474 DOI: 10.1136/bcr-2023-258969] [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: 01/27/2024] Open
Abstract
Metallic foreign bodies (FBs) are a safety risk during MRI. Here, we describe a boy in early childhood with an unexpected ferromagnetic FB discovered during a research brain MRI. Safety precautions included written and oral safety screening checklists and visual check during a structured safety pause. During introduction to the scanner, he was lifted to look at the bore. Staff became aware of an object flying into the bore. The child reached for his ear, and a 5 mm diameter ball bearing was found in the bore. The child had no external injury. We have introduced a 0.1 T handheld magnet to check for metallic FBs not known to the parent. FBs are a common paediatric emergency department presentation, particularly in younger children or those with cognitive or behavioural problems. This case highlights the importance of safety screening in paediatric MRI scanning, along with its fallibility.
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Affiliation(s)
- Katie Mckinnon
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, UK
| | | | - Gayle Barclay
- Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, UK
| | - Michael J Thrippleton
- Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Selina Abel
- School of Philosophy, Psychology, and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Edinburgh Imaging Facility, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Mark E Bastin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Heather C Whalley
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Hilary Richardson
- School of Philosophy, Psychology, and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - James P Boardman
- Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Kaplan AJ, Sheldon RR. Handheld Magnetometer-Assisted Localization and Removal of a Foreign Body From the Chest Wall. Mil Med 2024; 189:e420-e423. [PMID: 37470315 DOI: 10.1093/milmed/usad255] [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] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023] Open
Abstract
Foreign bodies fully embedded in soft tissues present a unique challenge to surgeons attempting excision. Small fragments can be nonpalpable, and many prove difficult to visualize intra-operatively by means of classic radiologic techniques. A 35-year-old active duty soldier presented requesting excision of ballistic fragment embedded in his chest wall that had previously failed a previous attempt at removal. The metallic foreign body was successfully localized intra-operatively using a handheld magnetometer probe and removed without complication. This case demonstrates the utility and cost-effectiveness of the handheld magnetometry for intra-operative localization of metallic foreign bodies. Metallic foreign bodies may be localized intra-operatively using inexpensive and reusable equipment that does not require radiation or bulky radiographic imaging equipment.
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Affiliation(s)
| | - Rowan R Sheldon
- Department of Surgery, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA
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Kushida-Contreras BH, Gómez-Calva B, Gaxiola-García MA. Cosmetic Injection of Illicit Foreign Materials: Imaging Features and Patterns of Migration in 413 Cases. Aesthet Surg J 2024; 44:183-191. [PMID: 37863473 DOI: 10.1093/asj/sjad336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The injection of illicit, nonregulated foreign materials is increasingly common and has negative consequences relative to the inflammatory process that ensues. OBJECTIVES The aim of this study was to identify anatomical and imaging characteristics after the cosmetic injection of illicit foreign materials. METHODS A retrospective review of clinical and imaging records was performed. The issues analyzed were the anatomical site, type of injected substance, imaging method for diagnosis, and patterns of migration. RESULTS Data on 413 patients were collected. Most patients were female, with a mean age of 44 years. The most commonly infiltrated region was the buttocks (n = 284; 53.58%) followed by the breast (n = 99; 18.67%). Magnetic resonance imaging was the most common method of diagnosis in those patients who had an imaging study (159 out of 168). The most frequent depth of foreign material detected by imaging was the muscular plane (n = 103; 61.30%). Migration was detected in 56.55% of patients who had an imaging study. Most infiltrated substances were unknown; biopolymers were the most commonly identified substances. Depending on the type of substance, migration rates varied from 13% to 29%; rate differences were not statistically significant (P = .712). Migration was more common when the depth of infiltration was in muscle (77.66%) than in subcutaneous tissue (23.4%); this difference was statistically significant (P < .0001). CONCLUSIONS Deep infiltration is related to greater migration rates, apparently regardless of the substance injected. LEVEL OF EVIDENCE: 3
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Zhang Z, Yang M, Zhang R. Radiographic grid for locating foreign bodies in maxillofacial emergency trauma. BMC Oral Health 2024; 24:46. [PMID: 38191426 PMCID: PMC10775646 DOI: 10.1186/s12903-023-03807-0] [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: 10/18/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES The accurate localization of the foreign bodies (FBs) is essential. This work presents a new noninvasive technique for subcutaneous metallic FBs under a radiographic grid, a system that simplifies the localization of facial FBs removal using a grid with embedded reference points. METHODS This work designed a retrospective study to evaluate the effect of a radiographic grid on FBs removal surgery. All patients who met the inclusion criteria and attended the Hospital of Stomatology of China Medical University from January 2022 to June 2023 were enrolled and randomly divided into grid and non-grid groups. The assessment of facial swelling, the primary indicator, was conducted on days 2 and 7 post-surgery. The variables were analyzed using the Student t test and a repeated-measures general linear model. RESULTS The study sample consisted of 20 patients, with 14 males (70%) and 6 females (30%), who had an average age of 30.30 ± 5.38. The average time of operation was 1.85 ± 0.66 h (range 0.7 to 3.2). In the present cases in this report, of the 20 patients' FBs, 14 were metal, 5 were glass, and 1 was residual root. And the FBs were surgically removed with no postoperative complications. Through comparison, it was found that the degree of swelling on day 2 postoperatively was significantly different between the grid group and the non-grid group (P < 0.05). CONCLUSIONS This study demonstrates that a radiographic grid with mark points is a more efficient approach compared with traditional methods for FBs removal, and this surgical method is more accurate, fast and noninvasive.
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Affiliation(s)
- Ziqi Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Mingliang Yang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Ran Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China.
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Li XL, Zhang QM, Lu SY, Liu TT, Li SL, Chen L, Xie FN, Wang L, Zhang CH, Wang DY, Huang LM. Accidental ingestion of multiple magnetic beads by children and their impact on the gastrointestinal tract: a single-center study. BMC Pediatr 2024; 24:5. [PMID: 38172693 PMCID: PMC10763124 DOI: 10.1186/s12887-023-04425-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/16/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE In this study, we aimed to enhance the treatment protocols and help understand the harm caused by the accidental ingestion of magnetic beads by children. METHODS Data were collected from 72 children with multiple gastrointestinal perforations or gastrointestinal obstructions. The 72 pediatric patients were divided into a perforation and a non-perforation group. The data collected for the analysis included the gender, age, medical history, place of residence (rural or urban), and symptoms along with the educational background of the caregiver, the location and quantity of any foreign bodies discovered during the procedure, whether perforation was confirmed during the procedure, and the number of times magnetic beads had been accidentally ingested. RESULTS The accuracy rate of preoperative gastrointestinal perforation diagnosis via ultrasound was 71%, while that of the upright abdominal X-ray method was only 46%. In terms of symptoms, the risk of perforation was 13.844 and 12.703 times greater in pediatric patients who experienced vomiting and abdominal pain with vomiting and abdominal distension, respectively, compared to patients in an asymptomatic state. There were no statistical differences between the perforation and the non-perforation groups in terms of age, gender, medical history, and the number of magnetic beads ingested (P > 0.05); however, there were statistical differences in terms of white blood cell count (P = 0.048) and c-reactive protein levels (P = 0.033). A total of 56% of cases underwent a laparotomy along with perforation repair and 19% underwent gastroscopy along with laparotomy. All pediatric patients recovered without complications following surgery. CONCLUSION Abdominal ultrasonography and/or upright abdominal X-ray analyses should be carried out as soon as possible in case of suspicion of accidental ingestion of magnetic beads by children. In most cases, immediate surgical intervention is required. Given the serious consequences of ingesting this type of foreign body, it is essential to inform parents and/or caregivers about the importance of preventing young children from using such products.
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Affiliation(s)
- Xian-Ling Li
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Qin-Ming Zhang
- Department of Surgery, Beijing United Family Hospital, 100015, Beijing, China
| | - Shou-Yan Lu
- Department of Surgery, Beijing Aiyuhua Women's and Children's Hospital, 100176, Beijing, China
| | - Ting-Ting Liu
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Shuan-Ling Li
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Long Chen
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Fang-Nan Xie
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Li Wang
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Chuang-Hui Zhang
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China
| | - Da-Yong Wang
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China.
| | - Liu-Ming Huang
- Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China.
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47
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Ma Y, Kong L, Xing Y, Qiao Z. A disappeared fish bone. Gastrointest Endosc 2024; 99:116-117. [PMID: 37423532 DOI: 10.1016/j.gie.2023.07.012] [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] [Received: 03/28/2023] [Revised: 05/05/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Yimin Ma
- Department of Gastroenterology, Gaochun People's Hospital of Nanjing, Nanjing
| | - Lingchao Kong
- Department of Gastroenterology, Gaochun People's Hospital of Nanjing, Nanjing
| | - Yiming Xing
- Department of Gastroenterology, Gaochun People's Hospital of Nanjing, Nanjing
| | - Zhenguo Qiao
- Department of Gastroenterology, Suzhou Ninth People's Hospital, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
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El Khoury P, Makhoul M, El Hadi C, Haber C, Rassi S. CT Scan in Children Suspected of Foreign Body Aspiration: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2024; 170:1-12. [PMID: 37473440 DOI: 10.1002/ohn.433] [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: 01/27/2023] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The goal of this study is to evaluate the sensitivity and specificity of computed tomography (CT) scans in the diagnosis of foreign body aspiration (FBA) in children, and to determine whether chest CT scans would reduce the need for diagnostic rigid bronchoscopies. DATA SOURCES MEDLINE, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for relevant articles and conference proceedings that were published in English through November 1, 2022. REVIEW METHODS We included prospective and retrospective studies comparing chest CT scans and rigid bronchoscopy for the diagnosis of FBA in pediatric patients (<16 years old). The pooled estimates of the sensitivity and specificity of the chest CT scan in the diagnosis of FBA were calculated using a fixed- or common-effects analysis and a random-effects analysis that accounts for heterogeneity if present. Forest plots were constructed to combine the evidence identified during the systematic review. RESULTS Eighteen articles (4178 patients) were included. The average age of the children was 2.26 (±0.75) years, and 65% (±5.64%) of them were boys. Cough was the most prevalent symptom upon presentation. The pooled analysis showed that the sensitivity of chest CT scan in detecting a foreign body in children was 99% (95% confidence interval, CI [97, 100]; I2 = 72%, τ2 = 0.0065, p < .01). The false negative rate was 1.8% (95% CI [0.3, 2.7]; I2 = 72%, p < .01). The specificity of chest CT scan was 92% (95% CI [83, 98]; I2 = 83%, τ2 = 0.0437, p < .01). CONCLUSIONS Chest CT scan is a sensitive and specific test for the diagnosis of FBA in the pediatric population. Its use can help to reduce unnecessary rigid bronchoscopies, especially in patients with a low clinical suspicion of aspiration. It should not be a replacement for the gold standard bronchoscopy, particularly in cases where there is a clear history and symptoms suggestive of aspiration.
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Affiliation(s)
- Patrick El Khoury
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Mikhael Makhoul
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Christopher El Hadi
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Christelle Haber
- Department of Radiology, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Simon Rassi
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
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Gretener YA, Huisman TAGM. [Foreign body ingestion]. Praxis (Bern 1994) 2024; 113:8-11. [PMID: 38381103] [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] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Foreign body ingestion by young children has been increasing for years. Ingestions of batteries and magnets are particularly problematic.[1] Before and during diagnosis, there are some important steps that should be followed to allow for proper patient management.
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Affiliation(s)
- Yannic A Gretener
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, USA
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, USA
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50
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Mekwan J, Chandra K, Atkinson P. Efficacy of hand-held metal detectors in the detection and localization of ingested metallic foreign bodies in children. CAN J EMERG MED 2024; 26:69. [PMID: 37707777 DOI: 10.1007/s43678-023-00593-0] [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: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Jayanand Mekwan
- Department of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, University Ave, Saint John, NB, Canada
| | - Kavish Chandra
- Department of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, University Ave, Saint John, NB, Canada
| | - Paul Atkinson
- Department of Emergency Medicine, Dalhousie Medicine New Brunswick, Horizon Health Network, University Ave, Saint John, NB, Canada.
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