376
|
Zhao ZW, Wu XC, Deng JH, Lian PH, Zhang XB. Ureteral obstruction and hydronephrosis caused by foreign body: A case report and literature review. Medicine (Baltimore) 2019; 98:e17780. [PMID: 31689845 PMCID: PMC6946273 DOI: 10.1097/md.0000000000017780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE Foreign bodies related ureteral obstruction and hydronephrosis is rare and usually cause numerous problems for clinical physicians. PATIENT CONCERNS We report a 36-year-old female who was referred to our hospital due to a 4-year history of dull pain on the left back. DIAGNOSIS X-ray and abdominal CT revealed a foreign body around the upper part of the left ureter with ureteral obstruction and hydronephrosis. INTERVENTIONS Laparoscopy was performed and a 3-cm sewing needle was removed successfully. OUTCOMES After 6 months' follow-up, the patient's ureteral obstruction and hydronephrosis were significantly reduced, and the double-J ureteral stent was removed. LESSONS This case indicated that ureteral obstruction and hydronephrosis caused by foreign bodies needed to be early diagnosed and located. Invasive therapies rather than conservative treatments are preferred to remove the FBs and relieve obstruction.
Collapse
|
377
|
Zuccarino L, Villani M, Carinci F, Barlattani A, Ottria L. Foreign body granuloma in the maxillofacial region: a case report. J BIOL REG HOMEOS AG 2019; 33:209-213. [PMID: 32338475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Foreign bodies can penetrate in soft tissues of the maxillofacial region through injuries and cutaneous lacerations from trauma. Most commonly found bodies are glass, metal and wood. We report the case of a 50-year-old male patient who came to our maxillofacial department complaining about the presence of an intraoral nodule located in the right upper gingival mucosa. The patient reported the story of a road accident, three months earlier, falling from a scooter without the aid of a protective helmet.
Collapse
|
378
|
de Bellefroid J, Vandecasteele S, Van Cauwenberge S, Bouillon R, Van den Bruel A. Textiloma-Induced 1,25-Dihydroxyvitamin D-Mediated Hypercalcemia: A Case Report and Literature Study. J Endocr Soc 2019; 3:2158-2164. [PMID: 31687642 PMCID: PMC6822642 DOI: 10.1210/js.2019-00206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/20/2019] [Indexed: 12/19/2022] Open
Abstract
Foreign body causing 1,25-dihydroxyvitamin D [1,25(OH)2D]-induced hypercalcemia is an uncommon yet clinically significant cause of hypercalcemia. We report an unusual case of hypercalcemia due to a textiloma (a surgical gauze inadvertently left in place during surgery). A PubMed search for (HYPERCALCEMIA) and (FOREIGN BODY) was performed. A foreign body (surgical gauze) left over after removal of a kidney transplant caused 1,25(OH)2D-induced hypercalcemia. The diagnosis was complicated by end-stage renal disease, low PTH, and high 1,25(OH)2D.
Collapse
|
379
|
Arshad M, Jeelani SM, Salim A, Hussain BD. Multiple Magnet Ingestion leading to Bowel Perforation: A Relatively Sinister Foreign Body. Cureus 2019; 11:e5866. [PMID: 31763089 PMCID: PMC6834100 DOI: 10.7759/cureus.5866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Foreign body ingestion is a common reason for seeking emergency care among children. One of the more serious foreign bodies are the ingestion of multiple magnets or concurrent ingestion of a magnet and a metallic foreign body. Conservative management with serial imaging can be misleading in such cases. Multiple magnets tend to have strong attractive forces among them and may encase loops of bowel within them. Once entrapped, pressure necrosis and perforation will ensue, and thus, a low threshold should be adopted for surgical exploration in such cases. We present the case of a two-year-old male who had an accidental, unwitnessed ingestion of multiple magnets and also report the subsequent surgical management and associated morbidity.
Collapse
|
380
|
Sun Y, Kwak JM, Kholinne E, Tan J, Koh KH, Jeon IH. Nonabsorbable Suture Knot on the Tendon Affects Rotator Cuff Healing: A Comparative Study of the Knots on Tendon and Bone in a Rat Model of Rotator Cuff Tear. Am J Sports Med 2019; 47:2809-2815. [PMID: 31412207 DOI: 10.1177/0363546519867928] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Nonabsorbable suture knots are usually used to link the tendon and bone during rotator cuff repair surgery. There are many variations in the arthroscopic knot-tying technique; however, the location of suture knot placement for rotator cuff healing has rarely been studied. HYPOTHESIS The authors compared the rotator cuff healing between knots tied on tendon and bone in a rotator cuff tear rat model. It has been hypothesized that knots can cause chronic inflammation and create the weakest link between tendon and bone, thus affecting rotator cuff healing. STUDY DESIGN Controlled laboratory study. METHODS Bilateral supraspinatus tenotomy and rotator cuff repair at the greater tuberosity were performed on 24 Wistar rats. Nonabsorbable surgical suture knots were made on the right supraspinatus tendon tissue and left humerus inferior to the greater tuberosity, respectively. Twelve rats each were sacrificed at 3 and 9 weeks. Six of the 12 rats were used for biomechanical testing and the remaining 6 for histologic evaluation. RESULTS The surgical knots placed on the bursal side of the tendon migrated to the articular side, as noted on gross observation in 22 of 24 samples. The knots on the tendon group showed significantly inferior tendon-bone integration and significantly inferior biomechanical results in terms of maximum load to failure and stiffness. An obvious chronic foreign body inflammatory reaction was found in the knots on the tendon group at 3 and 9 weeks. Furthermore, inferior bone-tendon interface regeneration and weakest link formation were obtained in the knots on the tendon group compared with those on the bone group. CONCLUSION Nonabsorbable suture knots placed on the tendon migrate to the articular side, causing chronic inflammation and weakening tendon-bone healing, which may explain some retears after rotator cuff repair. CLINICAL RELEVANCE The present animal study suggests that it is not recommended in clinical practice to make several bulky nonabsorbable suture knots on the rotator cuff tendon during rotator cuff repair surgery. It may be better to tie the knots at the bone side or do knotless repair.
Collapse
|
381
|
Kanu LN, Jiang Y, Gonzalez AFV, Mieler WF. Visual and Anatomic Outcomes in Perforating Ocular Injuries. ACTA ACUST UNITED AC 2019; 3:428-437. [PMID: 31742242 DOI: 10.1177/2474126419865992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Purpose This article reports the presentation, management, and outcomes in patients suffering perforating ocular injuries. Methods A retrospective review was conducted at a single ophthalmology Level 1 trauma center. Patients with evidence of traumatic ocular perforation, with surgical intervention attended by a single vitreoretinal surgeon (W.F.M.), were reviewed between 2009 and 2017. Results Six eyes from 6 patients with perforating ocular injuries were studied. All patients were male, between ages 11 and 56 years. Perforation was the result of gunshots (3), other accidental injury (2), or surgical complication (1). Varying degrees of retinal detachments were seen in all 6 patients. Pars plana vitrectomy, with endolaser around posterior entry or exit wounds, was performed on average 21.7 ± 8.9 days from the time of injury (range, 0-58 days). In all cases with intraorbital foreign bodies, the foreign bodies were left in place. The most recent postoperative visual acuity ranged from 20/25 to counting fingers. Missile injuries tended to have poorer vision. All cases achieved full anatomic attachment at most recent follow-up. There have been no orbital complications related to retained intraorbital foreign bodies, including endophthalmitis, orbital infections, or mechanical strabismus. Conclusion This study demonstrates successful anatomic outcomes of 6 cases of perforating ocular injuries. Visual outcomes were variable, though missile injuries demonstrated worse prognosis, whereas several nonmissile macula-involving cases achieved quite favorable results. Although traumatic perforating injuries generally have guarded visual prognoses, favorable results may be achieved in select scenarios.
Collapse
|
382
|
Maaloul I, Kmiha S, Yaich S, Thouraya K, Damak J, Aloulou H, Hachicha M. [Epidemiology of home accidents in childhood: experience in the Division of General Pediatrics in Southern Tunisia]. Pan Afr Med J 2019; 33:108. [PMID: 31489086 PMCID: PMC6711678 DOI: 10.11604/pamj.2019.33.108.12022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 08/20/2018] [Indexed: 11/25/2022] Open
Abstract
Les accidents domestiques représentent un problème sérieux de santé publique en pédiatrie. Ils sont responsables d’une lourde morbidité et mortalité parmi la population pédiatrique. Nous avons mené une étude rétrospective colligeant 231 cas d’accidents domestiques chez l’enfant au Service de Pédiatrie de l’Hôpital Hédi Chaker de Sfax durant une période de 5 ans (2008 - 2012). Durant la période d’étude, nous avons colligé 231 cas d’accidents domestiques. Il s’agissait de 124 garçons (53,7%) et 107 filles (46,3%). L’âge moyen était de 2 ans avec des extrêmes de 1 jour et 14 ans. Les enfants âgés de moins de 4 ans étaient les plus exposés (88,7%). Les intoxications accidentelles étaient les accidents les plus fréquents (105 cas). Les caustiques étaient les agents toxiques les plus fréquents (33 cas), suivis par les médicaments (28 cas) puis les hydrocarbures (16 cas). Les accidents par corps étrangers ont représenté le deuxième mécanisme accidentel (64 cas). Il s’agissait de 43 cas d’inhalation de corps étrangers et 21 cas d’ingestion de corps étranger. Nous avons enregistré 28 cas de traumatismes; il s’agissait d’une chute d’une certaine hauteur dans 25 cas. Nous avons recensé 26 cas d’envenimations scorpioniques, 5 noyades, 2 cas de brulure et un seul cas d’électrisation. Les intoxications accidentelles et les accidents par corps étrangers représentent les principaux accidents domestiques dans notre série et la tranche d’âge entre 1 et 4 ans est la plus exposée aux accidents domestiques.
Collapse
|
383
|
Oka A, Ishihara S, Mikami H, Sonoyama H, Mishiro T, Tobita H, Kawashima K, Miyake T, Ishimura N, Furuta K, Kinoshita Y, Nishina M. Retained Rice Cake: A Unique Upper Gastrointestinal Foreign Body: Case Report and a Literature Review. Intern Med 2019; 58:2485-2494. [PMID: 31178509 PMCID: PMC6761341 DOI: 10.2169/internalmedicine.2760-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
As a rarely recognized foreign body in the upper gastrointestinal tract, rice cake frequently requires endoscopic removal. We herein report six patients with characteristic sonography, computed tomography (CT), spectroscopy, endoscopy, and histological findings. A review of all published cases, including ours, revealed that retained rice cake in the stomach typically shows the following: abdominal pain (93.3%), mucosal injury (93.3%) with bleeding (42.9%); high-density (120-206 Hounsfield units) CT findings; and indication for endoscopy (80%). In the esophagus, hot, toasted rice cake causes thermal injury. Primary physicians should be aware of this popular-food-induced, but rare, disorder.
Collapse
|
384
|
Bongard AB, Furrow E, Granick JL. Retrospective evaluation of factors associated with degree of esophagitis, treatment, and outcomes in dogs presenting with esophageal foreign bodies (2004-2014): 114 cases. J Vet Emerg Crit Care (San Antonio) 2019; 29:528-534. [PMID: 31448848 DOI: 10.1111/vec.12875] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/22/2017] [Accepted: 08/26/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To characterize a population of dogs presenting for esophageal foreign body removal and evaluate factors associated with degree of esophagitis and minor and major complications. DESIGN Retrospective evaluation of dogs who presented for esophageal foreign body removal between January 2004 and December 2014. SETTING University veterinary teaching hospital. ANIMALS Data collected from 114 dogs included signalment, history, clinical signs, physical examination findings, duration and location of foreign body, degree of esophagitis, foreign body removal success, feeding tube placement, and clinical outcomes. Owners were contacted for outcome data not available in the medical record. Data were analyzed for breed predispositions, whether duration or type of foreign body was associated with degree of esophagitis or complications, and factors associated with feeding tube placement. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The overall success rate for foreign body removal via esophagoscopy was 95% with a complication rate of 22%. Small breed dogs were overrepresented. Dogs with a foreign body present for >24 h were significantly more likely to have severe esophagitis (P < 0.001) and major complications (P = 0.0044). Foreign body type did not predict degree of esophagitis or complications, though fishhooks were more likely to require surgical removal (P = 0.033). Feeding tubes (15 gastrostomy, 1 nasoesophageal) were placed in 14% of dogs and were more likely to be placed if the foreign body had been present for >24 h (P < 0.001). CONCLUSIONS Consistent with previous studies, esophageal foreign bodies, appropriately identified and endoscopically removed, carry a good prognosis, particularly if they have been present for ≤24 h.
Collapse
|
385
|
Setyo L, Sabater M, Young A, Rickman BH. Metastatic Osteolytic Angioleiomyosarcoma Induced by a Foreign Body in a Kangaroo (Macropus giganteus). Aust Vet J 2019; 97:357-360. [PMID: 31286481 DOI: 10.1111/avj.12849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/23/2019] [Accepted: 05/26/2019] [Indexed: 11/30/2022]
Abstract
An adult female Eastern Grey kangaroo (Macropus giganteus) was examined for lameness due to a mass located at the right tibiotarsal joint. Radiographs revealed a metal arrowhead-shaped foreign body within the mass alongside a pathologic fracture. Grossly, at necropsy, there was a multilobulated and haemorrhagic mass with intralesional metal fragments, associated osteolysis of the tibiotarsus and pulmonary metastatic nodules. Histologically the neoplasm was composed of plump elongated and fusiform cells that often formed concentrically around small vessels. The pulmonary nodules were composed of similar neoplastic cells, necrosis and haemorrhage. Neoplastic cells were positive immunohistochemically for vimentin and smooth muscle actin. The histological features, immunohistochemical profiles and behaviour of this tumour support a diagnosis of a primary angioleiomyosarcoma with lung metastasis associated with a metal foreign body.
Collapse
|
386
|
Abstract
PURPOSE Upper airway foreign body is one of the most encountered clinical situations in otolaryngology practice. In rare conditions, a living organism may be a foreign body in the upper airway. In this study, we demonstrate 19 patients with leech infestations in nose, nasopharynx, and larynx. METHODS This study was enrolled with 19 patients between 2012 and 2016 in a regional state hospital. All of the patients were admitted to clinic with these complaints: epistaxis, hemoptysis, coughing, foreign body sensation, and bloody stool. RESULTS There were 12 male and 7 female patients. The leech was in the nose in 12 patients, in nasopharynx in 6 patients, and in the larynx in only 1 patient. All leeches are removed under local anesthesia (except laryngeal presentation). No bleeding and complication were seen after extraction of leech. CONCLUSION Leech can be easily diagnosed and managed in the upper aero-digestive tract without any complication and leech-associated disease.
Collapse
|
387
|
Gray ML, Kappauf C, Govindaraj S. Management of an Unusual Intranasal Foreign Body Abutting the Cribriform Plate: A Case Report and Review of Literature. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2019; 12:1179550619858606. [PMID: 31308785 PMCID: PMC6604121 DOI: 10.1177/1179550619858606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 11/17/2022]
Abstract
A 35-year-old man with history of schizophrenia presented 3 weeks after placing a screw in his right nostril. Initial imaging showed a screw in the right ethmoid sinus with the tip penetrating the right cribriform plate. On exam, the patient was hemodynamically stable with purulent drainage in the right nasal cavity but no visible foreign body. While most nasal foreign bodies occur in children and are generally removed at the bedside, intranasal foreign bodies in adults tend to require further assessment. The foreign body in this case was concerning for skull base involvement and the patient was brought to the operating room (OR) with neurosurgery for endoscopic sinus surgery (ESS) and removal of foreign body. The screw was removed and the patient recovered with no signs of cerebrospinal fluid (CSF) leak postoperatively. Any concern for skull base or intracranial involvement should call for a full evaluation of the mechanism of injury and intervention in a controlled environment.
Collapse
|
388
|
Scott RA, Wood C, Khan I. The novel use of a nasal bridle system to remove a foreign body in the ear. Clin Case Rep 2019; 7:1439-1441. [PMID: 31360507 PMCID: PMC6637359 DOI: 10.1002/ccr3.2269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 05/04/2019] [Accepted: 05/07/2019] [Indexed: 11/21/2022] Open
Abstract
Foreign bodies in the ear are a common presentation that prompt referral to Otolaryngology. We describe a technique that is safe and simple to perform for the removal of metallic foreign bodies in the ear. Case report of an elderly gentleman presenting with otalgia and a hearing aid battery lodged within bony external ear canal.
Collapse
|
389
|
Ma T, Zheng W, An B, Xia Y, Chen G. Small bowel perforation secondary to foreign body ingestion mimicking acute appendicitis: Case report. Medicine (Baltimore) 2019; 98:e16489. [PMID: 31348257 PMCID: PMC6709264 DOI: 10.1097/md.0000000000016489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Foreign body ingestion is often encountered in clinical practice; however, intestinal perforation owing to foreign body ingestion is rare. PATIENT CONCERNS Here, we present the cases of 2 patients who accidentally swallowed foreign bodies and later presented with pain in the right lower abdominal quadrant. DIAGNOSES Both patients were initially diagnosed with acute appendicitis and underwent immediate emergency laparotomy. INTERVENTIONS During the operation, the appendix was found to be only mildly inflamed. On transection of the appendix, the mucosa was found to be inflamed, and yellow-white exudate was noted. We, therefore, decided to explore the entire bowel. The bowel examination revealed small bowel perforations, and palpation of the adjacent bowel revealed a hard, sharp object. The object was removed through the perforation site, the perforation was repaired, and the abdomen was closed in layers. OUTCOME The postoperative recovery, in both cases, was uneventful. LESSONS Patients who swallow sharp or large foreign bodies should undergo endoscopy as soon as possible to avoid intestinal perforation. Clinicians should inquire about a history of foreign body ingestion. The preoperative diagnosis of intestinal perforation secondary to foreign body ingestion requires a high degree of clinical suspicion and awareness.
Collapse
|
390
|
Erickson BP, Feng PW, Ko MJ, Modi YS, Johnson TE. Gun-related eye injuries: A primer. Surv Ophthalmol 2019; 65:67-78. [PMID: 31229522 DOI: 10.1016/j.survophthal.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 06/01/2019] [Accepted: 06/07/2019] [Indexed: 02/03/2023]
Abstract
Gun-related eye injuries are relatively common in the context of gunshot wounds to the head and neck. Many of the fundamental principles of gunshot wound management apply to the care of these patients, but the complex anatomy and functional relationships of the periocular region do pose special challenges. We provide a focused primer for physicians seeking a more in-depth understanding of gun-related eye injuries and present 3 representative cases outlining the spectrum of pathology, provide a focused review of the relevant ballistics concepts, and discuss the management of injuries to the periocular soft tissues, orbital structures, and globe. We found that good cosmetic and functional results can often be achieved with appropriate early intervention, but visual prognosis may remain guarded despite optimal treatment.
Collapse
|
391
|
Al-Musawi M, Rubay D, Ohanisian L, Sidley A, Abed AN. An Unusual Presentation of a Cardiac Foreign Body in a Pediatric Patient. Cureus 2019; 11:e4829. [PMID: 31404380 PMCID: PMC6682342 DOI: 10.7759/cureus.4829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cardiac foreign bodies (FBs) are rare. Their etiology can be attributed to penetrating injuries although they are also often found incidentally. The approach for removal of these FBs is variable and patient dependent. Although there is debate regarding indications for removal, there is a general consensus that symptomatic FBs presenting acutely, as well as asymptomatic FBs posing a greater risk of complication to the patient, should be removed. We present the case of a 14-year-old patient with a cardiac FB and a step-wise approach for removal.
Collapse
|
392
|
Lim CHL. Ant Bites Conjunctival Tissue: The ABCs of Removing an Ocular Ant Foreign Body. J Emerg Med 2019; 56:698-700. [PMID: 30904382 DOI: 10.1016/j.jemermed.2019.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND A variety of insect-related ocular injuries have been reported in the literature. However, no reports have been published documenting injuries resulting from exposure of the ocular surface to ants. This is surprising, given the relatively ubiquitous presence of ants. This is the first known case report to describe various techniques utilized in the removal of ants from the ocular surface. CASE REPORT This case report details the presentation of a distressed 24-year-old woman who presented to the Emergency Department with an ocular foreign body associated with pain and increased lacrimation. She was identified to have an ant adherent to her conjunctiva. Various techniques of removal were performed, with the ant finally removed without any trauma to underlying tissues. CONCLUSION This is the first case report to detail various techniques utilized in the removal of ants from the ocular surface, and discusses salient features that treating physicians should be aware of in managing patients presenting with ant bites.
Collapse
|
393
|
Packard E, Groff A, Shahid Z, Sahu N, Jain R. A 'Bit' of Appendicitis: A Case of a Foreign Object in the Adult Appendix. Cureus 2019; 11:e4751. [PMID: 31363433 PMCID: PMC6663284 DOI: 10.7759/cureus.4751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 05/24/2019] [Indexed: 02/07/2023] Open
Abstract
Appendicitis is the most common abdominal surgical emergency, and if left untreated, can lead to an abscess, peritonitis, or even death. The exact mechanism of appendicitis has yet to be elucidated, but the predominant theory is that different forms of luminal obstruction of the vermiform appendix lead to ischemia of the appendix wall and subsequent translocation of bacteria across the compromised mucosa, leading to transmural inflammation. The most common etiology is hyperplasia of lymphoid tissue in the mucosa, often secondary to infection and inflammation with gradual symptom onset. Rarer causes of obstruction include parasitic infiltration, fibrous bands, carcinoid syndrome, and foreign body ingestion and often have atypical or absent symptomatology, making diagnosis more challenging and complications more frequent. We present a rare case of foreign body-associated appendicitis with distal lodging in the appendix and highlight the importance of prophylactic appendectomy to avoid severe complications.
Collapse
|
394
|
Wyatt SR, Barron PM. Complications following removal of oesophageal foreign bodies: a retrospective review of 349 cases. Aust Vet J 2019; 97:116-121. [PMID: 30919444 DOI: 10.1111/avj.12796] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 12/18/2018] [Accepted: 01/23/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine the incidence and types of complications associated with oesophageal foreign body (FB) removal in dogs, as well as to evaluate potential risk factors for the development of complications. METHODS Clinical records were searched within Animal Emergency Service and Veterinary Specialist Services databases between July 2001 and March 2017. Data were collected regarding signalment, FB type, method of removal, medical management and complications. Follow-up records from the referring veterinarian were then obtained by either phone call or email. RESULTS A total of 349 FB cases were reviewed. The majority of FBs were bones (77.4%), with Staffordshire Bull Terriers (12.3%) and West Highland White Terriers (9.8%) the most common breeds seen. Complications at the time of FB removal occurred in 20 cases (5.9%), with 14 cases of perforation. Persistent gastrointestinal signs were reported in 4.7% of cases within the initial 72-h period following FB removal and 11.9% cases outside this time period. Respiratory signs such as dyspnoea and coughing were also reported in 8 cases (2.3%), all of which occurred within 72 h after FB removal. Follow-up of at least 1 month was available in 151 cases. Delayed complications occurred in 11 cases (7.3%), with stricture occurring in 4 cases (2.6%); 16 animals were either euthanased (n = 14) or died (n = 2) post-FB removal, resulting in a case fatality rate of 4.6%. CONCLUSION Use of antacid medications and FB type did not have a statistically significant relationship with complications following FB removal.
Collapse
|
395
|
Mahajan JK, Rao SG. Pen Cap Aspirations: Maneuvering for Successful Extraction. J Pediatr Intensive Care 2019; 7:126-128. [PMID: 31073484 DOI: 10.1055/s-0037-1613672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022] Open
Abstract
Aim of this study was to analyze the therapeutic approach with enhanced success of bronchoscopy. We retrospectively analyzed the results of bronchoscopic extraction of pen cap aspirations in our unit from 2000 to 2014. Out of 239 bronchoscopies performed for foreign bodies in airways, there were 8 cases of pen cap aspirations. All 8 were males and age ranged from 5 to 11 years. Seven cases had definitive history, while one patient had a history of chronic respiratory ailment. The foreign bodies were lodged in right and left bronchi in four cases each and seven had their open-end toward the proximal airways. Bronchoscopic extraction was successful in seven patients. The maneuver of rotating the optical forceps by 90 degrees so as to align the pen cap with the vocal cords resulted in success in all the cases. One patient underwent thoracotomy and bronchotomy for removal. Pen cap aspirations occur in school-going children. Aligning the optical forceps with vocal cords during extraction avoids the need for tracheostomy or thoracotomy.
Collapse
|
396
|
Ahmed M, Habis S, Saeed R, Mahmoud A, Attar N. Small Bowel Obstruction in a Virgin Abdomen: A Case Report. Cureus 2019; 11:e4594. [PMID: 31309019 PMCID: PMC6609295 DOI: 10.7759/cureus.4594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Small bowel obstruction (SBO) is a major cause of morbidity and financial burden in hospitals around the world. Foreign body (FB) ingestion as a cause is rare. While most cases are straight forward, some can be extremely subtle. We present a case of SBO caused by an undigested piece of pineapple core.
Collapse
|
397
|
Holloway A, Pivetta M, Rasotto R. Ultrasonographic and histopathological features in 8 cats with fibrotic small intestinal stricture. Vet Radiol Ultrasound 2019; 60:423-431. [PMID: 31050093 DOI: 10.1111/vru.12756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 01/20/2019] [Accepted: 02/15/2019] [Indexed: 01/18/2023] Open
Abstract
Benign stricture is an uncommon cause of chronic small intestinal obstruction in the cat. The purpose of this retrospective case series was to describe the ultrasonographic features, histopathological findings, and clinical presentation in a group of cats with benign small intestinal stricture. Inclusion criteria were cats presenting during the period 2010-2017, and that had ultrasonography and small intestinal stricture confirmed at surgery. For each cat, clinical data and ultrasonographic findings were retrieved from the medical record, and histopathology, where available, was reviewed. Eight cats met the inclusion criteria. The location of strictures was duodenum (1/8), mid- to distal jejunum (4/8), and ileum (3/8). Ultrasonographic findings included gastric distension (8/8) and generalized (3/8) or segmental (5/8) intestinal dilation consistent with mechanical obstruction. Ingesta did not propagate beyond the strictured segment. Wall thickening was mild to moderate (3-6 mm). Normal wall layering was disrupted in all cats. Strictures were predominantly hypoechoic (7/8) and associated with hyperechoic peri-intestinal mesentery (6/8). Annular strictures (5/8) were less than 15 mm in length whereas long-segment strictures (3/8) were greater than 15 mm in length. Histopathology showed transmural disease with fibrosis and inflammation (8/8), often (6/8) extending into the bordering mesentery. The mucosa was the most severely affected layer and epithelial injury accompanied the mucosal fibrosis/inflammation. Clinical presentation reflected delayed diagnosis of chronic bowel obstruction with debilitation (8/8), marked weight loss (8/8), and prerenal azotemia (5/8). Benign fibrostenotic stricture should be considered a differential diagnosis in debilitated young cats presenting with chronic bowel disease and ultrasonographic features of intestinal obstruction.
Collapse
|
398
|
Wang D, Zhao Y, Cha B, Fang P, Liu Y. Penetrating neck trauma with common carotid artery injury caused by a percussive drill: A case report. Medicine (Baltimore) 2019; 98:e15750. [PMID: 31145290 PMCID: PMC6709122 DOI: 10.1097/md.0000000000015750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Penetrating neck traumas are dangerous and have a high mortality rate, particularly in patients with common carotid artery injuries. Advances in diagnostic imaging technology have shifted management of penetrating neck injuries from mandatory exploration to selective management. The question is now regarding optimal selection of auxiliary examinations to assess "stability" rapidly and guide clinics in managing such patients. PATIENT CONCERNS A 56-year-old man suffered neck trauma with the right common carotid artery caused by a percussive drill. The carotid artery could not be clearly displayed in computed tomography (CT) angiography imaging. DIAGNOSES Penetrating neck trauma due to percussive drill bit with common carotid artery injury. INTERVENTIONS X-ray and bedside duplex ultrasound with color Doppler flow imaging were used to assess the state of trauma and the foreign body was removed under general anesthesia. OUTCOMES The patient was discharged at postoperative day 10 with no complication. The patient had no sequelae from this injury at 6-month follow up. LESSONS X-ray provides a comprehensive assessment of damage, and can efficiently detect foreign bodies in the skull and cervical vertebrae. Duplex ultrasound to be a viable method to exclude macrovascular injury in unstable patients who are not eligible for computed tomography angiography (CTA) or catheter angiography imaging. Widely available duplex ultrasound and x-ray should be considered in emergency situations.
Collapse
|
399
|
Wang Q, Zhou C, Liu J, Xiong B, Zheng C, Feng G. In situ formation of the loop snare technique for retrieval of foreign bodies from vessels. J Interv Med 2019; 1:247-251. [PMID: 34805858 PMCID: PMC8586705 DOI: 10.19779/j.cnki.2096-3602.2018.04.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels. Materials and methods: We retrospectively reviewed in situ formation of the loop snare technique for retrieval of foreign bodies in 6 patients. After placing the guide wire and the loop of the gooseneck snare on each side of the tubes, the soft tip of the guide wire was caught with the gooseneck snare to form a new loop structure. The foreign body was retrieved with the new loop snare by combining the gooseneck snare and the guide wire. We reviewed the application of this technique in 6 patients with fractured central venous catheters without free ends. Results: With in situ formation of the loop snare technique, the internal ruptured catheter was successfully removed from all of the 6 patients in about 2 to 4 min. There were no complications such as arrhythmia or heart valve injury in the 6 patients with the distal end of the fragment in the pulmonary artery or right atrium. Conclusion: The in situ formation loop snare technique is an effective and fast means of retrieving tubular foreign bodies without free ends from vessels. Further research is needed to investigate the practical utility of the method for retrieval of all kinds of foreign bodies.
Collapse
|
400
|
Na'ara S, Vainer I, Amit M, Gordin A. Foreign Body Aspiration in Infants and Older Children: A Comparative Study. EAR, NOSE & THROAT JOURNAL 2019; 99:47-51. [PMID: 30974996 DOI: 10.1177/0145561319839900] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Foreign body aspiration (FBA) is a major cause of morbidity and mortality in children. It is a preventable event that predominates in preschool age. The signs and symptoms mimic respiratory diseases common in the same age-group. We compared FBA in infants to FBA in older children. METHODS Retrospective analysis of all the cases of suspected FBA of children under the age of 18 years hospitalized at one medical center during 2002 to 2016. We analyzed the data according to age: up to 1 year (infants) and 1 to 18 years. RESULTS One hundred seventy-five children with suspected FBA were admitted; of whom, 27 (15%) were infants and 148 (85%) were older children (age 1-18 years). For the 2 age groups, adults witnessed 85% and 73%, respectively, of the incidents (P = .4). In the neonate group, 48% presented with normal X-ray findings compared to only 20% in the older group; 15% of the older group had a positive chest X-ray for a foreign body, while none had such in the infants' group (P = .01). For the 2 age groups, the majority of the FBs found were from organic origin. About half of the patients were diagnosed and managed within 24 hours of the aspiration event. In 10%, repeated bronchoscopy was performed due to a retained FB remnant. In a multivariate analysis, signs and symptoms (P < .05), location of the FB (P < .001), and witnessed aspiration (P < .001) were independent prognostic factors for the length of hospitalization. CONCLUSION Foreign body aspiration is not uncommon in young infants; the management is challenging due to small airways, the need to use smaller bronchoscopes, and the lack of working channel forces in pediatric bronchoscopes.
Collapse
|