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Tian YK, Su D, Yu ZB, Li N. Complex pyothorax due to infection with Parvimonas micra, Streptococcus constellatus, and Campylobacter rectus. Asian J Surg 2024:S1015-9584(24)01303-4. [PMID: 38971704 DOI: 10.1016/j.asjsur.2024.06.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024] Open
Affiliation(s)
- Yu-Kun Tian
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China
| | - Dan Su
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China
| | - Zhan-Biao Yu
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China
| | - Ning Li
- Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, 071000, Hebei, China.
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Ehrsam JP, Meier Adamenko O, Schlumpf RB, Schöb OM. Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case. Surg Laparosc Endosc Percutan Tech 2024; 34:206-221. [PMID: 38450728 PMCID: PMC10986785 DOI: 10.1097/sle.0000000000001275] [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: 11/08/2023] [Accepted: 12/19/2023] [Indexed: 03/08/2024]
Abstract
BACKGROUND Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies. METHODS We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options. RESULTS In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years. CONCLUSIONS Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.
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Senapathy G, Vengala S, Muriki R, Rughwani H, Kalapala R. Pancreatitis from posterior gastric wall perforation by ingested metallic wire-case report and review of literature. BJR Case Rep 2023; 9:20230070. [PMID: 37780975 PMCID: PMC10513008 DOI: 10.1259/bjrcr.20230070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/24/2023] [Indexed: 10/03/2023] Open
Abstract
Gastric and duodenal perforation from ingested organic and inorganic foreign bodies, such as sewing needles, toothpick, metallic wires, fish and chicken bone, are uncommon incidents as most foreign bodies pass in the faeces. The perforated foreign body can at times migrate and either penetrate causing traumatic injury or incite inflammation with formation of abscesses or pseudo-tumours in the adjacent organs such as the liver and pancreas. We report one such case of pancreatitis in a child resulting from a metallic wire perforating the posterior gastric wall and penetrating the pancreas. The findings were detected on CT and the foreign body was extracted endoscopically. We also present review of literature on similar case reports.
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Affiliation(s)
- Gayatri Senapathy
- Department of Radiology, Asian Institute of Gastroenterology, Gachibowli, Hyderabad, India
| | - Sudhakar Vengala
- Department of Radiology, Asian Institute of Gastroenterology, Gachibowli, Hyderabad, India
| | - Rohini Muriki
- Department of Gastroenterology, Asian Institute of Gastroenterology, Gachibowli, Hyderabad, India
| | - Hardik Rughwani
- Department of Gastroenterology, Asian Institute of Gastroenterology, Gachibowli, Hyderabad, India
| | - Rakesh Kalapala
- Department of Gastroenterology, Asian Institute of Gastroenterology, Gachibowli, Hyderabad, India
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Lin J, Tao H, Wang Z, Chen R, Chen Y, Lin W, Li B, Fang C, Yang J. Augmented reality navigation facilitates laparoscopic removal of foreign body in the pancreas that cause chronic complications. Surg Endosc 2022; 36:6326-6330. [PMID: 35589974 DOI: 10.1007/s00464-022-09195-w] [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: 07/28/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Foreign bodies that enter the pancreas and cause chronic complications cannot be removed by endoscopy. Surgical removal is necessary but also challenging. The development of augmented reality navigation has made it possible to accurate intraoperative navigation in laparoscopic surgery. METHODS A 37-year-old female had epigastric pain for 3 months and her abdominal CT showed a linear high-density shadow in her pancreas along with chronic pancreatitis. Three-dimensional models of the liver, pancreas, stomach, blood vessels, and foreign body were created based on CT images. Gastroptosis was found in the three-dimensional models, so surgical approach was adapted to open the hepatogastric ligament to reach the pancreas. After 2-3 s of video images were captured by 3D laparoscopy, a three-dimensional dense stereo-reconstruction method was used to obtain the surface model of pancreas, stomach, and blood vessels. The Globally Optimal Iterative Closest Point method was used to obtain a spatial transformation matrix between the preoperative CT image space and the intraoperative laparoscopic space. Under augmented reality navigation guidance, the position and location of the foreign body were displayed on the surface of the pancreas. Then intraoperative ultrasound was used for further verification and to quickly and easily confirm the surgical entrance. After minimal dissection and removal of the pancreatic parenchyma, the foreign body was removed completely. RESULTS The operation time was 60 min, the estimated blood loss was 10 ml. The foreign body was identified as a 3-cm-long fishbone. The patient recovered without complications and was discharged on the third postoperative day. CONCLUSION Because it enables direct visual navigation via simple operation, ARN facilitates the laparoscopic removal of foreign bodies in the pancreas with accurate and rapid positioning and minimal damage.
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Affiliation(s)
- Jinyu Lin
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Haisu Tao
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China.,Hepatic Surgery Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhuangxiong Wang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Rui Chen
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Yunlong Chen
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Wenjun Lin
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Baihong Li
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Chihua Fang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China. .,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China.
| | - Jian Yang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China. .,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China.
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Xia J, Xia L, Zhou H, Lin X, Xu F. Empyema caused by Streptococcus constellatus: a case report and literature review. BMC Infect Dis 2021; 21:1267. [PMID: 34930151 PMCID: PMC8686261 DOI: 10.1186/s12879-021-06955-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/07/2021] [Indexed: 11/29/2022] Open
Abstract
Background Streptococcus constellatus is a member of Streptococcus anginosus group (SAG) that tends to cause pyogenic infections in various sites. However, Streptococcus constellatus is easily ignored by routine clinical laboratory tests for its prolonged anaerobic culture environment. Case presentation A 71-year-old man was admitted to our hospital due to productive cough, fever, chest pain and shortness of breath for 3 weeks. Chest computed tomography showed patchy opacities and right-sided pleural effusion, so a chest tube was inserted and purulent and hemorrhagic fluid was aspirated. The routine etiological examinations of the pleural effusion were all negative, and next-generation sequencing (NGS) detected Streptococcus constellatus. Intravenous piperacillin-tazobactam 4.5 g every 8 h was used accordingly. The patient recovered and subsequent chest computed tomography confirmed the improvement. Conclusions We reported a case of empyema secondary to Streptococcus constellatus infection, which was identified by NGS, instead of bacterial culture. This case highlights the utility of NGS in detecting pathogens negative in traditional bacterial tests.
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Affiliation(s)
- Jingyan Xia
- Department of Radiation Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Lexin Xia
- Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Hui Zhou
- Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Xiuhui Lin
- Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Feng Xu
- Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
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Wang Y, Luo X, Zhang J. Successful laparoscopic treatment for sustained abdominal pain due to fish bone migrating into the neck of the pancreas: a case report and thinking about surgical approach through the literature review. Surg Case Rep 2021; 7:91. [PMID: 33851276 PMCID: PMC8044272 DOI: 10.1186/s40792-021-01174-y] [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: 03/09/2021] [Accepted: 04/06/2021] [Indexed: 11/12/2022] Open
Abstract
Background The majority of ingested foreign bodies pass through the gastrointestinal tract smoothly, with less than 1% requiring surgery. Fish bone could perforate through the wall of stomach or duodenum and then migrate to other surrounding organs, like the pancreas and liver. Case presentation We report herein the case of a 67-year-old male who presented with sustained mild epigastric pain. Abdominal computed tomography revealed a linear, hyperdense, foreign body along the stomach wall and pancreatic neck. We made a final diagnosis of localized inflammation caused by a fish bone penetrating the posterior wall of the gastric antrum and migrating into the neck of the pancreas. Upper gastrointestinal endoscopy was performed firstly, but no foreign body was found. Hence, a laparoscopic surgery was performed. The foreign body was removed safely in one piece and was identified as a 3.2-cm-long fish bone. The patient was discharged from the hospital on the fifth day after surgery without any postoperative complications. Conclusion Laparoscopic surgery has proven to be a safe and effective way to remove an ingested fish bone embedded in the pancreas.
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Affiliation(s)
- Yang Wang
- Hepatic Biliary and Pancreatic Cancer Center, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba, Chongqing, 400030, People's Republic of China
| | - Xianzhang Luo
- Hepatic Biliary and Pancreatic Cancer Center, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba, Chongqing, 400030, People's Republic of China
| | - Jiefeng Zhang
- Hepatic Biliary and Pancreatic Cancer Center, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba, Chongqing, 400030, People's Republic of China.
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Mulita F, Papadopoulos G, Tsochatzis S, Kehagias I. Laparoscopic removal of an ingested fish bone from the head of the pancreas: case report and review of literature. Pan Afr Med J 2020; 36:123. [PMID: 32849978 PMCID: PMC7422735 DOI: 10.11604/pamj.2020.36.123.23948] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/06/2020] [Indexed: 02/05/2023] Open
Abstract
Most ingested foreign bodies pass spontaneously through the gastrointestinal tract and only 1% of them can perforate or penetrate the wall of stomach and duodenum and migrate into organs, such as the liver and pancreas. We report herein the case of a 59-year-old woman who presented to the emergency department with epigastric pain and fever. Computed tomography of the abdomen revealed a linear foreign body that perforate the posterior wall of the prepyloric region of the stomach. The foreign body was removed laparoscopically in one piece and was identified as a 3-cm-long fish bone. The patient recovered without complications and was discharged on the 4th postoperative day. Pancreatic foreign body is a rare entity and laparoscopic removal is warranted in majority of cases.
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Affiliation(s)
- Francesk Mulita
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
| | - George Papadopoulos
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
| | - Stelios Tsochatzis
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
| | - Ioannis Kehagias
- Department of General Surgery, General University Hospital of Patras, Achaia, Greece
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Mima K, Sugihara H, Kato R, Matsumoto C, Nomoto D, Shigaki H, Kurashige J, Inoue M, Iwagami S, Mizumoto T, Kubota T, Miyanari N. Laparoscopic removal of an ingested fish bone that penetrated the stomach and was embedded in the pancreas: a case report. Surg Case Rep 2018; 4:149. [PMID: 30594971 PMCID: PMC6311171 DOI: 10.1186/s40792-018-0559-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/18/2018] [Indexed: 02/07/2023] Open
Abstract
Background The gastrointestinal tract can occasionally be perforated or penetrated by an ingested foreign body, such as a fish bone. However, there are very few reported cases in which an ingested fish bone penetrated the gastrointestinal tract and was embedded in the pancreas. Case presentation An 80-year-old male presented with epigastric pain. Computed tomography of the abdomen showed a linear, hyperdense, foreign body that penetrated through the posterior wall of the gastric antrum. There was no evidence of free air, abscess formation, migration of the foreign body into the pancreas, or pancreatitis. As the patient had a history of fish bone ingestion, we made a diagnosis of localized peritonitis caused by fish bone penetration of the posterior wall of the gastric antrum. We first attempted to remove the foreign body endoscopically, but failed because it was not detected. Hence, an emergency laparoscopic surgery was performed. A linear, hard, foreign body penetrated through the posterior wall of the gastric antrum and was embedded in the pancreas. The foreign body was safely removed laparoscopically and was identified as a 2.5-cm-long fish bone. Intraperitoneal lavage was performed, and a drain was placed in the lesser sac. The patient recovered without complications and was discharged on the 7th postoperative day. Conclusion Laparoscopic surgery could be performed safely for the removal of an ingested fish bone embedded in the pancreas.
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Affiliation(s)
- Kosuke Mima
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan.
| | - Hidetaka Sugihara
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Rikako Kato
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Chihiro Matsumoto
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Daichi Nomoto
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Hironobu Shigaki
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Junji Kurashige
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Mitsuhiro Inoue
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Shiro Iwagami
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Takao Mizumoto
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Tatsuo Kubota
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Nobutomo Miyanari
- Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
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Attila T, Mungan Z. Fish Bone Penetrating into the Head of Pancreas in a Patient with Billroth II Gastrojejunostomy. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2018; 26:221-222. [PMID: 31192294 DOI: 10.1159/000489720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/27/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Tan Attila
- Division of Gastroenterology and Hepatology, Koc University School of Medicine, Istanbul, Turkey
| | - Zeynel Mungan
- Division of Gastroenterology and Hepatology, American Hospital, Istanbul, Turkey
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10
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Liver Abscess in Patients With Leukemia and Prolonged Neutropenia. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2017. [DOI: 10.1097/ipc.0000000000000478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Lefkowitz RY, Ridge GE. Paederus dermatitis in a seafarer diagnosed via telemedicine collaboration. J Travel Med 2016; 23:taw017. [PMID: 27021498 DOI: 10.1093/jtm/taw017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 11/13/2022]
Abstract
Seafarers are traveling workers, subject to unique exposures and generally isolated from adequate medical care. This case report of paederus dermatitis diagnosed at sea highlights the importance of a multidisciplinary diagnostic approach and telecommunication in providing remote medical advice to isolated traveling workers such as seafarers.
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Affiliation(s)
- Rafael Y Lefkowitz
- Department of Internal Medicine, Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, CT, USA
| | - Gale E Ridge
- The Connecticut Agricultural Experiment Station, New Haven, CT, USA
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