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Devkota S, Pokharel P, Lamichhane S, Bhola H, Bhalla T. Migrated subcutaneous sharp foreign body in the anterior chest wall: An unusual presentation. Clin Case Rep 2024; 12:e8565. [PMID: 38455860 PMCID: PMC10918736 DOI: 10.1002/ccr3.8565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
Key Clinical Message Migration of any foreign body can cause potentially life threatening complications and should be reviewed by a multidisciplinary approach for the management. Diagnosis can be challenging; a history of foreign body injury could be suspicious. Abstract Foreign body injury to the chest wall can be an emergency situation and require a multidisciplinary approach for the management of the condition. Migration of the foreign body, though rare, can lead to potentially life threatening complications and require a multidisciplinary approach for the localization of the foreign body and subsequent management of the condition. A 50-year-old male presented to the emergency department with the complaint of left sided chest pain. Upon examination, the patient was found to have a penetrating injury 6 years back by a sharp object. Radiological investigations helped in the localization of the migrating foreign body, which was removed with effective surgical intervention. The postoperative chest x-ray was normal, the patient was asymptomatic and thus the patient was discharged on the same day following surgery.
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Affiliation(s)
- Shritik Devkota
- Department of Radiodiagnosis and ImagingAnil Baghi HospitalPunjabIndia
| | - Prajjwal Pokharel
- Department of CardiologyManmohan Cardiothoracic Vascular and Transplant CenterKathmanduNepal
| | - Samiksha Lamichhane
- Department of Radiodiagnosis and ImagingB. P. Koirala Institute of Health SciencesDharanNepal
| | - Harsha Bhola
- Department of General SurgeryAnil Baghi HospitalPunjabIndia
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Martin MP, Patel AH, Cole MW, Gadinsky NE, Collins L, Sherman WF. A Rare Case of a Lisfranc Ligament Transection. Orthop Rev (Pavia) 2023; 15:56664. [PMID: 36776274 PMCID: PMC9907328 DOI: 10.52965/001c.56664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Ligamentous Lisfranc injuries, which mimic a surgical transection are rare. Left untreated or missed, these injuries may result in severe complications including long-term disability. The present case describes a unique mechanism of injury via a sharp object puncture through the plantar surface of the midfoot. It highlights the utility of planning staged procedures to remove a large foreign body object, reports notable intraoperative techniques, and provides a decision management guide for treating this type of injury. Extensive surgical planning may be required when encountering similar cases and knowledge of this may be useful to providers.
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Affiliation(s)
| | | | | | | | - Lacee Collins
- Orthopaedic SurgeryTulane University School of Medicine
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Chen K, Wang M, Su Y. Foreign body removal with the assistance of ultrasound guidance and methylene blue staining in children-a cohort study. INTERNATIONAL ORTHOPAEDICS 2022; 46:1831-1838. [PMID: 35536367 DOI: 10.1007/s00264-022-05427-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Soft tissue foreign bodies (FBs) are very commonly observed in paediatric emergency departments. Not all FBs can be removed effectively, even via open surgery and image intensifier guidance. In the current study, we evaluated the efficiency of FB removal with the assistance of ultrasound (US) and methylene blue (MB) staining. METHODS We enrolled 80 patients at our clinical center between May 2016 and December 2020. Eleven patients were operated upon with the assistance of US guidance and MB and were defined as group A; the other 69 patients were defined as group B. For the patients in group A, US was first used to locate the FB; MB was then injected next to the FB. Open surgery was subsequently performed. For group B, the FBs were removed by conventional methods. The surgical outcomes were evaluated according to surgical duration, incision infection rates, radiograph exposure times, and FB residue rates. RESULTS The average surgery time for group A was 0.35 ± 0.10 hours; the corresponding time was 0.49 ± 0.50 hours in group B and there was a significant difference between the groups (p = 0.032). The radiograph exposure times were 1.33 ± 0.34 in group A and 4.65 ± 1.81 times in group B (p = 0.021). CONCLUSIONS This study demonstrates that assistance of US and MB staining is a more efficient approach compared with traditional methods for FB removal, and this surgical method can be used effectively for FB removal in children.
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Affiliation(s)
- Kai Chen
- Orthopedics Department, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China
| | - Menglei Wang
- Orthopedics Department, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China
| | - Yuxi Su
- Orthopedics Department, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China. .,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China. .,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China. .,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People's Republic of China.
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