1
|
Wang F, Hu C, Zhu Z, Wu D, Shu M. Clinical Characteristics of Children With Foreign Bodies in the Digestive Tract and Analysis of Risk Factors for Serious Complications. Clin Pediatr (Phila) 2024:99228241253344. [PMID: 38756001 DOI: 10.1177/00099228241253344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Foreign bodies (FBs) in the digestive tract are common in children, we analyzed the clinical characteristics of children with FBs in the digestive tract and discuss the risk factors for serious complications. We retrospectively reviewed clinical data of 139 children with FBs in the digestive tract. Based on the severity of complications caused by FBs, the patients were divided into risk and general groups for analysis and comparison. Significant differences were observed in the retention sites of FBs, the diameter of FBs retained in the esophagus, FBs retention time exceeding 24 h, and the absence of witnesses between the 2 groups. Inadequate care, button batteries (BBs), ingested mmFBs, FBs retained in the esophagus, long-term retention, and giant gastric bezoars may cause serious complications. In addition to treating FBs and the complications, clinicians should emphasize the importance of childcare to prevent the ingestion of FBs.
Collapse
Affiliation(s)
- Fengge Wang
- Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Chijun Hu
- Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Zhenni Zhu
- Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Daiqin Wu
- Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Meng Shu
- Department of Gastroenterology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| |
Collapse
|
2
|
Viola SE, Vijay A, Madhukara J. Sea urchin dermatitis with Dermoscopic clues. J Travel Med 2024:taae072. [PMID: 38753888 DOI: 10.1093/jtm/taae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/09/2024] [Indexed: 05/18/2024]
Abstract
This case series explores sea urchin spine injuries, a growing concern due to increased travel. These injuries, even in non-coastal areas, can mimic other foreign bodies and lack inflammation, posing a diagnostic challenge. Dermoscopy aided in visualization and extraction of retained spines, highlighting its utility in managing these injuries.
Collapse
Affiliation(s)
| | - Aithal Vijay
- Department of Dermatology, St John's Medical College Hospital, Bangalore
| | | |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Yuen F, Dennison S. Radiographic identification of challenging gastrointestinal tract foreign bodies: a descriptive study of how appearance varies in air versus water to aid interpretation. Am J Vet Res 2024:1-4. [PMID: 38621409 DOI: 10.2460/ajvr.23.10.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVE To provide veterinarians with updated radiographic descriptions of select radiolucent foreign material in a simulated gastrointestinal environment. SAMPLE 368 veterinarian respondents from the US. METHODS An online survey was administered between June 18, 2023, and July 2, 2023, through a private veterinarian-based social media group. Representative commonly ingested foreign bodies were radiographed surrounded by air and water to simulate being within the gastrointestinal tract. Two examiners evaluated and qualified the opacity of the objects for each environment. RESULTS The private social media group had a total of 3,900 members including veterinarians from all disciplines. A total of 362 small animal veterinarians (9.3% of the group) responded to the study reporting a total of 123 foreign objects that were not causing mechanical obstruction at the time of initial presentation. Sixty-eight foreign bodies were reported greater than or equal to 5 times and grouped as balls (n = 4), food (9), fabric (14), wood (3), soft plastic (14), hard plastic (18), or other (6). Most (98.5% [67/68]) objects were easily identifiable in air. In water, 23.5% (16/68) of the objects were obscured, and 39.7% (27/68) had inversion of the major opacity when compared to the opacity in air. CLINICAL RELEVANCE The opacity of some ingested radiolucent material can invert relative to air or fluid, which may reflect substantial differences in detection following repositioning. When known dietary indiscretion occurs, radiographing a sample of the material in air and water will improve the accuracy of assessment.
Collapse
|
5
|
Apandi A, Sai Guan L, Mohamad A, Muhamad Tamyez F, Ishak MN. An Atypical Squamous Papilloma of the Uvula. Cureus 2024; 16:e58008. [PMID: 38738073 PMCID: PMC11087670 DOI: 10.7759/cureus.58008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/14/2024] Open
Abstract
Squamous papilloma of the oral cavity is frequently seen in adult patients and is typically presented as painless exophytic granular or cauliflower-like lesions over the tongue, floor of the mouth, palate, uvula, lips, and faucial pillars. Most of the lesions are solitary and grow rapidly to about 0.5 cm. Oral squamous papilloma has no known malignant potential, with conservative surgical excision being the treatment of choice. Recurrence is rare. It occasionally causes symptoms, unless the presentation is atypical, as in our case. An elongated uvula can cause discomfort and reduce a patient's quality of life. This study aims to report an atypical presentation of a squamous papilloma over the soft palate.
Collapse
Affiliation(s)
- Afena Apandi
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
- Department of Medicine, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, MYS
| | - Lum Sai Guan
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, MYS
- Department of Medicine, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, MYS
| | - Amran Mohamad
- Department of Otorhinolaryngology, Hospital Sultanah Nur Zahirah, Kuala Terengganu, MYS
| | | | - Muhammad Nu'aim Ishak
- Department of Otorhinolaryngology - Head and Neck Surgery, Universiti Sultan Zainal Abidin, Kuala Terengganu, MYS
| |
Collapse
|
6
|
Druel T, Jalaguier T, Gaillard C, Gazarian A. Recommendations for radiographic assessment of hand wounds. J Hand Surg Eur Vol 2024; 49:499-500. [PMID: 37974361 DOI: 10.1177/17531934231211566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
A retrospective study of 945 hand patients was conducted to determine the relevance of systematic radiographic assessment. An osteoarticular lesion or a radiopaque foreign body was found in 34% of cases. The indications for radiographic assessment should be related to the mechanism of injury.
Collapse
Affiliation(s)
- Thibault Druel
- SOS Main, Department of Hand Surgery, Hôpital Edouard Herriot, Lyon, France
| | - Thomas Jalaguier
- SOS Main, Department of Hand Surgery, Hôpital Edouard Herriot, Lyon, France
| | - Christophe Gaillard
- SOS Main, Department of Hand Surgery, Hôpital Edouard Herriot, Lyon, France
- Department of Orthopaedic and Traumatology, Hôpital militaire Desgenettes, Lyon, France
| | - Aram Gazarian
- SOS Main, Department of Hand Surgery, Hôpital Edouard Herriot, Lyon, France
- Department of Hand Surgery, Clinique du Parc, Lyon, France
| |
Collapse
|
7
|
Camilo LO, Maganhe BL, Gallo Neto H, Sanches EG. Enterolith with a bonefish spine nidus in a Brazilian cownose ray Rhinoptera brasiliensis (Müller & Henle) (Myliobatiformes: Rhinopteridae). J Fish Dis 2024:e13946. [PMID: 38492214 DOI: 10.1111/jfd.13946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
An adult female Brazilian cownose ray (Rhinoptera brasiliensis), housed in Ubatuba Aquarium died after loss of appetite period. During necropsy, an enterolith was discovered partially obstructing the intestinal lumen. Examination of the enterolith revealed a bonefish spine nidus. Enterolithiasis has been linked to multiple factors including diet, genetics, alkaline intestinal environments and, as in this particular case, the ingestion and retention of foreign bodies. The composition of this enterolith from a cownose ray was primarily monohydrocalcite. This short communication, apparently the first to report enterolithiasis in stingrays, emphasizes the need for post-mortem examinations of carcasses on macroscopic and microscopic levels.
Collapse
Affiliation(s)
- L O Camilo
- Ubatuba Aquarium, Ubatuba, Brazil
- Marine Fish Laboratory, Fisheries Institute, Ubatuba, Brazil
| | - B L Maganhe
- Marine Fish Laboratory, Fisheries Institute, Ubatuba, Brazil
| | | | - E G Sanches
- Marine Fish Laboratory, Fisheries Institute, Ubatuba, Brazil
| |
Collapse
|
8
|
Gupta P, Jindal M, Garg S, Garg K. Occupational Nerve Injuries due to Metallic Foreign Bodies: A Case Series of Eighteen Patients. Malays Orthop J 2024; 18:84-90. [PMID: 38638651 PMCID: PMC11023338 DOI: 10.5704/moj.2403.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/22/2023] [Indexed: 04/20/2024] Open
Abstract
Introduction Peripheral nerve injuries (PNIs) remain an important health problem. PNIs mostly affect young men as this age group is mostly involved in road traffic accidents and other injuries at workplace. PNI can occur from foreign bodies like metal chips while working in industries using lathe machines. Among PNI's, injuries to the ulnar nerve, the brachial plexus and the median nerve are the most frequent lesions encountered. Materials and methods This presentation is on a series of 18 cases of nerve injuries among industrial workers located from finger level up to the arm excluding the brachial plexus due to metallic foreign bodies entering while operating lathe machines over a period of two years with patients being followed-up over a one year period. Results Mean age in this series was 31.3 years with age range 16-40 years and all were males. Two patients had more than one nerve involvement and one patient had associated vascular injury. All the patients showed functional improvement. Most common nerve injured was median nerve. Most common site for nerve injury was forearm. Combined lesions most commonly involved the ulnar and median nerves. Conclusion Social cost of traumatic peripheral nerve injuries is significant since it has a higher incidence in young, previously healthy, and economically active people.
Collapse
Affiliation(s)
- P Gupta
- Department of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, India
| | - M Jindal
- Department of Orthopaedics, Kalpana Chawla Govt Medical College and Hospital, Karnal, India
| | - S Garg
- Department of Radiotherapy, Guru Gobind Singh Medical College and Hospital, Faridkot, India
| | - K Garg
- Department of Anaesthesiology, Kalpana Chawla Govt Medical College and Hospital, Karnal, India
| |
Collapse
|
9
|
Bouiller K, Jacko NF, Shumaker MJ, Talbot BM, Read TD, David MZ. Factors associated with foreign body infection in methicillin-resistant Staphylococcus aureus bacteremia. Front Immunol 2024; 15:1335867. [PMID: 38433826 PMCID: PMC10904584 DOI: 10.3389/fimmu.2024.1335867] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Background We aimed to compare patient characteristics, MRSA sequence types, and biofilm production of MRSA strains that did and did not cause a foreign body infection in patients with MRSA bloodstream infections (BSI). Methods All adult patients with MRSA BSI hospitalized in two hospitals were identified by clinical microbiology laboratory surveillance. Only patients who had at least one implanted foreign body during the episode of BSI were included. Results In July 2018 - March 2022, of 423 patients identified with MRSA BSI, 118 (28%) had ≥1 foreign body. Among them, 51 (43%) had one or more foreign body infections. In multivariable analysis, factors associated with foreign body infection were history of MRSA infection in the last year (OR=4.7 [1.4-15.5], p=0.012) community-associated BSI (OR=68.1 [4.2-1114.3], p=0.003); surgical site infection as source of infection (OR=11.8 [2-70.4], p=0.007); presence of more than one foreign body (OR=3.4 [1.1-10.7], p=0.033); interval between foreign body implantation and infection <18 months (OR=3.3 [1.1-10], p=0.031); and positive blood culture ≥48h (OR=16.7 [4.3-65.7], p<0.001). The most prevalent sequence type was ST8 (39%), followed by ST5 (29%), and ST105 (20%) with no significant difference between patients with or without foreign body infection. Only 39% of MRSA isolates formed a moderate/strong biofilm. No significant difference was observed between patients with foreign body infection and those without foreign body infection. In multivariable analysis, subjects infected with a MRSA isolate producing moderate/strong in vitro biofilm were more likely to have a history of MRSA infection in the last year (OR=3.41 [1.23-9.43]), interval between foreign body implantation and MRSA BSI <18 months (OR=3.1 [1.05-9.2]) and ST8 (OR=10.64 [2-57.3]). Conclusion Most factors associated with foreign body infection in MRSA BSI were also characteristic of persistent infections. Biofilm-forming isolates were not associated with a higher risk of foreign-body infection but appeared to be associated with MRSA genetic lineage, especially ST8.
Collapse
Affiliation(s)
- Kevin Bouiller
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Université de Franche-Comté, CHU Besançon, UMR-CNRS 6249 Chrono-environnement, Department of Infectious and Tropical Diseases, Besançon, France
| | - Natasia F Jacko
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Margot J Shumaker
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Brooke M Talbot
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Timothy D Read
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Michael Z David
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
10
|
Zhang X, Xing M, Lei S, Li W, Li Z, Xie Y, Zhu C, Zhang S. Case report and literature review: Orally ingested toothpick perforating the lower rectum. Front Surg 2024; 11:1368762. [PMID: 38435079 PMCID: PMC10904550 DOI: 10.3389/fsurg.2024.1368762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Most foreign bodies (FBs) can spontaneously pass through the gastrointestinal tract. Sharp FBs are believed to be able to puncture any part of the gastrointestinal tract, causing perforation and potentially secondary damage to adjacent organs. Case description A 44-year-old man complained of having persistent dull pain in the perianal region. He was diagnosed with a toothpick impacted into the wall of the lower rectum after accepting a digital rectal examination of the lower rectum and a pelvic computed tomography (CT). The surgeon extracted the FB using vascular forceps guided by the operator's index finger. The patient was discharged after intravenous ceftriaxone was given for 6 days. A follow-up pelvic CT performed 2 weeks after surgery revealed that the perirectal fat and muscles had already normalized. Conclusion A systematic review of relevant literature from the past decade was performed to summarize the imaging features of an orally ingested toothpick perforating the gastrointestinal tract. The location of abdominal pain is an important clue for the diagnosis of toothpick perforation, and a CT examination is recommended as the first option for the detection of an ingested toothpick. Determining the location of the toothpick perforation and assessing the severity of local inflammation are important bases for the selection of treatment.
Collapse
Affiliation(s)
- Xingliang Zhang
- Department of Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Mei Xing
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Shaoyang Lei
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Wentao Li
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zijin Li
- Department of Radiology, Yuebei People’s Hospital, Shaoguan, Guangdong, China
| | - Yibing Xie
- Department of Graduate School, Hebei North University, Zhangjiakou, Hebei, China
| | - Chenyu Zhu
- Department of Graduate School, North China University of Science and Technology, Hebei, China
| | - Shuqian Zhang
- Department of Radiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| |
Collapse
|
11
|
Jain N, Singh Y, Singh A. Anesthetic Management of a Broken Tracheostomy Tube Stem as a Foreign Body in the Trachea: A Case Report. Cureus 2024; 16:e53254. [PMID: 38435921 PMCID: PMC10904353 DOI: 10.7759/cureus.53254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Tracheostomy is commonly performed in patients to secure the airway. There are known early and late complications related to tracheostomy. Few case reports have described the rupture of the stem of the tracheostomy tube and its migration into the tracheobronchial tree. Here we describe a pediatric case with a broken stem of the tracheostomy tube in the trachea, acting as a foreign body and causing mild respiratory distress. The patient was successfully managed with neck exploration under general anesthesia using a supraglottic airway device in low-resource settings. In addition, we have described the potential problems that may be faced while managing the airway of such patients and how to deal with these complications.
Collapse
Affiliation(s)
- Nisha Jain
- Anesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, New Delhi, IND
| | - Yudhyavir Singh
- Anesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, New Delhi, IND
| | - Abhishek Singh
- Anesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, New Delhi, IND
| |
Collapse
|
12
|
Ignatiev VV, Muraviev AV, Garapov TA, Tishukov MY. [Magnetic foreign bodies of the gastrointestinal tract in pediatric practice]. Khirurgiia (Mosk) 2024:29-37. [PMID: 38477241 DOI: 10.17116/hirurgia202403129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE To analyze the pediatric patients with multiple magnetic foreign bodies of the gastrointestinal tract undergoing surgical intervention; to present the treatment and diagnostic algorithm in pediatric practice; to compare surgical interventions for these lesions and determine the most optimal one. MATERIAL AND METHODS A retrospective single-center study included 9 patients diagnosed with multiple magnetic foreign bodies of the gastrointestinal tract. Exclusion criteria: outpatient cases and endoscopic removal of magnetic foreign bodies. All patients underwent laparoscopy and/or laparotomy. We analyzed postoperative data and determined the preferable approach. RESULTS All patients were discharged without complications. Length of hospital-stay was shorter after laparoscopy (7 vs. 12 days). Patients after laparoscopy didn't need for intensive care while laparotomy required ICU stay for 4.5±2.2 days. Enteral feeding started after 1 and 3 days, respectively. CONCLUSION Laparoscopy is preferable for multiple magnetic foreign bodies of the gastrointestinal tract due to shorter hospital-stay, no need for ICU-stay, lower surgical trauma and earlier enteral feeding.
Collapse
Affiliation(s)
- V V Ignatiev
- Sevastopol City Hospital No. 5 - Center for Maternal and Child Health, Sevastopol, Russia
| | - A V Muraviev
- Sevastopol City Hospital No. 5 - Center for Maternal and Child Health, Sevastopol, Russia
| | - T A Garapov
- Sevastopol City Hospital No. 5 - Center for Maternal and Child Health, Sevastopol, Russia
- Pirogov Sevastopol City Hospital No. 1, Sevastopol, Russia
| | | |
Collapse
|
13
|
Uchida K, Yokoyama H, Yamamoto A, Hashimoto K, Koike Y, Mohri Y. Safe extraction technique of a metallic blade after heated tobacco ingestion. Pediatr Int 2024; 66:e15763. [PMID: 38742689 DOI: 10.1111/ped.15763] [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: 09/01/2023] [Revised: 11/17/2023] [Accepted: 12/25/2023] [Indexed: 05/16/2024]
Affiliation(s)
- Keiichi Uchida
- Department of Pediatric Surgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan
| | - Honoka Yokoyama
- Department of Digestive and General Surgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan
| | - Akira Yamamoto
- Department of Digestive and General Surgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan
| | - Kiyoshi Hashimoto
- Department of Digestive and General Surgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan
| | - Yuhki Koike
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yasuhiko Mohri
- Department of Digestive and General Surgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan
| |
Collapse
|
14
|
Haider M, Saeed A, Zijlstra M, Wenzke K, Tommolino E. The Gastric Obstruction Due to Orbeez Beads Ingestion: A Case Report With Esophagogastroduodenoscopy Findings. Cureus 2024; 16:e51857. [PMID: 38327938 PMCID: PMC10848886 DOI: 10.7759/cureus.51857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 02/09/2024] Open
Abstract
Ingestion of non-food entities poses a critical risk, particularly in children and young adults. Mostly foreign bodies can safely pass through the gastrointestinal tract if they traverse the pylorus; however, ingestion of Orbeez beads can present as a unique challenge. Orbeez beads have the potential to absorb water and can expand in the stomach and small intestine, and can result in complications including constipation, intestinal obstruction, perforation, and peritonitis. Timely diagnosis and management are crucial to improve patient outcomes. We present a case of a 19-year-old male who ingested Orbeez beads and presented with nausea, vomiting, and abdominal pain. A non-contrast CT scan of the abdomen confirmed the foreign bodies. Fifty to seventy beads were successfully removed via esophagogastroduodenoscopy (EGD) without any complications, and the patient is currently doing well.
Collapse
Affiliation(s)
- Marjan Haider
- Internal Medicine, St. Joseph Mercy Ann Arbor Hospital, Ann Arbor, USA
| | - Aamir Saeed
- Internal Medicine, Merit Health Wesley Hospital, Hattiesburg, USA
| | - Michael Zijlstra
- Gastroenterology and Hepatology, Trinity Health Ann Arbor Hospital, Ann Arbor, USA
| | - Kevin Wenzke
- Gastroenterology and Hepatology, Trinity Health Ann Arbor Hospital, Ann Arbor, USA
| | - Emily Tommolino
- Gastroenterology and Hepatology, Trinity Health Ann Arbor Hospital, Ann Arbor, USA
| |
Collapse
|
15
|
Zhang J, Ding M, Tang A, Cao Y. A rare sequelae of esophageal perforation: Fibrosing mediastinitis. Pulm Circ 2024; 14:e12329. [PMID: 38174161 PMCID: PMC10762865 DOI: 10.1002/pul2.12329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/20/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
Fibrosing mediastinitis (FM) is a rare disease caused by different causes. If left untreated, the prognosis is poor. The common causes of FM are Tuberculosis and Histoplasma capsulatum infection. Esophageal perforation is also a rare condition that is often easily under- and mis-diagnosed due to the lack of specificity of symptoms. Here we report a case of FM caused by esophageal perforation.
Collapse
Affiliation(s)
- Jingwen Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital)LanzhouChina
| | - Mingwang Ding
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital)LanzhouChina
| | - Aiping Tang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital)LanzhouChina
| | - Yunshan Cao
- The Department of Cardiology, Pulmonary Vascular Disease Center (PVDC)Gansu Provincial HospitalLanzhouChina
| |
Collapse
|
16
|
Cho E, Park DS, Choi HG, Hong SK, Kim HJ, Lee HJ. Clinical features and predictors for developing complications of external auditory canal foreign bodies: A review of 455 cases. Clin Otolaryngol 2024; 49:142-146. [PMID: 37822086 DOI: 10.1111/coa.14103] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/18/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Eunhyun Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Doo Sik Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Sung-Kwang Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Republic of Korea
| |
Collapse
|
17
|
Alfurayh N, Alqahtani R, AlFada M. Keloid Scar Resistance to Intralesional Steroid Injections: Should We Look for Foreign Bodies? A Case Report. Clin Cosmet Investig Dermatol 2023; 16:3693-3697. [PMID: 38146404 PMCID: PMC10749577 DOI: 10.2147/ccid.s443813] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023]
Abstract
Keloid is a challenging pathological condition characterized by abnormal scarring that extends beyond the boundaries of the original wound. Despite the available treatment options, keloid scars remain difficult to manage. This case report discusses a 10-year-old boy with a keloid scar on his neck following branchial anomaly repair surgery. The patient underwent multiple treatments, including triamcinolone injections, cryotherapy, and a pulsed dye laser session, with limited improvement. Subsequently, an X-ray and ultrasound were performed revealing the presence of metallic clips over the surgical site. To our knowledge, the effect of the presence of foreign bodies within the keloid scar on its response to treatment is not well understood yet. The findings of this case encourage performing imaging studies on post-surgical keloid scars resistant to treatment to rule out the presence of any foreign material. However, more trials to investigate the effect of the presence of foreign bodies on the treatment of keloid scar are required before it can be set as a mandatory investigation.
Collapse
Affiliation(s)
- Nuha Alfurayh
- Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reem Alqahtani
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Mohammed AlFada
- Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
18
|
Ribeiro T, Mascarenhas Saraiva M, Afonso J, Brozzi L, Macedo G. Predicting Factors of Clinical Outcomes in Patients Hospitalized after Esophageal Foreign Body or Caustic Injuries: The Experience of a Tertiary Center. Diagnostics (Basel) 2023; 13:3304. [PMID: 37958198 PMCID: PMC10648504 DOI: 10.3390/diagnostics13213304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023] Open
Abstract
Ingestion of foreign bodies (IFB) and ingestion of caustic agents are frequent non-hemorrhagic causes of endoscopic urgencies, with the potential for severe complications. This study aimed to evaluate the predicting factors of the clinical outcomes of patients hospitalized as a result of IFB or ingestion of caustics (IC). This was a retrospective single-center study of patients admitted for IFB or IC between 2000 and 2019 at a tertiary center. Demographic and clinical data, as well as preliminary exams, were evaluated. Also, variables of the clinical outcomes, including the length of stay (LS) and other inpatient complications, were assessed. Sixty-six patients were included (44 IFB and 22 IC). The median LS was 7 days, with no differences between the groups (p = 0.07). The values of C-reactive protein (CRP) upon admission correlated with the LS in the IFB group (p < 0.01) but not with that of those admitted after IC. In the IFB patients, a diagnosis of perforation on both an endoscopy (p = 0.02) and CT scan (p < 0.01) was correlated with the LS. The Zargar classification was not correlated with the LS in the IC patients (p = 0.36). However, it was correlated with antibiotics, nosocomial pneumonia and an increased need for intensive care treatment. CT assessment of the severity of the caustic lesions did not correlate with the LS. In patients admitted for IFB, CRP values may help stratify the probability of complications. In patients admitted due to IC, the Zargar classification may help to predict inpatient complications, but it does not correlate with the LS.
Collapse
Affiliation(s)
- Tiago Ribeiro
- Department of Gastroenterology, Centro Hospitalar Universitário de São João, 4200-427 Porto, Portugal; (T.R.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal
| | - Miguel Mascarenhas Saraiva
- Department of Gastroenterology, Centro Hospitalar Universitário de São João, 4200-427 Porto, Portugal; (T.R.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal
- Department of Medicine, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal
| | - João Afonso
- Department of Gastroenterology, Centro Hospitalar Universitário de São João, 4200-427 Porto, Portugal; (T.R.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal
| | - Lorenzo Brozzi
- Gastroenterology and Digestive Endoscopy Unit, Pancreas Institute, Department of Medicine, G.B. Rossi University Hospital, 37134 Verona, Italy;
| | - Guilherme Macedo
- Department of Gastroenterology, Centro Hospitalar Universitário de São João, 4200-427 Porto, Portugal; (T.R.); (G.M.)
- WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal
- Department of Medicine, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal
| |
Collapse
|
19
|
Arai M, Takeshita H, Hirata W, Tachibana K, Nagamoto S, Kitayama S, Yano A, Okada Y, Kawakami S. Female intravesical foreign body penetrating the bladder wall: A rare case of traditional Asian hair stick kanzashi. Clin Case Rep 2023; 11:e8008. [PMID: 37808582 PMCID: PMC10551107 DOI: 10.1002/ccr3.8008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
A female in her thirties inserted an Asian traditional hair stick, kanzashi, into her urinary bladder for sexual gratification. We need to know that everyday objects can become bladder foreign bodies and how to manage them properly.
Collapse
Affiliation(s)
- Masahiro Arai
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Hideki Takeshita
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Wataru Hirata
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Kojiro Tachibana
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Shoichi Nagamoto
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Sachi Kitayama
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Akihiro Yano
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Yohei Okada
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| | - Satoru Kawakami
- Department of Urology, Saitama Medical CenterSaitama Medical UniversityKawagoe, SaitamaJapan
| |
Collapse
|
20
|
Overton N, Baruffi F, Neidhardt J, End B. Man with urethral foreign body sensation. J Am Coll Emerg Physicians Open 2023; 4:e13033. [PMID: 37662442 PMCID: PMC10469027 DOI: 10.1002/emp2.13033] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Nicholas Overton
- Department of Emergency Medicine1 Medical Center DrWest Virginia UniversityMorgantownWest VirginiaUSA
| | - Francesca Baruffi
- Department of Emergency Medicine1 Medical Center DrWest Virginia UniversityMorgantownWest VirginiaUSA
| | - Jessica Neidhardt
- Department of Emergency Medicine1 Medical Center DrWest Virginia UniversityMorgantownWest VirginiaUSA
| | - Bradley End
- Department of Emergency Medicine1 Medical Center DrWest Virginia UniversityMorgantownWest VirginiaUSA
- Department of Medical EducationWest Virginia University School of Medicine1 Medical Center DrWest Virginia University School of MedicineWest VirginiaMorgantownUSA
| |
Collapse
|
21
|
Untan I, Ersekerci E. A sewing needle as a urethral foreign body: A case report and literature review. Niger J Clin Pract 2023; 26:1588-1590. [PMID: 37929541 DOI: 10.4103/njcp.njcp_168_23] [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: 11/07/2023]
Abstract
Foreign bodies in the urethra can occur by self-insertion, and patients often hide the symptoms due to embarrassment. Foreign bodies act as a focus for infection and abscess formation and result in perforation or fistula when not detected on time. Foreign bodies can display symptoms such as frequent urination, dysuria, hematuria, urethrorrhagia, and obstruction. This case discusses a self-inserted urethral sewing needle that was removed cystoscopically from an adolescent.
Collapse
Affiliation(s)
- I Untan
- Department of Urology, Ahi Evran University, Training and Research Hospital, Kirsehir, Turkey
| | - E Ersekerci
- Department of Urology, Ahi Evran University, Training and Research Hospital, Kirsehir, Turkey
| |
Collapse
|
22
|
Çetin M, Erol A, Cesur Z, Solak N, Türk İ, Açıkel SB. Maternal temperament and anxiety sensitivity in children with foreign body aspiration. Rev Assoc Med Bras (1992) 2023; 69:e20230475. [PMID: 37729373 PMCID: PMC10508943 DOI: 10.1590/1806-9282.20230475] [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] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/28/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Foreign body aspiration is one of the childhood emergencies that thoracic surgeons are interested in, and it can cause morbidity and mortality. Although the relationship between various behavioral problems related to children and foreign body aspiration has been investigated so far, there is no study investigating the relationship between maternal temperament and anxiety sensitivity. This study aimed to investigate the relationship between maternal emotional temperament, anxiety sensitivity, and foreign body aspiration. METHODS Mothers of 18 children with foreign body aspiration have been evaluated by a thoracic surgeon, and 18 healthy controls have also been included in the study. Maternal emotional temperament has been measured with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Auto questionnaire scale, and anxiety sensitivity has been measured with the Anxiety Sensitivity Index-3. RESULTS There has been no statistically significant difference between groups in terms of maternal emotional temperament and anxiety sensitivity. In the logistic regression analysis conducted to determine the predictors of foreign body aspiration, it is determined that the mother's anxious temperament has predicted foreign body aspiration significantly. CONCLUSION As a result of the study, it can be concluded that mothers' anxious temperament can be considered a risk factor for foreign body aspiration because it affects parenting skills and children's ability to manage behavioral problems. Consistent results could be able to be obtained with studies including larger samples on the subject.
Collapse
Affiliation(s)
- Mehmet Çetin
- Niğde Training and Research Hospital, Department of Thoracic Surgery – Niğde, Turkey
| | - Abdullah Erol
- Niğde Training and Research Hospital, Department of Pediatrics – Niğde, Turkey
| | - Zeynep Cesur
- Uşak University, Faculty of Medicine, Department of Thoracic Surgery – Uşak, Turkey
| | - Necati Solak
- Sincan State Hospital, Department of Thoracic Surgery – Ankara, Turkey
| | - İlteriş Türk
- Ankara Atatürk Sanatoryum Training and Research Hospital, Department of Thoracic Surgery – Ankara, Turkey
| | - Sadettin Burak Açıkel
- Ankara University, Faculty of Medicine, Department of Child and Adolescent Psychiatry – Ankara, Turkey
| |
Collapse
|
23
|
Amini AA, Alzuabi A, Baniyassen M, Gharbi M, Aziz MA, Abbas MM. A 47-Year-Old Woman with a Retained Central Venous Catheter Line Guidewire Presenting with a Right Atrial Thrombus Requiring Removal During Open Heart Surgery: A Case Report. Am J Case Rep 2023; 24:e939908. [PMID: 37700515 PMCID: PMC10505040 DOI: 10.12659/ajcr.939908] [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: 02/17/2023] [Revised: 08/02/2023] [Accepted: 07/25/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND A central venous catheter (CVC) is an indwelling catheter that is inserted into a large central vein for different purposes, including hemodynamic monitoring and administration of fluids and medications. This report is of a 47-year-old woman with a retained CVC line guidewire presenting with a large right atrial thrombus requiring removal during open heart surgery. CVC insertion is one of the most frequently attempted procedures in intensive care units, emergency departments, and operation rooms, especially for critically ill patients. Possible complications range from failure to place the catheter to cardiac arrest. One of the rarest complications is missing the guidewire after insertion, which is usually discovered early after inserting it. CASE REPORT We report the case of a 47-year-old woman who had a CVC line inserted following complicated open cholecystectomy. A few years later, she developed shortness of breath, with an incidental finding of a huge right atrial thrombus and a wire shown on transthoracic echocardiography. The right atrial thrombus required open heart surgery to excise the thrombus and the wire, which was done successfully. The thrombus was histopathologically and clinically proven to be an organized right atrial thrombus formed around the CVC guidewire. CONCLUSIONS This case report presents a rare complication of CVC insertion. Because this procedure is increasingly used, clinicians should be aware of the potential complications of retained CVC lines. Moreover, this report outlines different techniques to prevent such fatal complications and emphasizes the significance of radiography after insertion.
Collapse
Affiliation(s)
- Ahmad Alsaka Amini
- Department of Anesthesia and Critical Care, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| | - Abeer Alzuabi
- Department of Anesthesia and Critical Care, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| | - Mohannad Baniyassen
- Department of Anesthesia and Critical Care, Sharjah Kuwait Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| | - Maro Gharbi
- Department of Anesthesia and Critical Care, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| | - Mohamed Abdel Aziz
- Department of Cardiac Surgery, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| | - Mohamed Magdy Abbas
- Department of Cardiac Electrophysiology, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| |
Collapse
|
24
|
Maggi G, Tessadori M, Marenzoni ML, Porciello F, Caivano D, Marchesi MC. Endoscopic Retrieval of Esophageal and Gastric Foreign Bodies in Cats and Dogs: A Retrospective Study of 92 Cases. Vet Sci 2023; 10:560. [PMID: 37756082 PMCID: PMC10538072 DOI: 10.3390/vetsci10090560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/26/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
Esophageal and gastric foreign bodies (FBs) commonly occur in small animal practices, and their endoscopic removal has been previously reported. However, few studies reported the endoscopic instruments used for the retrieval attempt and the time spent for endoscopic removal. Therefore, the aim of this study is to evaluate the factors that can influence the success rate and timing of the endoscopic retrieval of FBs. The medical records of 92 animals undergoing endoscopic removal of esophageal (n = 12) and gastric (n = 84) FBs have been reviewed. Two dogs had FBs in both the esophagus and stomach. From medical records and video recordings, there were extrapolated data on signalment, clinical signs, endoscopic devices used, success of retrieval, and duration of endoscopy. Endoscopic removal of FBs was successful in 88% cases, and the mean time spent for the extraction was 59.74 min (range, 10-120 min). The success rate and timing for the removal of endoscopic foreign bodies (EFBs) are influenced by several factors in our population: medium-breed dogs, adult animals, and localization of FBs in the body of the stomach increased the probability of failure during the endoscopic retrieval attempt. Conversely, the success and timing of the retrieval of EFBs were higher in puppies and with increasing operator's experience. Moreover, the use of combination devices such as polypectomy snare and grasping forceps negatively influenced the success of extraction of FBs. Further prospective and comparative studies in a large and multicentric population of patients can be useful to create interventional endoscopic guidelines, as in human medicine.
Collapse
Affiliation(s)
- Giulia Maggi
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (G.M.); (M.L.M.); (F.P.)
| | - Mattia Tessadori
- “Ponte Felcino” Veterinary Clinic, Via della Ghisa 3, 06134 Perugia, Italy;
| | - Maria Luisa Marenzoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (G.M.); (M.L.M.); (F.P.)
| | - Francesco Porciello
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (G.M.); (M.L.M.); (F.P.)
| | - Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (G.M.); (M.L.M.); (F.P.)
| | - Maria Chiara Marchesi
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (G.M.); (M.L.M.); (F.P.)
| |
Collapse
|
25
|
Loreau C, Caruselli M, Roncin C, Salvi N, Lenoire A, Allary C, De Queiroz M, Belghiti-Alaoui M, Michel F. Pediatric anesthetic for tracheobronchial foreign body extraction: A survey of practice in France. Paediatr Anaesth 2023; 33:736-745. [PMID: 37300331 DOI: 10.1111/pan.14704] [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: 03/04/2022] [Revised: 05/04/2023] [Accepted: 05/07/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Tracheobronchial foreign body aspiration is a classic pediatric emergency, and its associated morbidity particularly depends on the anesthetic management, which differs according to the center and the practitioner. AIMS The aim of this study was to evaluate the different anesthetic practices for tracheobronchial foreign body extraction. METHODS A survey was sent via email to the member physicians of the Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF). The survey included 28 questions about the organizational and anesthetic management of an evolving clinical case. RESULTS A total of 151 physicians responded to the survey. Only 13.2% of the respondents reported that their institution had a management protocol, and 21.7% required a computerized tomography scan before the procedure was performed for children who were asymptomatic or mildly symptomatic during the night. There were 56.3% of the respondents who reported that extraction with a rigid bronchoscope is the only procedure usually performed in their institution. Regarding rigid bronchoscopy, 47.0% used combined intravenous-inhalation anesthesia. The objective was to maintain the child on spontaneous ventilation for 63.6% of the respondents, but anesthesia management differed according to the physician's experience. CONCLUSIONS Our study confirms the diversity of practices concerning anesthetic for tracheobronchial foreign body extraction and found reveal differences in practice according to physician experience.
Collapse
Affiliation(s)
- Chine Loreau
- Department of Pediatric Anesthesia and Intensive Care, CHU Timone, Marseille, France
- Assistance-Publique - Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Marco Caruselli
- Department of Pediatric Anesthesia and Intensive Care, CHU Timone, Marseille, France
- Assistance-Publique - Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - César Roncin
- Department of Pediatric Anesthesia and Intensive Care, CHU Timone, Marseille, France
- Assistance-Publique - Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Nadège Salvi
- Department of Pediatric Anesthesia and Intensive Care, CHU Necker, Paris, France
- Assistance-Publique - Hôpitaux de Paris, Paris, France
- Centre Université de Paris, Paris, France
| | - Alexandre Lenoire
- Department of Pediatric Anesthesia and Intensive Care, CHU Necker, Paris, France
- Assistance-Publique - Hôpitaux de Paris, Paris, France
- Centre Université de Paris, Paris, France
| | - Chloé Allary
- Department of Pediatric Anesthesia and Intensive Care, CHU Timone, Marseille, France
- Assistance-Publique - Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Mathilde De Queiroz
- Department of Pediatric Anesthesia and Intensive Care, Femme-Mère-Enfant Hospital, Lyon, France
| | - Myriem Belghiti-Alaoui
- Department of Pediatric Anesthesia and Intensive Care, CHU Timone, Marseille, France
- Assistance-Publique - Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Fabrice Michel
- Department of Pediatric Anesthesia and Intensive Care, CHU Timone, Marseille, France
- Assistance-Publique - Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, Marseille, France
| |
Collapse
|
26
|
Rezazadeh A, Khanghah AS, Mousazadeh S, Noori F. Removing 216 sharp metal foreign objects from the digestive tract of a 30-year-old male: case report. Ann Med Surg (Lond) 2023; 85:4553-4560. [PMID: 37663736 PMCID: PMC10473348 DOI: 10.1097/ms9.0000000000000377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/25/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction and importance Foreign body (FB) ingestion and its complications are abundant in emergency departments. This potentially severe problem had a peak incidence in children aged 6 months to 6 years. Intentional adult cases are voluntary and more common in prisoners and people with psychiatric problems. However, most patients (90%) remain asymptomatic, and these pass through the body spontaneously. Case presentation The authors report a case of surgically removing plenteous sharp-pointed metallic foreign bodies ingested by a young male deaf-mute bipolar schizoaffective patient from his stomach, intestine, and rectum. Furthermore, the authors have reviewed the available literature for similar cases. Clinical discussion Less than 1% of patients need surgical removal, 10-20% need to be taken out endoscopically, and the remaining pass spontaneously. Plain radiography is the most available imaging modality detecting the number, material, and estimated place of the alimentary canal trapped. Conclusion For the risk of perforation, migration, and peritonitis, surgery is indicated in such situations.
Collapse
Affiliation(s)
| | - Ali Samady Khanghah
- Department of Surgery, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | | |
Collapse
|
27
|
Hanson JI, Bomar P, Kleist S, Rogalla D, Crihfield L, Gutovitz S. How Did That Get There? A Case Series of Adolescent Foreign Bodies. HCA Healthc J Med 2023; 4:303-308. [PMID: 37753417 PMCID: PMC10519637 DOI: 10.36518/2689-0216.1470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Introduction Pediatric foreign bodies (FBs) come in many shapes and sizes, and the method by which they enter the body can greatly impact the level of acuity at presentation. Most FBs in children are found in those younger than 5 years old, but the following 3 cases were found in adolescent patients. Case Presentation We report on 3 adolescent patients who presented to a single community-based emergency department with the chief complaint of abdominal pain and were found to have complications of abdominal FBs. If undiagnosed, the initial indolent courses of FBs can lead to serious complications, as shown in these examples. Conclusion These cases emphasize the need for physicians to maintain a high level of suspicion, to perform detailed histories, and to consider advanced imaging despite reassuring vital signs or physical examination.
Collapse
Affiliation(s)
| | - Paul Bomar
- Grand Strand Medical Center, Myrtle Beach, SC
| | | | | | | | | |
Collapse
|
28
|
Hong SJ, Kim C, Lee DW, Jang HJ, Cho SM, Choi KH, Hwang JH, Choe JY. Foreign body ingestion trends in children in the Daegu-Kyungpook Province, Korea before and during the COVID-19 period: a repeated cross-sectional study. Transl Pediatr 2023; 12:1364-1372. [PMID: 37575898 PMCID: PMC10416120 DOI: 10.21037/tp-23-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/29/2023] [Indexed: 08/15/2023] Open
Abstract
Background During the coronavirus disease 2019 (COVID-19) period, children spent more time at home, which is where most foreign body ingestions (FBIs) in children occur. We compared the rate of FBI in children in the Daegu-Kyungpook Province during COVID-19 to the rate in the 2 years before the COVID-19 period. Methods The period from January to December in the year 2020 was defined as the COVID-19 period, and the corresponding time period in 2018 and 2019 was defined as the pre-COVID-19 period. Medical records were analyzed retrospectively for pediatric patients aged 0-15 years who visited outpatient and emergency rooms at seven tertiary referral hospitals in Daegu-Kyungpook Province. Results The annual occurrence rate of FBIs in patients visiting seven tertiary referral hospitals was not different during COVID-19 compared to that in the pre-COVID-19 period and the median age of these patients during the COVID-19 and pre-COVID-19 periods was similar. However, occurrence rates increased in the groups aged 0-3 and 4-6 years but decreased in the group aged 7-15 years during the COVID-19 period. The proportion of male patients as well as inpatients increased significantly during the COVID-19 period (both P=0.01). The proportion of foreign bodies located in the post-pyloric region increased during the COVID-19 period (P=0.02). The most common symptom, foreign body sensation in the neck, was similar in both groups. There was no significant difference in the foreign body removal method between the two groups. The occurrence rates of swallowing of toys, coins, magnets, button batteries, and superabsorbent polymers non-significantly increased; and the food ingestion rate decreased, while the non-food ingestion rate increased in all age groups during the COVID-19 period. Conclusions The FBI rate in children did not differ during the COVID-19 period compared to that in the pre-COVID-19 period. The occurrence of FBI in boys, the number of foreign bodies located in the post-pyloric region, and the number of hospitalizations due to FBI increased during the COVID-19 period.
Collapse
Affiliation(s)
- Suk Jin Hong
- Department of Pediatrics, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Changho Kim
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Won Lee
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Hyo Jeong Jang
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
| | - Seung Man Cho
- Department of Pediatrics, Dongguk University School of Medicine, Gyeongju, Korea
| | - Kwang Hae Choi
- Department of Pediatrics, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Jun Hyun Hwang
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| |
Collapse
|
29
|
Grounds GS, Dent H, Nunes C, Dhar V. Tubeless field anaesthesia for surgical removal of an aspirated endoscopy capsule. Anaesth Rep 2023; 11:e12242. [PMID: 37588044 PMCID: PMC10425334 DOI: 10.1002/anr3.12242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/18/2023] Open
Abstract
Capsule endoscopy is a safe, minimally invasive procedure used to investigate gastrointestinal bleeding of unknown origin that persists or recurs after a negative initial endoscopy. The most common adverse effects of capsule endoscopy include abdominal pain, nausea and vomiting. Capsule pulmonary aspiration, although a rare complication, has been reported in the literature. Most reported cases resolve without further medical intervention. In these cases, the capsule is either expelled by coughing, or it re-enters the oropharynx and is then swallowed. In a small number of cases, the capsule remains in the lung, unable to be expectorated. This requires prompt diagnosis and emergency bronchoscopic removal under general anaesthesia. Due to the smooth, rounded surfaces of the capsule, it may be difficult to grasp, and consequently extraction may be technically challenging. The existing literature contains limited documentation on anaesthetic and surgical approaches for managing an aspirated endoscopy capsule. In this case report, we present the management of an aspirated endoscopy capsule in a district general hospital, in which thoracic surgery was not available. Local resources were used to manage this potentially life-threatening complication without patient transfer. In our case, we provided a tubeless field to optimise surgical access. This facilitated the successful surgical extraction of the endoscopy capsule from the left main bronchus.
Collapse
Affiliation(s)
- G. S. Grounds
- Department of AnaesthesiaKent and Canterbury HospitalCanterburyKentUK
| | - H. Dent
- Department of AnaesthesiaKent and Canterbury HospitalCanterburyKentUK
| | - C. Nunes
- Department of GastroenterologyKent and Canterbury HospitalCanterburyKentUK
| | - V. Dhar
- Department of Ear, Nose and Throat SurgeryWilliam Harvey HospitalAshfordKentUK
| |
Collapse
|
30
|
Sheets NW, Waldrop I, Carpenter WC, Dubina E, Kondal B, Schultz H, Plurad D. Rectal Foreign Bodies: A 10-Year Review of the National Electronic Injury Surveillance System. Cureus 2023; 15:e41471. [PMID: 37546136 PMCID: PMC10404145 DOI: 10.7759/cureus.41471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Rectal foreign bodies may result in significant morbidity, potentially necessitating surgical intervention and ostomy creation. The sensitive nature of the diagnosis may lead to inaccurate patient history and possible delay in diagnosis. Currently, there is a paucity of large national studies addressing this diagnosis. Therefore, we present national data describing the demographics and incidence of patients presenting with rectal foreign bodies. Methods The National Electronic Injury Surveillance System (NEISS) was utilized to collect data regarding rectal foreign bodies. Ten years of data were collected from 2012 to 2021. Inclusion criteria focused on the diagnosis of "foreign body" coupled with pelvic and lower torso injuries. Exclusion criteria encompassed patients without a rectal foreign body clearly identified in the narrative. Patients were compared based on disposition as low severity (treated/examined and released or left without being seen) or high severity (treated and admitted/hospitalized, held for observation, or transferred to another facility). General descriptive and inferential analyses were performed regarding demographics and dispositions. Results A total of 1,806 emergency department (ED) visits were identified for inclusion. Patients ranged in age from 0 to 93 years, with a mean age of 30 years. The largest age group identified was 11-15 and 21-25 years. Most patients were male (64.6%) and white (47.1%). The most common foreign bodies were massage devices and vibrators (22.7%), jewelry (8.1%), pens and pencils (4.4%), fishing gears (activity, apparel, or equipment) (3.7%), and nonglass bottles or jars (2.6%). Patients requiring admission, observation, or transfer differed from those patients that were discharged from the ED by age, sex, race, and product involved. Discussion Rectal foreign bodies are a rare diagnosis with a growing incidence. Though the most common objects are massage devices and vibrators consistent with sexual stimulation devices, there are limited product guidelines for safe use. Further studies to help identify at-risk persons, safety precautions, and manufacturing guidelines may help prevent potential morbidity associated with rectal foreign bodies.
Collapse
Affiliation(s)
- Nicholas W Sheets
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| | - Ian Waldrop
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| | | | - Emily Dubina
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| | - Bhani Kondal
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| | - Hayden Schultz
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| | - David Plurad
- Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA
| |
Collapse
|
31
|
Xiong Y, Yan J, Yan G, Feng L, Li Y, He S, Li R, Tan G, Feng B. Case report: An unusual case of small bowel bleeding and common iliac artery pseudoaneurysm caused by an unnoticed swallowed toothpick. Front Med (Lausanne) 2023; 10:1182746. [PMID: 37359020 PMCID: PMC10285080 DOI: 10.3389/fmed.2023.1182746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
Gastrointestinal (GI) bleeding is a common clinical condition that can be caused by a variety of reasons. Bleeding can occur anywhere in the GI tract, and it usually presents as vomiting of blood, melena or black stools. We herein present a case of a 48-year-old man who was ultimately diagnosed with perforation of the lower ileum, pseudoaneurysm of the right common iliac artery, lower ileum-right common iliac artery fistula, and pelvic abscess caused by accidental ingestion of a toothpick. This case suggests that accidental ingestion of a toothpick may also be the cause of GI bleeding in some patients. For patients with unexplained GI bleeding, especially those with small bowel bleeding, a rational and combined use of gastroduodenoscopy, colonoscopy, unenhanced and contrast-enhanced abdominal CT can help detect the causes of GI bleeding and improve diagnostic accuracy.
Collapse
Affiliation(s)
- Yao Xiong
- Division of Gastroenterology and Hepatology, Suining Central Hospital, Suining, Sichuan, China
| | - Jing Yan
- Department of Radiology, Suining Central Hospital, Suining, Sichuan, China
| | - Gaowu Yan
- Department of Radiology, Suining Central Hospital, Suining, Sichuan, China
| | - Lei Feng
- Division of Gastroenterology and Hepatology, Suining Central Hospital, Suining, Sichuan, China
| | - Yong Li
- Department of Radiology, Suining Central Hospital, Suining, Sichuan, China
| | - Suyu He
- Department of Radiology, Suining Central Hospital, Suining, Sichuan, China
| | - Ruyi Li
- Department of Radiology, Lixian People's Hospital, Aba, Sichuan, China
| | - Gangcheng Tan
- Department of Radiology, Lixian People's Hospital, Aba, Sichuan, China
| | - Bo Feng
- Department of Radiology, Lixian People's Hospital, Aba, Sichuan, China
| |
Collapse
|
32
|
Bohadana SC, Santos RGD, Magalhães MKC, Cesar RG. Foreign Body Accidents in a Pediatric Emergency Department. Int Arch Otorhinolaryngol 2023; 27:e316-e323. [PMID: 37125355 PMCID: PMC10147453 DOI: 10.1055/s-0042-1744255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 01/31/2022] [Indexed: 05/02/2023] Open
Abstract
Introduction Foreign body accidents (FBAs) are frequent in children and can be severe, being a common cause of morbidity and mortality and a public health problem. As these accidents are multifactorial, their cause can only be determined by analyzing the clinical details and characteristics of the object. Knowing the associated mechanisms and factors is essential to determine a risk profile and have a preventive, therapeutic, and diagnostic purpose. Objective The present study aimed to describe the incidence of FBAs in otorhinolaryngology according to their anatomical location, focusing on the aerodigestive system. Methods This is a retrospective study performed by reviewing the medical records of 668 cases seen in the emergency department of a tertiary pediatric hospital in São Paulo, state of São Paulo, Brazil, between 2014 and 2017. Results Foreign bodies (FBs) were found in the digestive system (238/668), in the nasal cavities (206/668), in the ears (182/668), in the oropharynx (34/668), and in the respiratory system (8/668). A total of 91.77% of the patients were treated in the emergency room. The main age group affected was < 5 years old, with no difference between genders. The most frequent complications affected the digestive system and the most serious occurred in cases involving the respiratory system. Conclusion Multidisciplinary teams should be ready in the emergency room to provide adequate care in FBAs. Early diagnosis, FB removal in the emergency room or the surgical center and follow-up are essential. Developing prevention campaigns including a risk profile for certain products and/or materials, helping to ensure safety for consumers, is necessary. For this, a national database with compulsory notification containing relevant information on FBAs in the pediatric population should be created.
Collapse
Affiliation(s)
- Saramira Cardoso Bohadana
- Department of Otorhinolaryngology, Hospital Infantil Sabará, São Paulo, SP, Brazil
- Address for correspondence Saramira Cardoso Bohadana, MD, PhD Rua Mato Grosso, 306, Sala 506, São Paulo, SP, 01239-040Brazil
| | | | | | - Regina Grigolli Cesar
- Department of Pediatrics, Medical Sciences College, Santa Casa de São Paulo, Hospital Infantil Sabará, São Paulo, SP, Brazil
| |
Collapse
|
33
|
Rappaport SH, Vineyard T, Hack M, Shah T, Dooley JW. Lanthanum masquerading as foreign body ingestion in a critically ill patient with end-stage renal disease. Am J Health Syst Pharm 2023; 80:430-434. [PMID: 36566498 DOI: 10.1093/ajhp/zxac380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Medication use may affect imaging results. In this case study, we report a case of lanthanum ingestion resulting in imaging consistent with ingested metallic foreign bodies. SUMMARY Hyperphosphatemia affects most patients with end-stage renal disease (ESRD) and is associated with morbidity and mortality. Lanthanum carbonate reduces daily phosphate absorption and is indicated as a non-calcium-based phosphate binder in patients with ESRD. A 58-year-old man with a medical history of stage 5 chronic kidney disease was admitted to the intensive care unit (ICU) for hyperkalemia and acute respiratory failure after a missed dialysis session. He required vasopressors, intubation, and continuous renal replacement therapy. Admission imaging demonstrated several ingested metallic foreign bodies within the colon. There was consideration of colorectal surgery and gastroenterology consultation. On the initial medication reconciliation, no medications that would have the radiographic appearance of ingested metallic foreign bodies were identified. On further review of prescription data available through the electronic medical record, it was noted that the patient had recently filled a prescription for lanthanum despite its apparent discontinuation on a previous admission. After interviewing the patient's wife, it was confirmed that the patient had continued taking lanthanum and that he was swallowing it whole and not chewing it. No consultations or interventions were performed, and the metallic foreign bodies were no longer present on further imaging after a period of 35 days. CONCLUSION Escalation of care was avoided in this patient due to the performance of diligent medication reconciliation and recognition of the impact of lanthanum ingestion on imaging.
Collapse
Affiliation(s)
- Stephen H Rappaport
- Department of Pharmacy, University of Rochester Medical Center-Strong Memorial Hospital, Rochester, NY, USA
| | - Tedd Vineyard
- Department of Nursing, University of Rochester Medical Center-Strong Memorial Hospital, Rochester, NY, USA
| | - Madelaine Hack
- Department of Surgery, Oregon Health & Sciences University, Portland, OR, USA
| | - Tanya Shah
- Department of Medicine, University of Rochester School of Medicine, Rochester, NY, USA
| | - Joseph W Dooley
- Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine, Rochester, NY, USA
| |
Collapse
|
34
|
Aydin O, Birbilen AZ, User IR, Turer OB, Teksam O. Lung ultrasound findings in children with foreign body aspiration. J Clin Ultrasound 2023; 51:447-451. [PMID: 36054370 DOI: 10.1002/jcu.23306] [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] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Foreign body aspiration (FBA) has a wide clinical spectrum, patients may be asymptomatic or present with cardiopulmonary arrest. Radiological imaging methods are used in addition to history and physical examination findings for certain diagnosis. Lung ultrasonography (LUS), whose usage area is increasing year by year, can be included in these. This study aimed to investigate ultrasonography findings in FBA and hypothesized that LUS may have a standard place in FBA diagnosis. METHODS Patients who administered to the pediatric emergency department between August 2019-August 2021, considered according to the clinical findings and physical examination possible FBA, and who undergone rigid bronchoscopy by pediatric surgery were included in the study. RESULTS Thirty-two patients were included in the study. According to the results of bronchoscopy, FBA was detected in 25 patients. The most common finding in radiography was hyperinflation on one side, while LUS findings were confluent-B lines in eight patients, barcode-sign in five patients, pleural line abnormalities in two patients, and pleural consolidation in two patients. CONCLUSION This study is the first study aiming to evaluate LUS findings in FBA to the best of our knowledge. The B-lines, barcode sign, pleural line abnormalities and consolidation are seen findings in LUS of the patients with FBA. Although it is far from replacing chest radiography in these patients, it is possible to say that it has an equivalent value with chest radiography.
Collapse
Affiliation(s)
- Orkun Aydin
- Division of Pediatric Emergency, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ahmet Ziya Birbilen
- Division of Pediatric Emergency, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Idil Rana User
- Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ozlem Boybeyi Turer
- Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ozlem Teksam
- Division of Pediatric Emergency, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
35
|
Prata JC, Dias-Pereira P. Microplastics in Terrestrial Domestic Animals and Human Health: Implications for Food Security and Food Safety and Their Role as Sentinels. Animals (Basel) 2023; 13. [PMID: 36830448 DOI: 10.3390/ani13040661] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
Terrestrial domestic animals are exposed to microplastics, therefore, contaminating the food chain, in the case of livestock, or acting as sentinels for human exposure, in the case of companion animals. The aim of this review was to address the importance of terrestrial domestic animals on human exposure to microplastics. Animal products may already show some microplastics contamination, which may occur during their lifetime, possibly also compromising productivity, and during processing, originating from equipment and packaging. Moreover, release of microplastics in animal feces (or manure) leads to the contamination of agricultural fields, with possible impacts and internalization in plants. Therefore, microplastics pose a threat to food security, compromising food productivity, and food safety, by being a foreign material found in animal products. Conversely, in urban environments, companion animals (cats and dogs) may be relevant sentinels for human exposure. While oral exposure may vary in pets compared to humans, due to indiscriminate ingestion and chewing or licking behaviors, airborne exposure is likely to be a good indicator for human exposure. Therefore, future studies should address the importance of terrestrial domestic animals for human exposure of microplastics, both in the food chain and as sentinels for environmental exposure.
Collapse
|
36
|
Muacevic A, Adler JR, Goh BS. The Mysterious Whistling Breath: Foreign Body Aspiration. Cureus 2023; 15:e34267. [PMID: 36855495 PMCID: PMC9968441 DOI: 10.7759/cureus.34267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 01/28/2023] Open
Abstract
Foreign body aspiration is commonly seen in the pediatric age group and can be a life-threatening condition. Typical presentations include coughing, wheezing, and choking and can often masquerade as asthma causing misdiagnosis and treatment delay. Most of the time, the actual aspiration event is unnoticed, and patients may remain asymptomatic until they present with recurrent infections with or without positive radiological findings. Aspirated objects tend to migrate distally, and organic objects may induce edema and inflammation. Diagnosis is crucial as near-total or total obstruction of the airway may cause asphyxia and, subsequently, death if no immediate intervention is taken.
Collapse
|
37
|
Yılmaz Çebi A, Batu Oto B, Kılıçarslan O, Sarıcı AM. Pseudomelanoma: occult intraocular foreign body mimicking choroidal melanoma. GMS Ophthalmol Cases 2023; 13:Doc03. [PMID: 36875629 PMCID: PMC9979075 DOI: 10.3205/oc000211] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Purpose To report an occult intraocular foreign body mimicking choroidal melanoma. Methods Medical records and imagings of the patient were retrospectively reviewed. Case description A 76-year-old male was referred to our ocular oncology clinic with a suspicious hyperpigmented retinal lesion in the left eye. Biomicroscopy showed aphakia and peripheral iridectomy in the left eye. Fundoscopy revealed a pigmented, slightly elevated lesion on the macula of the left eye surrounded by diffuse atrophy. B-scan ultrasonography showed a preretinal hyperechoic lesion with posterior shadowing. There was no choroidal mass in B-scan or optical coherence tomography (OCT) imaging. On further questioning, it was disclosed that the patient had been hit by an iron fragment in the left eye forty years ago. Conclusion Choroidal melanoma is a vision- and life-threatening intraocular malignant tumour. Various neoplastic, degenerative, and inflammatory conditions can simulate choroidal melanoma. A previous history of penetrating ocular trauma should lead the surgeon to re-evaluate a diagnosis of melanoma.
Collapse
Affiliation(s)
| | - Bilge Batu Oto
- Ophthalmology Department, Cerrahpaşa Faculty of Medicine, Istanbul University - Cerrahpaşa, Istanbul, Turkey
| | | | - Ahmet Murat Sarıcı
- Ophthalmology Department, Cerrahpaşa Faculty of Medicine, Istanbul University - Cerrahpaşa, Istanbul, Turkey
| |
Collapse
|
38
|
Puerta Sarmiento GE, Modragón I, Echeverri A, Sua LF, Bonilla-Abadía F, Aguirre-Valencia D. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA), medical treatment of severe systemic compromise: case report. Colomb Med (Cali) 2023; 54:e5004625. [PMID: 37424740 PMCID: PMC10327631 DOI: 10.25100/cm.v54i1.4625] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/18/2022] [Accepted: 12/27/2022] [Indexed: 07/11/2023] Open
Abstract
Case description A 42-year-old woman with severe pulmonary and mediastinal inflammatory involvement, secondary to infiltration of a silicone-related allogenic material with systemic migration. Clinical findings The patient developed esophageal and bronchial stenosis, recurrent infections, malnutrition, and respiratory deterioration, making surgical removal of the allogenic material impossible. Treatment and outcome Clinical and radiological improvement was achieved after treatment with multiple intravenous and oral immunomodulators. Clinical relevance Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a heterogeneous disease resulting from exposure to allogenic substances in a susceptible subject. These substances cause autoimmune or autoinflammatory phenomena. Since ASIA was described ten years ago, its diagnostic criteria are still under discussion, with an uncertain prognosis. The ideal therapy is based on eliminating the causative substance, but this is not always possible. Therefore, it is necessary to start an immunomodulatory treatment, using it in this patient, a scheme that had not been previously reported in the literature.
Collapse
Affiliation(s)
- Germán Eduardo Puerta Sarmiento
- Fundación clínica Valle del Lili, Servicio de Reumatología, Cali, Colombia
- Universidad ICESI, Facultad de Medicina, Cali, Colombia
| | - Inés Modragón
- Universidad ICESI, Facultad de Medicina, Cali, Colombia
| | - Alex Echeverri
- Fundación clínica Valle del Lili, Servicio de Reumatología, Cali, Colombia
| | - Luz Fernanda Sua
- Fundación clínica Valle del Lili, Departamento de Patología, Cali, Colombia
| | | | | |
Collapse
|
39
|
Sutherland J, Bowen L. Ingestion of foreign bodies and caustic substances in children. BJA Educ 2023; 23:2-7. [PMID: 36601025 PMCID: PMC9805929 DOI: 10.1016/j.bjae.2022.09.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
| | - L. Bowen
- Children's Hospital for Wales, Cardiff, Wales, UK
| |
Collapse
|
40
|
Sibilio A, Bucchi E, Alfieri C, Marongiu F, Curcio A. Successful retrieval of a needle point from the breast through a vacuum-assisted breast biopsy system. Acta Radiol Open 2022; 11:20584601221143499. [PMID: 36507313 PMCID: PMC9732792 DOI: 10.1177/20584601221143499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Stereotactic vacuum-assisted breast biopsy (VABB) system is generally used to perform breast biopsies after identifying suspicious lesions that are occult on ultrasound. In this case, we used an 8-Gauge VABB to retrieve a needle point retained in the outer-lower quadrant of the right breast of a patient previously treated with lumpectomy. The use of stereotactic VABB system in this specific clinical setting has been never described before and resulted minimally invasive and perfectly suitable for correct localisation and retrieval of the 3-mm needle point; moreover, it may be easily reproduced elsewhere.
Collapse
Affiliation(s)
- Andrea Sibilio
- UOC - Chirurgia Senologica
Forlì-Ravenna, Ravenna (RA),
Italy,Andrea Sibilio, U.O.C, Chirurgia Senologica
Forlì-Ravenna, P.O. Ravenna, Viale Randi, 5 - 48121, Ravenna, Italy.
| | - Elisa Bucchi
- Centro di Prevenzione
Oncologica, Lugo (RA), Italy
| | | | | | - Annalisa Curcio
- UOC - Chirurgia Senologica
Forlì-Ravenna, Ravenna (RA),
Italy
| |
Collapse
|
41
|
Ichikawa S, Onishi H. Non-traumatic adult acute abdomen with high-attenuation lesions or materials in the gastrointestinal tract on unenhanced computed tomography. Singapore Med J 2022; 63:462-468. [PMID: 36259572 PMCID: PMC9584067 DOI: 10.4103/singaporemedj.smj-2021-101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Computed tomography (CT) is an imaging modality that provides otherwise unobtainable information in the diagnostic workup for acute abdomen. The patient's clinical history, physical examination, and laboratory findings are essential for a correct diagnosis; however, some diagnoses are difficult to establish. Although contrast-enhanced CT is the preferred diagnostic tool and provides invaluable information, using only post-contrast images can lead to misdiagnoses. Unenhanced CT images are more useful than post-contrast images for detecting high-attenuation lesions or materials because surrounding tissues also show high attenuation on post-contrast images. Unenhanced CT often provides key imaging findings for a correct diagnosis; hence, the purpose of this article is to describe CT findings in acute abdomen with high-attenuation lesions in the gastrointestinal tract.
Collapse
Affiliation(s)
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
42
|
Abstract
Among the plethora of foreign body impactions, fish bones are common examples that patients may struggle to properly disclose in clinical situations. This study investigated whether patients could pinpoint where the ingested fish bone was lodged. In addition, we investigated the differences between fish bone and other foreign bodies, the usefulness of computed tomography (CT), and the related risk factors for hospitalization. The cases of patients who underwent an endoscopic removal of fish bone between April 2008 and April 2020 were retrospectively reviewed. The clinical outcomes, X-ray scan, CT, and complications of each patient were investigated. A total of 96 patients were included in this study. The mean size of the impacted fish bone was 23.78 mm, and most were found in the upper esophagus (n = 38). There was a weak correlation between pain location and the actual lesion location (r = 0.419, P < .001). Compared to those of other foreign bodies, the location of impacted fish bones was different (P < .001), the X-ray detection rate of fish bones was lower (P < .001), and the complication incidence was higher (P = .030). CT (95.89%) showed higher sensitivity than X-ray scanning (11.24%) (P < .001). Foreign body size (P = .004) and door-to-endoscopy time (P = .029) were related to admission. Patients only managed to point out the approximate location of the ingested fish bone. CT detected fish bones well, but scans should include at least the entire esophagus instead of solely the area where pain is felt. Fish bone impaction has different clinical characteristics from other foreign bodies. Endoscopic removal without delay can reduce the admission rates.
Collapse
Affiliation(s)
- Gyu Man Oh
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
- *Correspondence: Kyoungwon Jung, Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea (e-mail: )
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| |
Collapse
|
43
|
Giltmier A, Aunins B, Ishman SL, Roche C. Management of Live Insects in the External Auditory Canal: A Wilderness Perspective. Wilderness Environ Med 2022; 33:318-323. [PMID: 35644737 DOI: 10.1016/j.wem.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
A live insect within the external auditory canal is an unpleasant possibility during wilderness recreation. To our knowledge, no study has attempted to quantify the risk of this event occurring in the wilderness. However, such events anecdotally seem to occur with some regularity in a variety of climates. Most cases are benign, but a small subset of patients can develop complications including infection, hearing loss, and vestibular complaints related to the foreign body. In the emergency department or clinic, removal of the insect is a simple procedure in most circumstances; however, the material and expertise required for backcountry removal of the insect are often limited. With this consideration in mind, we offer a conservative approach to backcountry insect removal based on a selective review of the published literature on this topic. Where published data are lacking, we make recommendations based on anecdotal experience of the authors dealing with this condition in austere environments and in the emergency department. We recommend insect removal only if the patient is acutely symptomatic and the insect is visualized and graspable with the instrument used for removal. In any other circumstance, intervention should be deferred until definitive care is reached because of risks of complications associated with removal, including infection, bleeding, and tympanic membrane damage.
Collapse
Affiliation(s)
- Andrew Giltmier
- University of Cincinnati College of Medicine, Cincinnati, Ohio.
| | - Benjamin Aunins
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Stacey L Ishman
- University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Conal Roche
- University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| |
Collapse
|
44
|
Stanisce L, Solomon DH, Koshkareva Y. When "Stay" Sutures Stay. Ear Nose Throat J 2022:1455613221104428. [PMID: 35609264 DOI: 10.1177/01455613221104428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Chronic airway foreign bodies represent a rare and challenging entity faced by otolaryngologists. Herein, we describe the case of an adult woman found to have a 17 cm-long internalized tracheostomy stay suture retained 2 years after decannulation. Thorough evaluation and contingency planning allowed for safe and successful removal of this novel airway foreign body. The selective use of stay sutures in adult tracheostomies and proper peri-operative care may have prevented its incidence.
Collapse
Affiliation(s)
- Luke Stanisce
- Division of Otolaryngology - Head and Neck Surgery, 2202Cooper University Health Care, Camden, NJ, USA
| | - Donald H Solomon
- Division of Otolaryngology - Head and Neck Surgery, 2202Cooper University Health Care, Camden, NJ, USA
| | - Yekaterina Koshkareva
- Division of Otolaryngology - Head and Neck Surgery, 2202Cooper University Health Care, Camden, NJ, USA
| |
Collapse
|
45
|
Atwood C, Ulualp SO, Ungar GK. A Fractured Tracheostomy Tube Causing Airway Compromise. Am J Case Rep 2022; 23:e936072. [PMID: 35591761 PMCID: PMC9128454 DOI: 10.12659/ajcr.936072] [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: 01/11/2021] [Revised: 04/15/2022] [Accepted: 04/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND A wide variety of emergency scenarios associated with tracheostomy tubes have been reported in patients with complex airway disease. Fracture of a tracheostomy tube is a rare complication with a potential for catastrophic outcome. The aim of this case report is to present clinical features and management of airway compromise due to a fractured tracheostomy tube in a patient with subglottic and tracheal stenosis. CASE REPORT A 19-year-old woman with a history of chronic lung disease, developmental delay, subglottic stenosis, and tracheal stenosis presented to the Emergency Department after her mother noticed that the tracheostomy tube was broken at the junction of the cannula and neck plate. Upon arrival, the patient was stable and the stoma site had a pinpoint-size opening. A chest X-ray revealed a dislodged tracheostomy tube with the shaft's convexity ventrally oriented in the trachea. The stoma was dilated to allow passage of a 2.5-mm flexible laryngoscope into the trachea. The fractured tracheostomy tube lodged in the trachea distal to the stoma and proximal to the carina. The fractured tracheostomy tube migrated to the suprastomal site at the time of repeat tracheoscopy under general anesthesia. The fractured tracheostomy tube was removed transorally through the tracheal and subglottic stenosis with the use of optical forceps and rigid bronchoscope. CONCLUSIONS Prompt recognition and management of a fractured tracheostomy tube is critical to prevent morbidity and mortality. Caregivers and healthcare providers must be prudent about proper tracheostomy tube care, potential manufacturing defects, and monitoring the condition of tracheostomy tubes.
Collapse
Affiliation(s)
- Carlyn Atwood
- Department of Otolaryngology – Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Seckin O. Ulualp
- Department of Otolaryngology – Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Division of Pediatric Otolaryngology, Children’s Health System of Dallas, Dallas, TX, USA
| | - Galit Kastner Ungar
- Division of Pediatric Anesthesiology, Children’s Health System of Dallas, Dallas, TX, USA
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
46
|
Mikhaylusov R, Negoduyko V, Pavlov S, Litvinova O, Babenko N, Kumetchko M. The influence of foreign textile bodies from military clothes on the healing process of experimental injuries of soft tissues. Porto Biomed J 2022; 7:e145. [PMID: 38304160 PMCID: PMC10830079 DOI: 10.1097/j.pbj.0000000000000145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background The healing of combat wounds can be complicated by the presence of foreign bodies, including fragments of military clothing. The present work aims to study the morphological features of soft tissue injuries with textile fibers implanted into wounds, personnel military forms during wound healing, in the experiment. Methods By randomization, 54 rats were divided into 3 groups. Control group animals performed a layer-by-layer incision of soft tissues without implantation of foreign bodies. Animals of the experimental group 1 were made implantation of fibers of a fabric consisting of 100% cotton, and of the experimental group 2-of fibers of a fabric consisting of 65% cotton and 35% polyester. Removal of laboratory animals from the experiment was carried out on the 15th, 30th, and 60th day. Soft tissue samples were histologically examined. Results The least pronounced inflammation was observed in rats of the control group. Wound healing in the experimental groups was slowed down due to the presence of inflammatory foci. A more pronounced inflammatory reaction was characterized by a group of animals with implanted tissue fibers consisting of 100% cotton. In the group with implanted tissue fibers consisting of 65% cotton and 35% polyester, the inflammatory reactions were less pronounced. Conclusions The presence of textile foreign bodies hampers the healing process of wounds of soft tissues due to the developing processes of inflammation around foreign bodies. The uniform of servicemen (35% synthetic and 65% natural fiber) is less reactive, leaving a wound as a textile foreign body, and has a less pronounced inflammatory effect, apparently due to the presence of synthetic threads that are more inert compared to fabric containing 100% natural fiber. This confirms the need for thorough debridement of combat wounds during the primary surgical treatment.
Collapse
Affiliation(s)
| | - Vladimir Negoduyko
- Military Medical Clinical Center of the Northern Region of the Ministry of Defense of Ukraine, Ukraine
| | | | | | | | | |
Collapse
|
47
|
Steinmetz A, Dohmann GWJ, Blobner CC. Dacryocystitis in dogs caused by foreign bodies-Diagnosis and therapy in 14 Cases. Vet Ophthalmol 2022; 25:180-185. [PMID: 34984785 DOI: 10.1111/vop.12968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe foreign bodies (FBs) in the nasolacrimal sac of dogs, the history, and simple diagnostic and therapeutic approaches. Animals studied Fourteen dogs of different breeds, ages, and sexes were presented with unilateral dacryocystitis and had been treated without success for over 1-8 months. PROCEDURES Patient history, including prior treatment, was obtained from medical records. Slit-lamp examination was performed in all cases (SL 17, Kowa Company Ltd.). Jones tests 1 and/or 2 were performed in 13/14 cases. Dacryocystotomy was initiated with an incision into one canaliculus until the lacrimal sac was exposed and could be explored. After extracting the FB from the nasolacrimal sac, the surgical wound and canaliculus were left open. Aftercare included the administration of antibiotic eye drops with or without dexamethasone and systemic analgesia. RESULTS All 14 dogs were mesocephalic. Four of them were Dachshunds. Dacryocystotomy revealed plant-related FBs in all cases. The purulent discharge disappeared immediately after removal and did not recur during follow-up. CONCLUSIONS A simple dacryocystotomy is recommended for dogs with a strong suspicion of a foreign body in the lacrimal drainage system. Dacryocystorhinography appears to be an optional tool in these cases.
Collapse
|
48
|
Anoh NA, Kouadio NL, Konan K, Traoré L, GohoK M, Boussou K, Konank JM, Niava GR, Akouwendo E, Kouadio KG. [Ingestion of unusual foreign bodies in adults about two cases observed at the treichville university hospital center]. Mali Med 2022; 37:78-80. [PMID: 38506212] [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] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Most of ingested foreign bodies passthrough the digestive tract spontaneously. The surgical care represents less than 1%. We report two cases of unexpected ingested foreign bodies treated surgically during the year 2019 in order to identify the surgical indications through a literaturereview. There were one woman and one man respectivelyaged 46 and 33. The accidentlyingestedforeign bodies werea denture and a toothbrush. An attempt to endoscopically extract the denture was unsuccessful. Peritonitis appeared as the complication in both cases. A radiography of unprepared abdomen showed the foreign body in the epigastic area, associated with a pneumoperitonitis in one case. Gastrostomy through laparotomy allowed to extract the foreign body without any complication. Surgery should be indicated either in complications or failure of endoscopic means to extractlocked foreign bodies.
Collapse
Affiliation(s)
- N A Anoh
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - N L Kouadio
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - Kip Konan
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - L Traoré
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - M GohoK
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - Kjc Boussou
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - J M Konank
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - G R Niava
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - E Akouwendo
- Service de chirurgie digestive et proctologique CHU de Treichville
| | - K G Kouadio
- Service de chirurgie digestive et proctologique CHU de Treichville
| |
Collapse
|
49
|
Takada Y, Ishikawa T, Kawashima H, Mizutani Y, Ohno E, Iida T, Ogawa H, Hayashi M, Takami H, Onoe S, Ishigami M. Fish bone migration after pancreaticoduodenectomy: Incidence and treatment options. J Dig Dis 2022; 23:44-49. [PMID: 34965014 DOI: 10.1111/1751-2980.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Migration of a fish bone to the bile duct or pancreatic duct is a possible complication after pancreaticoduodenectomy (PD). The aim of this study was to clarify the incidence and indications for intervention in such cases. METHODS We reviewed the cases with fish bone migration after PD detected on computed tomography (CT) scan between October 2000 and October 2020 were reviewed and the incidence of fish bone migration, presence of symptoms and signs, therapeutic modalities and patient outcomes were analyzed. RESULTS Among the 1475 PD procedures performed at our institution during the study period, 14 cases of fish bone migration were noted on CT, the incidence of which was 0.95% (14/1475). The time duration from surgery to the detection of fish bone ranged from 88 to 5902 days (median 917 d). Ten patients remained asymptomatic without therapeutic intervention for up to 2919 days (median 509 d). Four patients were treated by endoscopy, either at the patient's request (n = 1) or because of their symptoms (n = 3), and removal was successful in three cases but failed in one case in which the fish bone migrated to the right intrahepatic bile duct. No surgical treatment was required in any case. CONCLUSIONS The incidence of fish bone migration on CT after PD was about 1%. Some cases resolved spontaneously, and most of the asymptomatic cases required no intervention. For symptomatic cases, endoscopic treatment should be considered first. It is important to confirm the location of the fish bone by CT and determine whether it can be removed.
Collapse
Affiliation(s)
- Yoshihisa Takada
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Takuya Ishikawa
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Hiroki Kawashima
- Department of Endoscopy, Nagoya University Hospital, Showa-ku, Nagoya, Japan
| | - Yasuyuki Mizutani
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Eisaburo Ohno
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Tadashi Iida
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Hiroshi Ogawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Masamichi Hayashi
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Hideki Takami
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Shunsuke Onoe
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Masatoshi Ishigami
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| |
Collapse
|
50
|
Xu B, Wu L, Bi J, Liu J, Chen C, Lin L, Chen C, Qiu F, Shang S. Management of Inedible Airway Foreign Bodies in Pediatric Rigid Bronchoscopy: Experience From a National Children's Regional Medical Center in China. Front Pediatr 2022; 10:891864. [PMID: 35813380 PMCID: PMC9256913 DOI: 10.3389/fped.2022.891864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED The aim of this study is to analyze the characteristics of inedible airway foreign bodies in pediatric rigid bronchoscopy to facilitate the improvement of management and technology. This retrospective analytical study was performed from January 2017 to June 2020. All admissions of pediatric patients (age<18 years) with foreign-body aspiration diagnosis codes ([ICD]-10:T17 300, T17 400, T17 500 and T17 900) and procedure codes (33.7801) were extracted. Age, sex, preoperative history and imaging data, surgical records, length of hospital stay, reoperations and postoperative complications were included. Data were analyzed with SPSS 20. A total of 1237 patients were hospitalized and underwent rigid bronchoscopy. Forty-five (3.6%) patients with inedible foreign bodies in the airway were confirmed. There were no significant differences in sex, time of onset and length of hospital stay between the inedible and edible foreign body groups, except for age and a definite history of foreign body aspiration (P = 0.000). Coughing, wheezing and fever were the common clinical symptoms in all patients. The following were the common locations of inedible foreign bodies: right bronchus (22/45), left bronchus (18/45), trachea (3/45) and larynx (2/45). The most frequent inedible foreign bodies were parts of a pen (15/45), a light-emitting diode (7/45) and plastic parts of toys (6/45). Vocal cord injury and a laryngeal web were observed in one case each. CONCLUSION Rigid bronchoscopy is the method of choice for the removal of inedible foreign bodies. Adequate preoperative assessment to rely on CT scans, skillful operation techniques to avoid damaging and active management of postoperative complications are important for the success of the procedure.
Collapse
Affiliation(s)
- Bin Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Lei Wu
- Department of Pulmonology, Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jing Bi
- Department of Otorhinolaryngology-Head and Neck Surgery, Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jia Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Cao Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Lexi Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Chao Chen
- Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Fei Qiu
- Department of Otorhinolaryngology-Head and Neck Surgery, Department of Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Shiqiang Shang
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| |
Collapse
|