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Hikiishi A, Nakai T, Matsui E, Yamane K, Sato K, Watanabe T, Asai K, Eguchi Y, Kawaguchi T. Successful Removal of a Foreign Body Located in the Peripheral Airway Using Flexible Bronchoscopy with Virtual Bronchoscopy Navigation. Intern Med 2024; 63:1439-1442. [PMID: 37839885 DOI: 10.2169/internalmedicine.2072-23] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
A case in which a foreign body located in the peripheral airway of the lung was removed by flexible bronchoscopy using a virtual bronchoscopy navigation (VBN) system has been reported. The patient was a 60-year-old man. Chest radiography revealed an incidental foreign body in the left lower lung. Chest computed tomography with 1.0-mm slices was used to create a VBN system and confirm the foreign body in left B9biiαy, which was removed by flexible bronchoscopy. Thus, peripheral foreign bodies can be safely removed using flexible bronchoscopy by creating a VBN system in advance.
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Affiliation(s)
- Atsuhito Hikiishi
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
- Department of Respiratory Medicine, Bellland General Hospital, Japan
| | - Toshiyuki Nakai
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Erika Matsui
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Kenshi Yamane
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Kanako Sato
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Yosuke Eguchi
- Department of Respiratory Medicine, Bellland General Hospital, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
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Shirakata C, Hanaue R, Ohtsubo H, Shiozaki A, Ohishi K, Ishisaka S, Ohtsu D. A case report of live-stranded rough-toothed dolphin (Steno bredanensis) with plastic debris ingestion on the Pacific coast of Japan. J Vet Med Sci 2024:23-0329. [PMID: 38710623 DOI: 10.1292/jvms.23-0329] [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: 05/08/2024] Open
Abstract
A juvenile rough-toothed dolphin (Steno bredanensis) was live-stranded and rescued in Kanagawa Prefecture, Japan. From the results of diagnostic examinations, blood tests indicated that the dolphin was malnourished, dehydrated, and anemic. The dolphin died on sixth day of rescue despite treatment. At autopsy, 570g of foreign material, including 34 pieces of cellophanes and plastic debris (PD), were found in the forestomach. Additional gross findings, including some endoparasitism and presence of accessory spleens were also identified. This is the first case in Japan which accidental ingestion of foreign bodies, including PD, was suspected to be the cause of death in a cetacean.
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Affiliation(s)
- Chika Shirakata
- Enoshima Aquarium
- Laboratory of Veterinary Physiology, Tokyo University of Agriculture and Technology
| | | | | | - Akira Shiozaki
- Department of Zoology, National Museum of Nature and Science
| | - Kazue Ohishi
- Faculty of Health and Medical Sciences, Kanagawa Institute of Technology
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Canakci H, Akbas MU, Arslan E, Tulaci KG, Yazici H. A Rare Laryngeal Foreign Body Case: Postcricoid Total Dental Prosthesis. Laryngoscope 2024; 134:2331-2334. [PMID: 37916852 DOI: 10.1002/lary.31151] [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: 07/19/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 11/03/2023]
Abstract
In this case report, 60-year-old patient who aspirated total dental prosthesis into the postcricoid region was presented with patient's history, clinical findings, radiologic examinations and surgical treatment with comparison of literature data. To our literature knowledge, this is the first total dental prosthesis detected in postcricoid region. This was unusual because it did not cause any respiratory disorders such as laryngospasm and asphyxia, although it led to mucosal abrasions in a wide area of esophageus. Laryngoscope, 134:2331-2334, 2024.
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Affiliation(s)
- Hasan Canakci
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balıkesir, Turkey
| | - Mustafa U Akbas
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balıkesir, Turkey
| | - Erhan Arslan
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balıkesir, Turkey
| | - Kamil G Tulaci
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balıkesir, Turkey
| | - Hasmet Yazici
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balıkesir, Turkey
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Setiawan A, Huang C, Mitrayana M. Development of non-contact foreign body imaging base on photoacoustic signal intensity measurement. J Appl Clin Med Phys 2024; 25:e14230. [PMID: 38014732 PMCID: PMC11087178 DOI: 10.1002/acm2.14230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND It is challenging to visually identify tiny and concealed foreign objects within the body due to their small size and subcutaneous location while they can cause infections. METHODS A non-contact photoacoustic system based on Rosencwaig-Gersho photoacoustic theory and dual modulator method is developed for detecting foreign objects in meat. RESULT The experiments conducted validate the successful development of this measurement technique with 10 μm spatial resolution and its corresponding mathematical model, demonstrating an 11% Mean Absolute Percentage Error (MAPE) in comparison to the experimental results. Dual modulator successfully regulates laser energy at MPE limit. CONCLUSION The utilization of non-contact photoacoustic signal intensity measurements enables the identification of foreign objects within the body. Further, the application of mathematical modelling can validate the measurement outcomes. These findings serve as a foundation for creating an affordable and straightforward foreign body detector.
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Affiliation(s)
- Andreas Setiawan
- Department of PhysicsUniversitas Kristen Satya WacanaSalatigaIndonesia
| | - Chia‐Yi Huang
- Department of Applied PhysicsTunghai UniversityTaichungTaiwan R.O.C
| | - Mitrayana Mitrayana
- Department of PhysicsFaculty of Mathematics and Natural Sciences Universitas Gadjah MadaSekip Utara BulaksumurYogyakartaIndonesia
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Kennedy JM, Kumta NA, Lai J. Successful endoscopic removal of high-power magnetic balls embedded in the duodenal wall. JPGN Rep 2024; 5:182-185. [PMID: 38756134 PMCID: PMC11093918 DOI: 10.1002/jpr3.12060] [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] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/28/2023] [Accepted: 02/06/2024] [Indexed: 05/18/2024]
Abstract
The dangers of magnet ingestion are well known. When multiple magnets are ingested, interventional removal is often necessary to prevent and/or treat complications. Despite reports of both endoscopic and surgical techniques in the literature, there is a lack of clear guidance on the best method for removal of high-power magnets when they are embedded within the intestinal wall (increasing concern for fistulation, perforation, and bowel wall necrosis). This case demonstrates the successful endoscopic removal of magnetic balls incidentally identified on X-ray and found to be embedded in the duodenal wall in a critically ill 2-year-old patient. Endoscopic removal can be considered in similar situations, if all resources (interventional endoscopy and pediatric surgery) are available to proceed safely.
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Affiliation(s)
| | - Nikhil A. Kumta
- Icahn School of Medicine at Mount SinaiNew York CityNew YorkUSA
| | - Joanne Lai
- Icahn School of Medicine at Mount SinaiNew York CityNew YorkUSA
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Yalcin G, Derinoz-Guleryuz O, Alan DH, Akca-Caglar A. How should one intervene when a foreign body is blocking a child's oral cavity? Paediatr Int Child Health 2024; 44:30-33. [PMID: 38334132 DOI: 10.1080/20469047.2024.2313298] [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: 07/07/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Foreign bodies lodged in the oral cavity can be life-threatening. Their removal should be determined on the basis of the patient's condition, the type of object, the removal techniques available, the appropriate medication available and the potential complications. CASE REPORT A 9-month-old girl was brought to the emergency room by ambulance after a part of a toy became stuck in her oral cavity. Her father had unsuccessfully attempted to remove it at home. A blue cylindrical, rigid plastic toy part was seen during examination of her oral cavity and her tongue was trapped inside it. On initial assessment, her vital signs were within the normal range. She was agitated, a small amount of saliva mixed with blood was coming out of her mouth and she could not swallow her spittle. She was treated in the resuscitation room by an otorhinolaryngologist and a paediatric emergency team, and the foreign body was removed using bayonet forceps inside the mouth. The child was monitored in the paediatric emergency observation unit for 6 hours for signs of asphyxia and aspiration, and she was discharged without complications. CONCLUSION Foreign bodies in the oral cavity can cause serious complications, including injury, bleeding and sudden airway obstruction. Experienced healthcare professionals, especially those skilled in airway management, should handle these cases using a multidisciplinary approach to ensure respiratory safety.Abbreviations: LMA: laryngeal mask airway; PED: paediatric emergency department.
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Affiliation(s)
- Gamze Yalcin
- Department of Paediatrics, Faculty of Medıcıne, Gazı Unıversıty, Ankara, Turkıye
| | - Oksan Derinoz-Guleryuz
- Division of Paediatric Emergency, Department of Paediatrics, Faculty of Medıcıne, Gazı Unıversıty, Ankara, Turkıye
| | - Deniz Han Alan
- Department of Otorhinolaryngology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayla Akca-Caglar
- Division of Paediatric Emergency, Department of Paediatrics, Faculty of Medıcıne, Gazı Unıversıty, Ankara, Turkıye
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Di Girolamo N, Tollefson C. Computed tomographic diagnosis and clinical outcomes of small intestinal obstruction caused by trichobezoars in client-owned rabbits. Vet Radiol Ultrasound 2024; 65:264-274. [PMID: 38436052 DOI: 10.1111/vru.13349] [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: 09/14/2023] [Revised: 12/07/2023] [Accepted: 01/16/2024] [Indexed: 03/05/2024] Open
Abstract
Small intestinal obstruction in rabbits, although demonstrated to be common, is still poorly characterized. The objective of this study was to report features of small intestinal obstruction caused by trichobezoars in rabbits upon CT and their clinical outcomes. Rabbits with a diagnosis of intestinal obstruction that underwent CT scanning were included in this study. From each CT scan, obstruction location, appearance, Hounsfield units, size (mm), volume (mm3), distance from the stomach, and diameter of the small intestine proximal and distal to it, were extracted. Nine rabbits were included in the study. All rabbits presented for anorexia and had a distended or enlarged stomach (7) or abdomen (2). CT scan showed a non-contrast-enhancing, ovoid, smoothly marginated structure with a hyperattenuating rim, heterogeneous center, and variable amount of centrally located gas, in the duodenum (5), the jejunum (2), or the ileum (2). The density of the trichobezoars ranged from -156 to 58 HU (median, -44 HU) and volume ranged from 86.1 to 633.8 mm3 (median, 320.6 mm3). Three rabbits underwent medical management. Two of them survived, and one of them died. Six rabbits underwent surgery, of which three were successfully discharged from the hospital. CT proved to be a valuable imaging modality in rabbits with a suspected intestinal obstruction to provide the exact location of the obstruction and the characteristics of the obstructive material. The location and size of the trichobezoar may have relevant clinical implications.
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Affiliation(s)
- Nicola Di Girolamo
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Christopher Tollefson
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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8
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Sun X, Ren J, Li B, Liu S, Zou J, Chen F, Wang H. Remove an Unusual Laryngeal Foreign Body with a Modified Endoscopic Injection Needle. Laryngoscope 2024; 134:2338-2340. [PMID: 37909667 DOI: 10.1002/lary.31121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023]
Abstract
Foreign body (FB) aspiration requiring prompt intervention to prevent severe complications. The endoscopic injection needle, commonly employed for intramucosal injections in the gastrointestinal tract and respiratory tract, while with no previous reports of used for FB extraction. Here we report a case of a pea impacted in the laryngeal ventricle of an adult patient, which became lodged in her right laryngeal ventricle. Conventional methods, such as flexible forceps and baskets, were deemed unsuitable for retrieving this fragile and mushy FB. Therefore, we introduce a novel technique using a modified endoscopic injection needle, which proved successful in removing the foreign body. Laryngoscope, 134:2338-2340, 2024.
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Affiliation(s)
- Xiaoru Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Ren
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Li
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Shixi Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Zou
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Haiyang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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9
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Tai J, Gao K, Huang Z, Zhan B. Unusual Case of Esophageal Foreign Body: A Whole Mantis Shrimp. Ear Nose Throat J 2024:1455613241249043. [PMID: 38642030 DOI: 10.1177/01455613241249043] [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: 04/22/2024] Open
Abstract
Esophageal foreign bodies (FBs) are one of the common emergencies in otolaryngology, usually involving objects accidentally swallowed, and generally do not result in severe respiratory distress. This article presents an extremely rare case of an esophageal FB, where a 44-year-old man accidentally ingested an entire mantis shrimp while sucking its flavored tail, and was sent to the emergency department for severe throat pain and difficulty breathing. We immediately performed a laryngoscopy that revealed the FB that obstructs the entrance of the esophagus, obstructing the glottis due to the long shape of the shrimp. The mantis shrimp had barbs on its shell and trying to remove it intact would cause significant damage to the pharyngeal mucosa. Therefore, we extracted the mantis shrimp in segments under general anesthesia and applied electrocoagulation to stop bleeding from the damaged and bleeding posterior pharyngeal mucosa. As an esophagography was performed the following day, there were no signs of esophageal perforation. Through the detailed description and analysis of this case, our aim is to raise clinical awareness among physicians of such rare occurrences. Most important, appropriate examination and procedures of FBs should be performed based on the type, shape, and location of the FB.
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Affiliation(s)
- Junhu Tai
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
| | - Kai Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
| | - Zhiwei Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
| | - Bin Zhan
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
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10
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Chen JY, Chen YC, Wu SL. Deep Brain Stimulation in Advanced Parkinson's Disease: An Uncommon Case of Allergic Encephalitis. J Mov Disord 2024:jmd.23237. [PMID: 38616161 DOI: 10.14802/jmd.23237] [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: 11/16/2023] [Accepted: 04/12/2024] [Indexed: 04/16/2024] Open
Affiliation(s)
- Jyun-Yi Chen
- Department of Neurology, Changhua Christian Hospital, Changhua City, Taiwan
| | - Yen-Chung Chen
- Department of Neurology, Changhua Christian Hospital, Changhua City, Taiwan
| | - Shey-Lin Wu
- Department of Neurology, Changhua Christian Hospital, Changhua City, Taiwan
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11
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Zhang R, Chen Z, Li C. Right Coronary Artery Occlusion Due to Foreign Body From Left Chest Traumatic Injury. JACC Cardiovasc Interv 2024; 17:940-941. [PMID: 38599700 DOI: 10.1016/j.jcin.2024.01.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 01/02/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Ran Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Zhongxiu Chen
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Chen Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
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12
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Parri N, Madera A, D'Aiuto F, Zampogna S, Milani GP. Systematic review shows that suction-based airway clearance devices for foreign body airway obstruction are promising. Acta Paediatr 2024. [PMID: 38563507 DOI: 10.1111/apa.17229] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/04/2024]
Affiliation(s)
| | - Anna Madera
- Department of Pediatric, Carlo Poma Hospital, Mantova, Italy
| | - Francesca D'Aiuto
- Pediatric Emergency Unit, Di Cristina Children's Hospital, Azienda di Rilievo Nazionale e di Alta Specializzazione Civico Di Cristina Benfratelli, Palermo, Italy
| | | | - Gregorio Paolo Milani
- Department of Health Science and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Roberts G, McKay B, Nathanson A, Hii MW, Banting S. Endoscopic management of ingested toothpick resulting in duodeno-ureteric fistula. J Surg Case Rep 2024; 2024:rjae214. [PMID: 38638924 PMCID: PMC11026059 DOI: 10.1093/jscr/rjae214] [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: 02/19/2024] [Accepted: 03/17/2024] [Indexed: 04/20/2024] Open
Abstract
Toothpicks are commonly used but rarely ingested. Unlike most foreign bodies, if accidentally swallowed these rarely spontaneously pass. The duodenum has been reported as the most common site of toothpick foreign body lodgement in the upper gastrointestinal tract. We report the case of a 57-year-old presenting with recurrent urosepsis after non recognition of a toothpick impaction in the duodenum with fistulisation into the right renal pelvis. Endoscopic removal of the foreign body was successful in management of the urosepsis.
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Affiliation(s)
- Georgia Roberts
- Department of Upper GI & HPB Surgery, St Vincent’s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia
| | - Bartholomew McKay
- Department of Upper GI & HPB Surgery, St Vincent’s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia
| | - Andrew Nathanson
- Department of Upper GI & HPB Surgery, St Vincent’s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia
| | - Michael W Hii
- Department of Upper GI & HPB Surgery, St Vincent’s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia
- The Department of Surgery, St Vincent’s Hospital, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia
| | - Simon Banting
- Department of Upper GI & HPB Surgery, St Vincent’s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia
- The Department of Surgery, St Vincent’s Hospital, The University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia
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14
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Qiu X, Wang F, Li T. Liquid concrete as a gastrointestinal tract foreign body. Trop Doct 2024; 54:204-206. [PMID: 38146189 DOI: 10.1177/00494755231220095] [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: 12/27/2023]
Abstract
Gastrointestinal foreign bodies present a common clinical challenge. We present an unusual case of a 58-year-old construction worker who ingested liquid concrete that risked solidifying in his stomach. Gastroscopy revealed only partial solidification and pyloric obstruction, which were successfully resolved through endoscopic fragmentation and mechanical removal. To protect the gastric mucosa during elimination, liquid paraffin and a cellulose-based formula were administered. Complete gastrointestinal evacuation was achieved within 3 days, with no complications observed. This case emphasises the urgency of the early removal of concrete.
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Affiliation(s)
- Xiaowen Qiu
- Attending Doctor, Intensive Care Unit, Rushan People's Hospital, Rushan, Shandong, China
| | - Fengyan Wang
- Attending Doctor, Department of Gastroenterology, Weihai Central Hospital Affiliated to Qingdao University, Weihai, Shandong, China
| | - Tao Li
- Attending Doctor, Intensive Care Unit, China-Japan Friendship Hospital, Beijing, China
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15
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Georgakopoulou VE, Tarantinos K, Mermigkis D. Foreign Body in the Tracheobronchial Tree as a Cause of Hemoptysis in an Adult Without Risk Factors for Aspiration: A Case Report. Cureus 2024; 16:e57596. [PMID: 38707010 PMCID: PMC11069630 DOI: 10.7759/cureus.57596] [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: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Although aspiration of a foreign body into the trachea and bronchi can occur in all age groups, it is more common in infants and young children. Foreign bodies in the tracheobronchial tree are uncommon in adults and mainly present in patients with dysphagia and an altered level of consciousness. The identification of foreign bodies in the tracheobronchial tree is frequently overlooked or delayed, leading patients to present later with chronic symptoms and potential complications. These complications may include persistent coughing, wheezing, obstructive pneumonitis, bronchiectasis, and abscess formation secondary to recurrent pulmonary infections. This article aims to present the case of a 27-year-old patient without risk factors for aspiration who has experienced recurrent self-limiting hemoptysis episodes for five years. Bronchoscopy revealed a foreign body at the entrance to the middle lobe bronchus. The presence of a foreign body in the tracheobronchial tree should be considered in any patient with recurrent hemoptysis. Bronchoscopy leads to accurate diagnosis, treatment, and prevention of complications.
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16
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Ehrsam JP, Meier Adamenko O, Schlumpf RB, Schöb OM. Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case. Surg Laparosc Endosc Percutan Tech 2024; 34:206-221. [PMID: 38450728 PMCID: PMC10986785 DOI: 10.1097/sle.0000000000001275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/19/2023] [Indexed: 03/08/2024]
Abstract
BACKGROUND Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies. METHODS We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options. RESULTS In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years. CONCLUSIONS Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.
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Ma L, Liu Z, Wang Y, Wang T, Sun G, Wang L, Fan K, Liu J, Ma L, Qin W, Hu J, Cai M, Zhang G, Li Q, Zhou P. Endoscopic management of duodenal perforation caused by foreign bodies in adults: A retrospective study. United European Gastroenterol J 2024; 12:390-398. [PMID: 38159037 PMCID: PMC11017768 DOI: 10.1002/ueg2.12505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/12/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND AIMS Duodenal perforation caused by foreign bodies (FBs) is very rare but is an urgent emergency that traditionally requires surgical intervention. Several case reports have reported the successful endoscopic removal of duodenal perforating FBs. Here we aimed to evaluate the safety and efficacy of endoscopic management of duodenal perforating FBs in adults. METHODS Between October 2004 and October 2022, 12,851 patients with endoscopically diagnosed gastrointestinal FBs from four tertiary hospitals in China were retrospectively reviewed. Patients were enrolled if they were endoscopically and/or radiographically diagnosed with duodenal perforating FBs. RESULTS The incidence of duodenal total FBs and perforating FBs was 1.9% and 0.3%, respectively. Thirty-four patients were enrolled. Endoscopic removal was achieved in 25 patients (73.5%), and nine patients (26.5%) received surgery. For the endoscopic group, most perforating FBs were located in the duodenal bulb (36.0%) and descending part (28.0%). The adverse events included 3 mucosal injuries and 1 localized peritonitis. All patients were cured after conventional treatment. In the surgical group, most FBs were lodged in the descending part (55.6%). One patient developed localized peritonitis and one patient died of multiple organ failure. The significant features of FBs requiring surgery included FB over 10 cm, both sides perforation, multiple perforating FBs and massive pus overflow. CONCLUSION Endoscopic removal of duodenal perforating FBs is safe and effective, and can be the first choice of treatment for experienced endoscopists. Surgical intervention may be required for patients with FBs over 10 cm, both sides perforation, multiple perforating FBs, or severe infections.
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Affiliation(s)
- Li‐Yun Ma
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Zu‐Qiang Liu
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Ye Wang
- Department of GastroenterologyTianjin First Central HospitalTianjinChina
| | - Tao Wang
- Department of GastroenterologyTianjin Medical University General HospitalTianjinChina
| | - Guang‐bin Sun
- Department of GastroenterologyTianjin Fifth Central HospitalTianjinChina
| | - Li Wang
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Ke‐Yang Fan
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Jing‐Zheng Liu
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Li‐Li Ma
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Wen‐Zheng Qin
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Jian‐Wei Hu
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Ming‐Yan Cai
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
| | - Guo‐Liang Zhang
- Department of GastroenterologyTianjin First Central HospitalTianjinChina
| | - Quan‐Lin Li
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Collaborative Innovation Center of EndoscopyShanghaiChina
| | - Ping‐Hong Zhou
- Endoscopy Center and Endoscopy Research InstituteZhongshan HospitalFudan UniversityShanghaiChina
- Shanghai Collaborative Innovation Center of EndoscopyShanghaiChina
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18
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KC S, Gupta RK, Kumar A, Khanal B, Lamichhane S, Buhusal A, Sah VP, Bartaula S, Raki IH, Jindal R. Acute intestinal obstruction secondary to ingested foreign body in an adult with autism spectrum disorder: A rare case report and review of literature. Clin Case Rep 2024; 12:e8759. [PMID: 38617069 PMCID: PMC11009455 DOI: 10.1002/ccr3.8759] [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: 01/25/2024] [Revised: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024] Open
Abstract
Key Clinical Message Foreign body ingestion is common in pediatric age group however can be found in any age group with intellectual disability and neurodevelopmental delay. There is usually a delay in presentation and interventions following foreign body ingestion in patients with neurodevelopmental delay, leading to increased morbidity, mortality, and complications owing to inability of such patients giving relevant history. Most ingested foreign bodies naturally pass through the digestive tract without untoward effects. Only a few patients may require surgical interventions. Principle of management should be to reduce anxiety among patients and their visitors. Speedy recovery is enhanced so that they can return to their familiar environment soon. Abstract Foreign body ingestion is common in pediatric populations and may be found in any age group with intellectual disability and neurodevelopmental delay. As the patient cannot give a clear and relevant history, there is usually a delay in presentation and interventions following foreign body ingestion in patients with neurodevelopmental delay, leading to increased morbidity, mortality, and complications. Most foreign bodies pass through the digestive system without any complications, and very few require surgical intervention. The goal should be to reduce anxiety among patients and their visitors and to enhance speedy recovery so that they can return to their familiar environment soon. Here we report a case of Acute intestinal obstruction secondary to ingestion of the head portion of a doll which was managed with emergency laparotomy with enterotomy and removal of foreign body in a 16 years female with Autism Spectrum Disorder.
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Affiliation(s)
- Suraj KC
- Department of General SurgeryBPKIHSDharanNepal
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19
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Rustemov D, Bilal R, Tukinov R, Nekessov A, Dzhenalaev D, Ermeshev E, Mukhamedov Z, Mustafinov D, Utebaliev R, Sakuov Z, Kaliev B. Case Report: Unique management strategy for rare case of esophageal foreign body. Front Surg 2024; 11:1370876. [PMID: 38505410 PMCID: PMC10948502 DOI: 10.3389/fsurg.2024.1370876] [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: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/21/2024] Open
Abstract
Background Foreign bodies that enter the esophagus can cause serious complications that may require extensive surgical intervention, including open surgery. The treatment method depends on the location, size, configuration, and number of foreign bodies in the esophagus, but to date, the best method to remove foreign bodies from the esophagus remains uncertain. Foreign bodies which can damage the walls of esophagus varies from bones and bone fragments, to metallic objects and batteries. In this article, we present a rare case of a "fish bone" penetrating through the esophagus walls and directly punctured the aorta, forming a post-traumatic saccular pseudoaneurysm of the descending thoracic aorta, which was successfully treated with endovascular stent placement to the aorta and with endoscopic foreign body removal. Case summary We reported a case of a 16-year-old male with a 6-day history of chest pain after consuming fish. As result of immediate test in regional hospital using oral flexible esophagogastroduodenoscopy abnormalities were not reported. Due to persistence of beforementioned symptoms, a fiberoptic esophagogastroduodenoscopy was performed 3 days later, revealing a 1.5-2.0 cm long altered area with contact bleeding 33.0 cm from the incisors, but no visualization of any foreign body. Computed tomography revealed a fish bone that had completely passed through walls of the esophagus and punctured the aortic wall, forming an aneurysm. Patient was urgently hospitalized by air ambulance to our hospital for high-specialized medical intervention after 6 days. After the endovascular placement of a stent graft, the fish bone was successfully removed by endoscopic intervention. 12 months follow up showed no abnormalities. Conclusion Endoscopic removal of foreign bodies in the esophagus and extracting a foreign body after thoracic endovascular aortic stent may be a feasible option for some cases.
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Affiliation(s)
- Dastan Rustemov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Ruslan Bilal
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Ruslan Tukinov
- Clinical Academic Department of Radiology and Nuclear Medicine, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Adilzhan Nekessov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Damir Dzhenalaev
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Erbulat Ermeshev
- Clinical Academic Department of Radiology and Nuclear Medicine, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Zarip Mukhamedov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Dulat Mustafinov
- Clinical Academic Department of Pediatric Surgery, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Ruslan Utebaliev
- Resuscitation and Intensive Care Unit, Clinical Academic Department Pediatric Anesthesiology, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Zhenis Sakuov
- Resuscitation and Intensive Care Unit, Clinical Academic Department Pediatric Anesthesiology, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
| | - Baurzhan Kaliev
- Clinical Academic Department of Radiology and Nuclear Medicine, National Research Center for Maternal and Child Health, University Medical Center, Astana, Kazakhstan
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20
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Kramer N, Manthei S. An Unusual Case of Sinusitis in a Flight Attendant. Cureus 2024; 16:e55639. [PMID: 38586646 PMCID: PMC10995749 DOI: 10.7759/cureus.55639] [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: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
Foreign body sinusitis is a rare but important condition that should be taken into account when considering differential diagnoses. In this case report, we present a unique case of sinusitis caused by a foreign body originating from a dental procedure. Additionally, the complexity of the case was compounded by the patient's occupation as a flight attendant. A 49-year-old female flight attendant presented with a two-month history of facial pressure exacerbated by flying. A computed tomography (CT) of her paranasal sinuses confirmed the presence of a radiopaque foreign body near the left maxillary infundibulum, with minimal left ethmoid sinus mucosal thickening. Initially, she elected for non-operative management due to schedule conflicts. Upon follow-up over the next year, she complains of recurring severe facial swelling and congestion. A repeat CT scan shows that she has a dental amalgam that migrated from her left maxilla to the ethmoid infundibulum, lodged between her uncinate process and ethmoid bulla. The patient subsequently underwent foreign body removal. The patient recovered well, and a follow-up CT confirmed the complete removal of the foreign body. This case provides excellent insight into the mechanism of foreign body migration and sinusitis complicated by the unique circumstances of barotrauma associated with regular air travel.
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Affiliation(s)
| | - Scott Manthei
- Otolaryngology, Nevada Ear and Sinus Institute, Las Vegas, USA
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21
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Siddiqui AS. Bronchial artery embolization for the treatment of delayed massive hemoptysis due to a retained bullet. Respirol Case Rep 2024; 12:e01340. [PMID: 38533350 PMCID: PMC10965269 DOI: 10.1002/rcr2.1340] [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: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024] Open
Abstract
Bronchial artery embolization is a feasible option for treating hemoptysis caused by foreign objects in patients who are not candidates for surgery.
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Affiliation(s)
- Atif Saleem Siddiqui
- Department of Medicine, Division of Pulmonary and Critical Care MedicineHouston Methodist HospitalHoustonTexasUSA
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22
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Waarala ZMS, Santucci C, Sandberg JH. 'Bit' off more than he could chew: asymptomatic foreign body in the appendix. J Surg Case Rep 2024; 2024:rjae109. [PMID: 38463744 PMCID: PMC10921028 DOI: 10.1093/jscr/rjae109] [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: 01/31/2024] [Accepted: 02/11/2024] [Indexed: 03/12/2024] Open
Abstract
This report details the case of a 69-year-old male who had presented to the emergency department at the suggestion of his dentist after ingesting a diamond-tipped drill bit during a routine dental procedure. Through the use of radiograph, computed tomography, and colonoscopy, the drill bit was determined to be lodged in the distal vermiform appendix. Throughout his clinical course, the patient remained asymptomatic but was monitored closely for signs of complications of a retained foreign body in the appendix. Gastroenterology and general surgery were consulted on the case but ultimately non-surgical approaches prevailed and the drill bit passed in the stool. This patient's case highlights the success of noninvasive measures for appendiceal foreign body removal.
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Affiliation(s)
- Zachary M S Waarala
- Michigan State University College of Osteopathic Medicine, 965 Wilson Rd, East Lansing, MI 48824, United States
| | - Christopher Santucci
- Nova Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, 3200 S University Dr, Fort Lauderdale, FL 33328, United States
| | - Jay H Sandberg
- Michigan State University College of Osteopathic Medicine, 965 Wilson Rd, East Lansing, MI 48824, United States
- Oakland Medical Center, 115 E Long Lake Rd, Troy, MI 48085, United States
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23
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Eldeib O, Eldeib A, Harris L. Delayed Surgical Intervention for a Self-Inflicted Left Chest Injury From a Nail Gun: Addressing 28 Nails Six Months Post-incident. Cureus 2024; 16:e56789. [PMID: 38650817 PMCID: PMC11034954 DOI: 10.7759/cureus.56789] [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: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
In 2021, there were 1.7 million suicide attempts in the US, with firearms being the most common method used, comprising more than 50% of attempts. We present a case report of delayed operative intervention for foreign body removal after a suicide attempt using a nail gun fired into the left hemi thorax. Initial conservative management was complicated by the delayed presentation of hemoptysis requiring surgical intervention. We hypothesize that the delay was secondary to foreign body migration. Initial management was attempted robotically, but dense adhesions were encountered, requiring conversion to an open thoracotomy. Twenty-eight nails were removed. The post-operative course was uncomplicated.
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Affiliation(s)
- Omar Eldeib
- Surgery, State University of New York (SUNY) Downstate Health Sciences University College of Medicine, Brooklyn, USA
| | - Ahmed Eldeib
- Surgery, State University of New York (SUNY) Downstate Health Sciences University College of Medicine, Brooklyn, USA
| | - Loren Harris
- Surgery, Richmond University Medical Center, Staten Island, USA
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24
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Brooks JK, Kreisheh GC, Choi SK, Sultan AS, Rostami A, Price JB. Dental implant failure possibly attributed to embedded pencil graphite: first clinical report. Gen Dent 2024; 72:65-68. [PMID: 38411488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Implant failures have been associated with a diversity of etiologic processes, predominately arising from bone loss (peri-implantitis) due to inadequate maintenance of oral hygiene or excess luting agents. The aim of this article is to report a novel case of the apparent failure of a dental implant to undergo osseointegration in the presence of submerged pencil graphite. Practitioners are advised to carefully evaluate the clinical and radiographic site of a proposed implant for occult foreign substances. Embedded pencil graphite in the jawbone may promote a foreign body reaction and should be considered in the list of possible contributing factors to dental implant complications.
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25
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Low Kapalu CM, Uraizee O, Lerner DG, Thomson M, Attard T. Endoscopist experience with pediatric recurrent and intentional foreign body ingestion (RIFBI): Management considerations and future directions. J Pediatr Gastroenterol Nutr 2024; 78:711-719. [PMID: 38284750 DOI: 10.1002/jpn3.12114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVES AND STUDY Accidental foreign body ingestion (FBI) is a common pediatric referral concern. In contrast, recurrent and intentional FBI (RIFBI) is infrequent and associated with greater endoscopic and surgical intervention in adults. Although pediatric guidelines exist for FBI, the risk and therapeutic implications of RIFBI are not addressed. An anonymous international survey on pediatric gastroenterologist experience with RIFBI was distributed. METHODS A 33-item REDCap© survey was distributed via email to pediatric gastroenterologists identified through mailing and email lists obtained from pediatric gastroenterology professional organizations. RESULTS During 9-12/2021 we accrued 202 completed surveys. Respondents were from 27 countries and across the career span. Eighty percent reported experience with RIFBI; 74% reported seeing ≤ 3 patients with RIFBI within the past 24 months and 4% reported seeing ≥ 6. Of those who treated RIFBI, 38% reported an average number of annual ingestions per patient was ≥5. Frequent morbidity but not mortality was reported. Half reported adherence to FBI guidelines. Later-career endoscopists treated RIFBI more aggressively than accidental ingestion. Ninety-six percent noted that patients with RIFBI had psychiatric comorbidities. Providers at academic medical centers reported referring to behavioral health more than those in other settings. CONCLUSION Most gastroenterologists surveyed reported encountering RFBI several times a year and in patients with psychiatric comorbidities. Greater likelihood of adverse outcomes associated with endoscopy was reported. Most reported referral to behavioral health and few had RIFBI management protocols. A broader spectrum of psychologic comorbidities in the pediatric population with RIFBI, notably depression and autism spectrum disorder, were reported.
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Affiliation(s)
- Christina M Low Kapalu
- Pediatric Psychology and Gastroenterology, Oregon Health & Science University, Portland, Oregon, USA
- Gastroenterology, Hepatology and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, USA
- Department of Pediatrics, University of Missouri Kansas City, Kansas City, Missouri, USA
| | - Omar Uraizee
- College of Osteopathic Medicine, Kansas City University, Kansas City, Missouri, USA
| | - Diana G Lerner
- Section of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mike Thomson
- Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Thomas Attard
- Gastroenterology, Hepatology and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, USA
- Department of Pediatrics, University of Missouri Kansas City, Kansas City, Missouri, USA
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26
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Devkota S, Pokharel P, Lamichhane S, Bhola H, Bhalla T. Migrated subcutaneous sharp foreign body in the anterior chest wall: An unusual presentation. Clin Case Rep 2024; 12:e8565. [PMID: 38455860 PMCID: PMC10918736 DOI: 10.1002/ccr3.8565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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: 10/09/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
Key Clinical Message Migration of any foreign body can cause potentially life threatening complications and should be reviewed by a multidisciplinary approach for the management. Diagnosis can be challenging; a history of foreign body injury could be suspicious. Abstract Foreign body injury to the chest wall can be an emergency situation and require a multidisciplinary approach for the management of the condition. Migration of the foreign body, though rare, can lead to potentially life threatening complications and require a multidisciplinary approach for the localization of the foreign body and subsequent management of the condition. A 50-year-old male presented to the emergency department with the complaint of left sided chest pain. Upon examination, the patient was found to have a penetrating injury 6 years back by a sharp object. Radiological investigations helped in the localization of the migrating foreign body, which was removed with effective surgical intervention. The postoperative chest x-ray was normal, the patient was asymptomatic and thus the patient was discharged on the same day following surgery.
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Affiliation(s)
- Shritik Devkota
- Department of Radiodiagnosis and ImagingAnil Baghi HospitalPunjabIndia
| | - Prajjwal Pokharel
- Department of CardiologyManmohan Cardiothoracic Vascular and Transplant CenterKathmanduNepal
| | - Samiksha Lamichhane
- Department of Radiodiagnosis and ImagingB. P. Koirala Institute of Health SciencesDharanNepal
| | - Harsha Bhola
- Department of General SurgeryAnil Baghi HospitalPunjabIndia
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27
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Ahluwalia J, Drury E, Haupert M. Removal of Cyanoacrylate Glue From the External Auditory Canal With Hydrogen Peroxide and Acetic Acid: A Case Report. Cureus 2024; 16:e57213. [PMID: 38681471 PMCID: PMC11056237 DOI: 10.7759/cureus.57213] [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: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Ear canal foreign bodies are commonly encountered in the field of otolaryngology. This is especially common in the pediatric otolaryngology discipline. As a foreign body, cyanoacrylate glue (also called "super glue") can be difficult to remove and cause significant patient distress. Multiple solvents can be described as aiding in removing such foreign bodies. Here, a case is described in which hydrogen peroxide and acetic acid were used sequentially to remove cyanoacrylate glue from the external auditory canal. We describe a technique allowing en bloc removal of the cyanoacrylate glue. Thankfully, the patient's hearing returned to baseline post-operatively with minimal complications. Overall, cyanoacrylate glue can be a very difficult foreign body to remove from the ear canal. In this case, the sequential use of hydrogen peroxide and acetic acid to soak the glue was a safe and successful method to facilitate glue removal from the ear canal.
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Affiliation(s)
| | - Emily Drury
- Otolaryngology, Ascension St. John Hospital, Detroit, USA
| | - Michael Haupert
- Pediatric Otolaryngology, Ascension St. John Hospital, Detroit, USA
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28
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Kaushal M, Mahant TS, Mandal A, Sandhu N, Iqbal Z, Brar R. Saviour tool now a foreign body. Lung India 2024; 41:135-138. [PMID: 38700408 PMCID: PMC10959307 DOI: 10.4103/lungindia.lungindia_450_22] [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: 09/11/2022] [Revised: 07/07/2023] [Accepted: 07/16/2023] [Indexed: 05/05/2024] Open
Abstract
ABSTRACT Foreign bodies are commonly seen in children, here presenting a case of a male adult with an impacted thumb pin in the left lower lobe bronchus. Extraction required fiber-optic bronchoscopy, failure of which led to thoracotomy with bronchotomy.
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Affiliation(s)
- Mohit Kaushal
- Department of Pulmonary Medicine, Fortis Hospital, Mohali, Punjab, India
| | - T. S. Mahant
- Department of Pulmonary Medicine, Fortis Hospital, Mohali, Punjab, India
| | - Amit Mandal
- Department of Pulmonary Medicine, Fortis Hospital, Mohali, Punjab, India
| | - Navreet Sandhu
- Department of Pulmonary Medicine, Fortis Hospital, Mohali, Punjab, India
| | - Zafar Iqbal
- Department of Pulmonary Medicine, Fortis Hospital, Mohali, Punjab, India
| | - Rahat Brar
- Department of Pulmonary Medicine, Fortis Hospital, Mohali, Punjab, India
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29
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Kara K, Ozdemir C, Tural Onur S, Satici C, Tokgoz Akyil F, Nedime Sokucu S. Late Diagnosis of Foreign Body Aspiration in Adults: Case Series and Review of the Literature. Respir Care 2024; 69:317-324. [PMID: 37935526 PMCID: PMC10984597 DOI: 10.4187/respcare.10723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND Tracheobronchial foreign body (FB) aspiration (FBA) is a life-threatening emergency mostly observed in childhood and advanced age. With early diagnosis, the FB can be removed using bronchoscopic methods without causing irreversible damage. METHODS This was a single-center, retrospective observational study. Subjects diagnosed with FBA via either bronchoscopic methods and/or radiological findings, having no medical history of aspirated FB, and who were detected to have aspirated FB for longer than 30 days were included in the study. Medical records and radiological and bronchoscopic findings of the subjects were investigated from the hospital information database system. RESULTS Of the 255 patients with FBA, 17.6% (N = 45) were diagnosed late. The mean age was 53 y; 28% were female, and 60% of the subjects had a history of ever smoking. The estimated residence time of the FB in the bronchial system was 22.8 months. The most common complaints were cough and shortness of breath. Forty-two percent of the aspirated FBs were organic material. FB artifact could be observed in 6.7% of posteroanterior chest radiographs and 65% of thorax computed tomography (CT) scans. Rigid bronchoscopy had been primarily preferred as therapeutic interventional procedure. It was also found that the artifact most frequently resided in the right bronchial system and was most commonly found in the right lower lobe, while granulation tissue was formed in 85% of the subjects. CONCLUSIONS The findings of the present study demonstrate that subjects tended to forget the FBA, leading to insidious respiratory system symptoms, with recurrent infections. In cases with an endobronchial mass lesion image on thorax CT, clinicians should consider the possibility of FBA. Delayed diagnosis of both organic and inorganic FB may cause granulation tissue.
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Affiliation(s)
- Kaan Kara
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey.
| | - Cengiz Ozdemir
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Seda Tural Onur
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Celal Satici
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Fatma Tokgoz Akyil
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
| | - Sinem Nedime Sokucu
- Drs Kara, Tural Onur, Satici, Tokgoz Akyil, and Nedime Sokucu are affiliated with Chest Disease, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. Dr Ozdemir is affiliated with Chest Disease, Liv Hospital, Istanbul, Turkey
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Jimenez-Ramos L, Ripolles-Garcia A, Caro-Suarez M, Latre-Moreno A, Laguna F, Villagrasa M. Nasolacrimal sac foreign body extraction using vitreoretinal forceps in 28 dogs. Vet Ophthalmol 2024. [PMID: 38414137 DOI: 10.1111/vop.13199] [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: 10/05/2023] [Revised: 01/21/2024] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE To describe a novel technique of nasolacrimal foreign body extraction in dogs by using a 20G vitreoretinal forceps introduced through the superior lacrimal punctum. METHODS A retrospective review of the medical records of dogs with dacryocystitis due to nasolacrimal foreign bodies between the years 2001 and 2022 was performed. We recorded the breed, age, affected eye, type and number of foreign bodies, concomitant diseases, and the use of imaging techniques. All animals underwent the same procedure of a 20G vitreoretinal forceps insertion through the upper canaliculus reaching the lacrimal sac and retrograde extraction of the foreign bodies. RESULTS A total of 28 dogs were included, 16 males and 12 females, with a mean (±SD) age of 4.7 (±3.2) years. The most common breeds were Wire-Haired Dachshund (4/28; 14.29%) and Labrador Retriever (3/28; 10.71%). Additional imaging techniques were used, such as orbital ultrasound in 13 cases (13/28; 46.43%) and computed tomography in one case (1/28; 3.57%). The most common type of foreign body retrieved was grass awns, although seeds and plant debris were also found. Dacryocystitis resolved after removal of the foreign body and appropriate medical therapy was ensured in all cases in the 1-month postprocedure follow-up. CONCLUSION Extraction of nasolacrimal foreign bodies with vitreoretinal forceps is a novel, noninvasive, and easily applicable technique that, although not successful in all cases, can be attempted before performing more aggressive surgery.
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Affiliation(s)
- Laura Jimenez-Ramos
- Department of Ophthalmology, Hospital Veterinario Puchol, Madrid, Spain
- Centro Oftalmológico Veterinario Goya, Madrid, Spain
| | - Ana Ripolles-Garcia
- Department of Ophthalmology, Hospital Veterinario Puchol, Madrid, Spain
- Centro Oftalmológico Veterinario Goya, Madrid, Spain
| | - Miriam Caro-Suarez
- Department of Ophthalmology, Hospital Veterinario Puchol, Madrid, Spain
- Centro Oftalmológico Veterinario Goya, Madrid, Spain
| | - Almudena Latre-Moreno
- Department of Ophthalmology, Hospital Veterinario Puchol, Madrid, Spain
- Centro Oftalmológico Veterinario Goya, Madrid, Spain
| | - Fernando Laguna
- Department of Ophthalmology, Hospital Veterinario Puchol, Madrid, Spain
- Centro Oftalmológico Veterinario Goya, Madrid, Spain
| | - Manuel Villagrasa
- Department of Ophthalmology, Hospital Veterinario Puchol, Madrid, Spain
- Centro Oftalmológico Veterinario Goya, Madrid, Spain
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31
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Khorgami M, Khalaj F, Gholampour M, Tatari H. Missile embolism from pulmonary vein to left ventricle: report of a case. Front Cardiovasc Med 2024; 11:1342146. [PMID: 38464844 PMCID: PMC10920231 DOI: 10.3389/fcvm.2024.1342146] [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: 11/29/2023] [Accepted: 01/22/2024] [Indexed: 03/12/2024] Open
Abstract
Missile embolization is rare in penetrating trauma, occurring in 0.3% of cases. Bullet embolism into the left ventricle is less frequent, with few instances described in the literature. This paper describes an instance of left ventricular bullet embolism from the pulmonary venous system following gunshot chest trauma. A 7-year-old boy sustained a gunshot wound to his chest during an assault accident. Despite thoracic pain, he remained conscious and exhibited vital signs. A CXR and CT scan revealed a bullet in the left mediastinum. A left thoracotomy was performed to remove blood and clots from the pericardium. The patient was sent to a tertiary referral hospital for further investigation. The patient underwent elective surgery to remove the foreign body from inside the heart. The procedure involved a partial thymectomy and pericardial opening, and the patient was released from medical care after 14 days. After 6 months, there were no signs or symptoms of cardiothoracic infection or evidence of mitral valve regurgitation in echocardiography.
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Affiliation(s)
- Mohammadrafie Khorgami
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fattaneh Khalaj
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maziar Gholampour
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Tatari
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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32
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Bouzid MEM, Tbini M, Ben Ayed M, Idriss S, Ben Salah M. Multiple Retained Needles in the Neck of a Drug User: A Case Report. Ear Nose Throat J 2024:1455613241234285. [PMID: 38372025 DOI: 10.1177/01455613241234285] [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: 02/20/2024] Open
Abstract
Retained needles are frequently observed in intravenous drug users. However, an incidental discovery of multiple needles at the neck seldom occurs. These foreign bodies remain either asymptomatic or cause local and central complications that can be fatal. We report the case of a 43-year-old male having a medical record of human immunodeficiency virus and hepatitis C who presented to our department with a 3-day history of a febrile lateral neck swelling. He reported a history of repetitive intravenous drug use and previous abscesses that were surgically drained. We noted a left and tender 8 cm neck swelling with torticollis. Computed tomography scan showed a collected myositis of the sternocleidomastoid muscle in association to multiple metallic foreign bodies at the neck that were compatible with the aspect of broken needles. Imagery also showed a thrombosis of the ipsilateral jugular vein. No central embolism of a foreign body was noted. We performed a surgical drainage of the muscular abscess and managed to retrieve a 1 cm broken needle that was retained at the level of the collection. We did not retrieve the other needles since they were asymptomatic. The patient was placed under intravenous antibiotics for 1 week followed by oral amoxicillin-clavulanate with a total regression of the cellulitis. At the further follow-ups, the rest of the foreign bodies remained asymptomatic. Our study emphasizes on the importance of suspecting a retained foreign body in intravenous drug users to ensure an adequate management of the possible complications and to protect the medical team from incidental needle injuries.
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Affiliation(s)
- Mohamed El Mehdi Bouzid
- Department of Otorhinolaryngology-Head and Neck Surgery, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Makram Tbini
- Department of Otorhinolaryngology-Head and Neck Surgery, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Mariam Ben Ayed
- Department of Otorhinolaryngology-Head and Neck Surgery, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sarra Idriss
- Department of Otorhinolaryngology-Head and Neck Surgery, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Mamia Ben Salah
- Department of Otorhinolaryngology-Head and Neck Surgery, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Ueda T, Sato H, Ogimi T, Deguchi R, Suzuki H. Use of Endoscopy to Remove Fish Bone that Caused Sigmoid Colon Perforation. Intern Med 2024:3063-23. [PMID: 38369354 DOI: 10.2169/internalmedicine.3063-23] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
An 87-year-old man experiencing lower abdominal discomfort resulting from the ingestion of a fish bone underwent conservative management involving endoscopic extraction of the fish bone lodged in the sigmoid colon. Most patients with lower gastrointestinal tract perforations typically develop peritonitis or abscesses, necessitating surgical intervention. Notably, endoscopic management of lower gastrointestinal tract perforations is infrequently employed. Patients presenting with localized abdominal symptoms along with a stable overall health condition may benefit from conservative therapeutic approaches that utilize endoscopic methods. Notably, the transition from endoscopic procedures for foreign body removal to surgical intervention requires close collaboration with a surgeon and must be executed judiciously.
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Affiliation(s)
- Takashi Ueda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Hirohiko Sato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Takashi Ogimi
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Japan
| | - Ryuzo Deguchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Hidekazu Suzuki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Japan
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Velay L, Thibaud J, Rousseau KS, Lhuillery E, Libermann S, Gautherot A, Bonneau L, Etchepareborde S. Safe gastric wall closure in dogs using a single-layer full-thickness simple continuous suture pattern. J Am Vet Med Assoc 2024; 262:1-5. [PMID: 38041945 DOI: 10.2460/javma.23.06.0344] [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: 07/01/2023] [Accepted: 10/31/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE To evaluate different suture patterns for gastrostomy closure, with a focus on major complications and survival time. We hypothesized that using a full-thickness single-layer simple continuous pattern would be as safe as the traditional double-layer pattern and would not be associated with more major complications. To our knowledge, this is the first study to compare the suture patterns used for gastric closure in clinical situations. ANIMALS 60 dogs that underwent gastrostomy for foreign body removal, with 20 dogs in each group. METHODS Dogs treated with gastrotomy from January 1, 2018, to January 1, 2023, were randomly assigned to groups based on the suture pattern used at the gastrotomy site. Gastrotomies were closed with a double-layer inverting continuous pattern (DLI) in the DLI group. Gastrotomies were closed using a double-layer simple continuous pattern (DLS) in the DLS group. Gastrotomies were closed with a full-thickness single-layer simple continuous pattern (SLS) in the SLS group. RESULTS All dogs were discharged from hospitalization. The survival rate did not differ among the 3 groups 1 month postoperatively, and major complications were not observed. CLINICAL RELEVANCE Using a full-thickness single-layer pattern is a safe alternative for gastrotomy closure.
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Affiliation(s)
- Ludivine Velay
- 1Centre Hospitalier Vétérinaire des Cordeliers, Meaux, France
| | | | | | | | | | | | - Lucie Bonneau
- 1Centre Hospitalier Vétérinaire des Cordeliers, Meaux, France
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Santos M, Carreira NR, Gouveia J, Acabado A. A Rare Case of Phytobezoar Related to Occupational Exposure. Cureus 2024; 16:e54826. [PMID: 38529456 PMCID: PMC10962870 DOI: 10.7759/cureus.54826] [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: 02/12/2024] [Indexed: 03/27/2024] Open
Abstract
Bezoars constitute a compacted collection of undigested or partially digested material, potentially leading to intestinal obstruction. They most frequently occur in the stomach, with classification based on their composition. Many gastric bezoars are asymptomatic and frequently manifest in patients with gastrointestinal disturbances or psychiatric issues. We present a rare case of a bezoar related to occupational exposure that illustrates the least-discussed health risks associated with certain jobs.
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Affiliation(s)
- Madalena Santos
- Internal Medicine, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, PRT
| | - Nuno R Carreira
- Medicine 2, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, PRT
| | - Joana Gouveia
- Internal Medicine, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, PRT
| | - Alba Acabado
- Internal Medicine, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, PRT
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36
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Stefan AJ, Ghanem T, Mayerhoff R. Single-Port Robotic Removal of a Submucosal Foreign Body in the Distal Hypopharynx. Laryngoscope 2024; 134:588-591. [PMID: 37439371 DOI: 10.1002/lary.30882] [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: 03/08/2023] [Revised: 06/02/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
In this report, we present a 55-year-old female with cervical stenosis that underwent C5-C7 anterior cervical discectomy and fusion surgery complicated by hardware failure requiring removal. One screw remained after transcervical hardware removal due to operative difficulty with the risk of exposing the hypopharyngeal submucosal space. The retained screw caused the patient significant discomfort and dysphagia prompting a transoral attempt at removal. Using a hypopharynx blade on an oral retractor for access, the single-port surgical robot successfully removed the foreign body from the distal hypopharynx. In this case, a single-port surgical robot expanded access to the inferior hypopharynx. Laryngoscope, 134:588-591, 2024.
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Affiliation(s)
- Andrew J Stefan
- Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Tamer Ghanem
- Department of Otolaryngology, Henry Ford Health, Detroit, Michigan, U.S.A
| | - Ross Mayerhoff
- Department of Otolaryngology, Henry Ford Health, Detroit, Michigan, U.S.A
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37
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Atayi AA, Omar AM, Floyd MS. Preputial advancement flap for delayed urethrocutaneous fistula of the glans following urethral insertion of an 'AAA' battery. Urologia 2024; 91:226-231. [PMID: 37491907 DOI: 10.1177/03915603231189026] [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: 07/27/2023]
Abstract
INTRODUCTION Foreign body insertion associated with sexual gratification is known as polyembolokoilomania. Following removal of the foreign body, long-term complications are infrequently seen. Whilst conservative and endoscopic approaches usually suffice, in extreme cases open surgical approaches are required. We describe an unusual case of polyembolokoilomania in a 25-year-old male involving a single 'AAA' battery who developed a urethrocutaneous fistula requiring delayed reconstructive surgery. CASE PRESENTATION Following an initial successful open extraction of an 'AAA' battery from the mid penile urethra the patient developed a delayed urethrocutaenous fistula of the glans. This was managed using a single stage closure with a preputial graft on its vascular pedicle thereby preserving the foreskin and avoiding a buccal graft. No intra-operative or post-operative complications occurred with a catheter left in situ for 2 weeks. Formal histology confirmed a foreign body type reaction. Following outpatient review successful cosmetic, functional, and sexual outcomes were recorded with questionnaires and medical photography. CONCLUSION Preputial advancement flap with foreskin preservation for distal urethrocutaenous fistula is a successful method of treating delayed urethrocutaenous fistula of the distal urethra in cases of polyembolokoilomania.
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Affiliation(s)
- Andrew A Atayi
- Department of Reconstructive Urology, Whiston Hospital, St Helens & Knowsley Hospital NHS Trust, Merseyside, UK
| | - Ahmad M Omar
- Department of Reconstructive Urology, Whiston Hospital, St Helens & Knowsley Hospital NHS Trust, Merseyside, UK
| | - Michael S Floyd
- Department of Reconstructive Urology, Whiston Hospital, St Helens & Knowsley Hospital NHS Trust, Merseyside, UK
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38
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Wang Q, Cheng S, Zhang X, Xie T, Sun X, Niu Z, Liu Y, Jin X. An asymptomatic perforation of the gastrointestinal tract caused by ingestion of foreign body: A case report. Clin Case Rep 2024; 12:e8142. [PMID: 38292217 PMCID: PMC10822780 DOI: 10.1002/ccr3.8142] [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: 02/01/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 02/01/2024] Open
Abstract
Ingestion of foreign bodies is very common in clinical practice. However, gastrointestinal perforation caused by a foreign body is rare, as most foreign bodies can pass the alimentary tract spontaneously or be removed endoscopically. Ingesting a foreign body causes gastrointestinal tract perforation in less than 1% of cases that require surgery. In the past, the literature about gastrointestinal tract perforation caused by foreign bodies had been widely reported worldwide. However, the case of foreign bodies causing gastrointestinal perforation without significant abdominal infection was rarely documented. A 47-year-old woman presented with intermittent left lower abdominal pain associated with a mass for 1 month and had no other symptoms. Laparotomy was performed after clinical assessment. During the operation, a local inflammatory mass that adhered to the abdominal wall, part of the small intestine, and sigmoid colon was found in the left lower quarter of the abdominal cavity. The surrounding intestinal wall was edematous. There were two bony foreign bodies in it. Postoperative pathology suggested an inflammatory mass. A foreign body rarely migrates into the abdominal cavity without symptoms that may be related to the omentum's slow perforation process and good function. The best treatment is surgery and using appropriate antibiotics.
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Affiliation(s)
- Qiang Wang
- Department of General SurgeryAffiliated Hospital of Hebei UniversityBaodingHebei ProvinceChina
| | - Shujie Cheng
- Department of General SurgeryAffiliated Hospital of Hebei UniversityBaodingHebei ProvinceChina
| | - Xuejiao Zhang
- Hebei Institute of DermatologyBaodingHebei ProvinceChina
| | - Tianhao Xie
- Department of General SurgeryAffiliated Hospital of Hebei UniversityBaodingHebei ProvinceChina
| | - Xinli Sun
- Department of General SurgeryAffiliated Hospital of Hebei UniversityBaodingHebei ProvinceChina
| | - Zheng Niu
- Department of General SurgeryAffiliated Hospital of Hebei UniversityBaodingHebei ProvinceChina
| | - Yahan Liu
- Department of General SurgeryAffiliated Hospital of Hebei UniversityBaodingHebei ProvinceChina
| | - Xiaoshi Jin
- Department of General SurgeryAffiliated Hospital of Hebei UniversityBaodingHebei ProvinceChina
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Holland L, Hernandez Torres SI, Snider EJ. Using AI Segmentation Models to Improve Foreign Body Detection and Triage from Ultrasound Images. Bioengineering (Basel) 2024; 11:128. [PMID: 38391614 PMCID: PMC10886314 DOI: 10.3390/bioengineering11020128] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/20/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Medical imaging can be a critical tool for triaging casualties in trauma situations. In remote or military medicine scenarios, triage is essential for identifying how to use limited resources or prioritize evacuation for the most serious cases. Ultrasound imaging, while portable and often available near the point of injury, can only be used for triage if images are properly acquired, interpreted, and objectively triage scored. Here, we detail how AI segmentation models can be used for improving image interpretation and objective triage evaluation for a medical application focused on foreign bodies embedded in tissues at variable distances from critical neurovascular features. Ultrasound images previously collected in a tissue phantom with or without neurovascular features were labeled with ground truth masks. These image sets were used to train two different segmentation AI frameworks: YOLOv7 and U-Net segmentation models. Overall, both approaches were successful in identifying shrapnel in the image set, with U-Net outperforming YOLOv7 for single-class segmentation. Both segmentation models were also evaluated with a more complex image set containing shrapnel, artery, vein, and nerve features. YOLOv7 obtained higher precision scores across multiple classes whereas U-Net achieved higher recall scores. Using each AI model, a triage distance metric was adapted to measure the proximity of shrapnel to the nearest neurovascular feature, with U-Net more closely mirroring the triage distances measured from ground truth labels. Overall, the segmentation AI models were successful in detecting shrapnel in ultrasound images and could allow for improved injury triage in emergency medicine scenarios.
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Affiliation(s)
- Lawrence Holland
- Organ Support and Automation Technologies Group, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA
| | - Sofia I Hernandez Torres
- Organ Support and Automation Technologies Group, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA
| | - Eric J Snider
- Organ Support and Automation Technologies Group, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA
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40
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Luo N, Liang XY, Li L, Zhang X, Zang CM, Liu X, Fan XZ. Foreign body accompanied with thrombosis in the right internal jugular vein: A case report. Clin Hemorheol Microcirc 2024; 86:451-455. [PMID: 38007641 DOI: 10.3233/ch-231988] [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: 11/27/2023]
Abstract
A rare foreign body accompanied by thrombosis in the right internal jugular vein was accidentally observed. We collected the medical history of this special patient, analyzed the causes and characteristics of the foreign body and thrombosis formation, and subsequently observed the changes in thrombosis. Finally, we discussed the diagnostic value of ultrasound for such rare intravascular lesions.
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Affiliation(s)
- Nan Luo
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
- Anhui Medical University Fifth Clinical Medical College, Anhui, China
| | - Xiao-Yu Liang
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Lu Li
- Department of Outpatients, the 26th Rest Center for Retired Cadres, Beijing, China
| | - Xiao Zhang
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Chun-Mei Zang
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Xi Liu
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Xiao-Zhou Fan
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
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41
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El Khoury P, Makhoul M, El Hadi C, Haber C, Rassi S. CT Scan in Children Suspected of Foreign Body Aspiration: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2024; 170:1-12. [PMID: 37473440 DOI: 10.1002/ohn.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The goal of this study is to evaluate the sensitivity and specificity of computed tomography (CT) scans in the diagnosis of foreign body aspiration (FBA) in children, and to determine whether chest CT scans would reduce the need for diagnostic rigid bronchoscopies. DATA SOURCES MEDLINE, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for relevant articles and conference proceedings that were published in English through November 1, 2022. REVIEW METHODS We included prospective and retrospective studies comparing chest CT scans and rigid bronchoscopy for the diagnosis of FBA in pediatric patients (<16 years old). The pooled estimates of the sensitivity and specificity of the chest CT scan in the diagnosis of FBA were calculated using a fixed- or common-effects analysis and a random-effects analysis that accounts for heterogeneity if present. Forest plots were constructed to combine the evidence identified during the systematic review. RESULTS Eighteen articles (4178 patients) were included. The average age of the children was 2.26 (±0.75) years, and 65% (±5.64%) of them were boys. Cough was the most prevalent symptom upon presentation. The pooled analysis showed that the sensitivity of chest CT scan in detecting a foreign body in children was 99% (95% confidence interval, CI [97, 100]; I2 = 72%, τ2 = 0.0065, p < .01). The false negative rate was 1.8% (95% CI [0.3, 2.7]; I2 = 72%, p < .01). The specificity of chest CT scan was 92% (95% CI [83, 98]; I2 = 83%, τ2 = 0.0437, p < .01). CONCLUSIONS Chest CT scan is a sensitive and specific test for the diagnosis of FBA in the pediatric population. Its use can help to reduce unnecessary rigid bronchoscopies, especially in patients with a low clinical suspicion of aspiration. It should not be a replacement for the gold standard bronchoscopy, particularly in cases where there is a clear history and symptoms suggestive of aspiration.
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Affiliation(s)
- Patrick El Khoury
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Mikhael Makhoul
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Christopher El Hadi
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Christelle Haber
- Department of Radiology, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Simon Rassi
- Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
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42
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Kabak SL, Melnichenko YM, Anishchenko SL, Savrasova NA, Pavlov OM, Mekhtiev RS. [Maxillary sinusitis as a complication of dental implants placement: a case report]. Vestn Otorinolaringol 2024; 89:42-44. [PMID: 38506025 DOI: 10.17116/otorino20248901142] [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: 03/21/2024]
Abstract
The article presents a case of chronic odontogenic maxillary sinusitis and the results of its surgical treatment. The cause of the sinusitis, confirmed by the results of X-ray and pathohistological studies, was an inflammatory process affecting the bone tissue around the implant, installed in the place of the upper first molar which was accompanied by the development of an oroantral fistula. During the surgical intervention, the communication between the oral cavity and the maxillary sinus was eliminated, and the implant with the abutment, which was entirely in its cavity, was also removed.
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Affiliation(s)
- S L Kabak
- Belarusian State Medical University, Minsk, Republic of Belarus
| | | | - S L Anishchenko
- City Clinical Pathoanatomical Bureau, Minsk, Republic of Belarus
| | | | - O M Pavlov
- Belarusian State Medical University, Minsk, Republic of Belarus
| | - R S Mekhtiev
- Belarusian State Medical University, Minsk, Republic of Belarus
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43
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Sato T, Kato Y, Kataba H, Yoshida K, Hayashi H, Kakihana M, Ikeda N. Intrathoracic Needle Migration from the Mediastinum into the Thoracic Cavity. Ann Thorac Cardiovasc Surg 2024; 30:24-00039. [PMID: 38631862 PMCID: PMC11082495 DOI: 10.5761/atcs.cr.24-00039] [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: 03/05/2024] [Accepted: 03/31/2024] [Indexed: 04/19/2024] Open
Abstract
Intrathoracic needles are rarely used in clinical practice. They can migrate within the body, injure large blood vessels and other organs, and cause severe complications. We report an interesting case of intrathoracic needle removal using video-assisted thoracoscopic surgery. The needle was inserted under the left clavicle, penetrated the mediastinum, and migrated into the right thoracic cavity. Although pneumothorax developed during the disease course, no severe complications were observed. This rare case illustrates the course of needle migration from the mediastinum into the thoracic cavity. Prompt imaging and surgical removal of foreign bodies are necessary in cases of intrathoracic foreign bodies.
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Affiliation(s)
- Tomo Sato
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | - Yasufumi Kato
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | - Hiroaki Kataba
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | | | - Hiroki Hayashi
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | | | - Norihiko Ikeda
- Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan
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Mohamedahmed AYY, Jouni H, Kakarla J, Ebraheem M, Eccersley J. Sigmoid Colon Perforation, Pelvic Collection, and Hydronephrosis Caused by an Ingested Chicken Wishbone. Cureus 2024; 16:e52478. [PMID: 38370995 PMCID: PMC10870089 DOI: 10.7759/cureus.52478] [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: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
This case report presents an unusual and challenging case of an 82-year-old female patient who presented with constipation and abdominal pain and was diagnosed with bowel perforation and hydronephrosis caused by an ingested chicken wishbone. This patient was treated with emergency laparotomy and bowel sigmoid resection. She made a good recovery and was discharged home. The patient's clinical presentation, diagnostic challenges, and successful management are discussed.
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Affiliation(s)
| | - Hassan Jouni
- General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
| | - Jyotsna Kakarla
- General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
| | - Mohamed Ebraheem
- General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
| | - James Eccersley
- Colorectal Surgery and General Surgery, University Hospitals of Derby and Burton, Burton-on-Trent, GBR
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45
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McLeish S, Harwood R, Decker E, Almond S, Hall NJ, Durand C. Managing magnets: An audit of introduction of the Royal College of Emergency Medicine Best Practice Guideline. Acta Paediatr 2024; 113:127-134. [PMID: 37641921 DOI: 10.1111/apa.16956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
AIM To evaluate management of children and young people presenting to the Emergency Department (ED) with magnet ingestion before and after new guidance. METHODS In May 2021, a National Patient Safety Agency and Royal College of Emergency Medicine (RCEM) Best Practice Guideline about management of ingested magnets was published. This was implemented in our department. Children and young people presenting after magnet ingestion were identified from SNOMED (coded routinely collected data) and X-ray requests between January 2016 and March 2022. Management was compared to national guidance. RESULTS There were 138 patient episodes of magnet ingestion, with a rising incidence over the 5-year period. Following introduction of the guideline, there was a higher incidence of admission (36% vs. 20%) and operative intervention (15.7% vs. 8%). Use of follow-up X-ray increased from 56% to 90%. There was substantial variation in the management prior to guidance which reduced after introduction of the RCEM guidance. CONCLUSION Management of magnet ingestion has become more standardised since introduction of the National RCEM Best Practice Guideline, but there is still room for improvement.
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Affiliation(s)
- S McLeish
- Emergency Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - R Harwood
- Department of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - E Decker
- Department of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - S Almond
- Department of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - N J Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - C Durand
- Emergency Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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46
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Okhotnikov OI, Yakovleva MV, Krasnikov PA, Okhotnikov OO. [Recurrent bacterial abscess of the left liver lobe caused by a foreign body (fish bone)]. Khirurgiia (Mosk) 2024:91-96. [PMID: 38258694 DOI: 10.17116/hirurgia202401191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
The authors present minimally invasive surgical treatment of recurrent liver abscess caused by migration of fish bone from the upper gastrointestinal tract. Two-stage treatment implied small-caliber transparietal drainage of abscess with evacuation of purulent detritus at the first stage. At the second stage, primary percutaneous approach was transformed into access of sufficient diameter for flexible or rigid optics for visually controlled bone extraction. Foreign body removal through the drainage tube with endoscopic capture under visual control is preferable regarding safety compared to removal under ultrasound and/or X-ray control. Indeed, endoscopic approach is valuable for optimal positioning of the object and prevention of damage to liver parenchyma during extraction.
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Affiliation(s)
- O I Okhotnikov
- Kursk Regional Multi-field Clinical Hospital, Kursk, Russia
- Kursk State Medical University, Kursk, Russia
| | - M V Yakovleva
- Kursk Regional Multi-field Clinical Hospital, Kursk, Russia
- Kursk State Medical University, Kursk, Russia
| | - P A Krasnikov
- Kursk Regional Multi-field Clinical Hospital, Kursk, Russia
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Hoang VT, Hoang TH, Nguyen HQ, Pham NTT, Vo TH, Chansomphou V, Hoang DT. Perforated appendicitis due to fishbone. J Surg Case Rep 2024; 2024:rjad694. [PMID: 38186759 PMCID: PMC10766585 DOI: 10.1093/jscr/rjad694] [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: 10/26/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Appendicitis is a common condition in daily clinical practice. Appendicitis due to foreign bodies is uncommon and may result from obstruction or perforation mechanism. We present a rare case of a 43-year-old male patient who was diagnosed with perforated appendicitis due to a fish bone by imaging studies and confirmed postoperatively. Confirming the fish bone causing the perforation on images is sometimes difficult, requiring the radiologist to actively search and determine the source. In addition to appendectomy, the surgeon also needs to pay attention to removing all foreign objects and treating perforations of surrounding organs.
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Affiliation(s)
- Van T Hoang
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot, Vietnam
| | - The H Hoang
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot, Vietnam
| | - Hoang Q Nguyen
- Department of Radiology, Family Hospital, Da Nang, Vietnam
| | - Ngoc T T Pham
- The University of Danang - School of Medicine and Pharmacy, Da Nang, Vietnam
| | - Tien H Vo
- Department of Radiology, Tam Tri Nha Trang General Hospital, Nha Trang, Vietnam
| | - Vichit Chansomphou
- Department of Radiology, Savannakhet Medical-Diagnostic Center, Kaysone Phomvihane, Laos
| | - Duc T Hoang
- Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, United States
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48
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Bance RRR, Acharya V, Paula C, Panesar J. To X-Ray or Not to X-Ray? Discussing Unknown Nasal Foreign Bodies and Button Batteries. Ear Nose Throat J 2024; 103:NP49-NP52. [PMID: 34338035 DOI: 10.1177/01455613211033123] [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: 11/16/2022] Open
Abstract
The emergency of esophageal button batteries is recognized. Foreign bodies in the ear or nose are treated as comparatively nonemergent. We present the case of a child who presented with suspected pen-nib in the nostril to highlight the importance of investigation and intervention in unwitnessed nasal foreign body and review the literature regarding X-rays in these cases. Fifteen papers were identified as per search parameters; 3 papers recommend the use of plain radiographs for nasal foreign bodies. We propose that in unwitnessed pediatric nasal foreign body insertion, a facial X-ray should be considered, especially if suspecting a metallic foreign body.
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Affiliation(s)
- Rujuta R Roplekar Bance
- Luton and Dunstable University Hospital, Luton, Bedfordshire, United Kingdom
- University College London Hospital, Cambridge, United Kingdom
| | - Vikas Acharya
- Luton and Dunstable University Hospital, Luton, Bedfordshire, United Kingdom
- Northwick Park Hospital, Harrow, United Kingdom
| | - Coyle Paula
- Luton and Dunstable University Hospital, Luton, Bedfordshire, United Kingdom
| | - J Panesar
- Luton and Dunstable University Hospital, Luton, Bedfordshire, United Kingdom
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Monro S, Feketeova E. Streptococcus viridans Liver Abscess and Septicemia Likely Secondary to a Swallowed Dental Bridge. Cureus 2023; 15:e49998. [PMID: 38186473 PMCID: PMC10767456 DOI: 10.7759/cureus.49998] [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: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Pyogenic liver abscesses are relatively rare in developed countries such as the United States, and, when they do occur, they are typically secondary to direct or hematogenous spread of intra-abdominal pathologies. Gastrointestinal pathogens such as Escherichia coli and Enterococcus species are typically implicated. Conversely, the Streptococcus viridans group is a rare cause of bacteremia and abscess formation, especially in immunocompetent patients. We present a case of a 53-year-old male who presented with S. viridans liver abscess that was found to be secondary to a swallowed dental bridge that was lodged in the patient's descending colon. The patient was treated with intravenous antibiotics, percutaneous drainage, and colonoscopy for removal of the foreign body; the patient had a good response to treatment and was discharged on oral antibiotics. In any patient who has fever and abnormal liver function tests, hepatobiliary sepsis including liver abscess should always be excluded. Additionally, it is important to suspect unusual pathogens and sources of infection. We suggest empiric broad-spectrum antibiotic coverage when liver abscess is suspected and tailoring treatment as the specific organism and susceptibilities are identified. Moreover, we suggest the importance of removing any foreign bodies promptly upon discovery as they may serve as an important nidus of infection.
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Affiliation(s)
- Shannon Monro
- Internal Medicine, Garnet Health Medical Center, Middletown, USA
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50
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Dev S, Pokhrel KM, Mulmi U, Devkota S, Dev B, Bhattarai A. Chicken bone-induced ileal perforation peritonitis mimicking duodenal perforation peritonitis: a case report. Ann Med Surg (Lond) 2023; 85:6202-6205. [PMID: 38098546 PMCID: PMC10718394 DOI: 10.1097/ms9.0000000000001404] [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: 08/17/2023] [Accepted: 10/07/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Foreign body ingestion can lead to bowel perforation and peritonitis. We present a case of a 54-year-old male who ingested a chicken bone, resulting in ileal perforation that mimicked duodenal perforation peritonitis. Case Presentation The patient has a history of peptic ulcer disease and regularly used non-steroidal anti-inflammatory drugs over the counter, adding more evidence to the provisional diagnosis of duodenal perforation. Exploratory laparotomy revealed the ileal perforation and the chicken bone was successfully removed. Wedge resection of the perforated segment and ileo-ileal anastomosis were performed. Discussion Although history, examination, and investigation were more in favor of duodenal ulcer, our patient had ileal perforation due to chicken bone. Prompt identification and early surgical intervention are crucial to prevent complications and reduce mortality rates. The patient had an uneventful recovery. Conclusion Timely referral to a tertiary care center is essential for early surgical intervention and successful management of bowel perforation caused by a foreign body.
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Affiliation(s)
- Santosh Dev
- Department of General Surgery, Tribhuvan University Teaching Hospital
| | - Kailash Mani Pokhrel
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu
| | - Utsha Mulmi
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu
| | - Shishir Devkota
- Department of General Surgery, Tribhuvan University Teaching Hospital
| | - Barsha Dev
- Nepalgunj Medical College and Teaching Hospital, Banke, Nepal
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