Re: J-tip wire entrapment in a vena cava filter during central line placement.
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Aged↗
Biomedical subjects
Thomas V Mincheff
Publications and source records attributed to Thomas V Mincheff.
Bullet fragment within the appendix: a case report.
A 9-year-old Caucasian male presented initially to his pediatrician with abdominal pain. The child underwent a UGI, which showed mild gastric erosions, however the scout film revealed a metal fragment lodged near the right sacroiliac joint on the AP view. The child was referred to a general surgeon who conducted a series of other diagnostic tests, which ultimately revealed and verified that the metal fragment was lodged in the distal appendix. Careful family history obtained showed that the family eats a great deal of wild game, including deer meat. It was felt that this metal fragment was a portion of a consumed bullet, which was retained in the appendix. The child's blood lead (Pb) level was elevated at 16ug/dl. An elective prophylactic appendectomy was performed due to the potential for developing appendicitis and possible lead toxicity.
Abdominal Pain↗
Metastatic spread to a percutaneous gastrostomy site from head and neck cancer: case report and literature review.
BACKGROUND: The placement of percutaneous endoscopic gastrostomy tubes is a common procedure in patients with head and neck cancer who require adequate nutrition because of the inability to swallow before or after surgery and adjuvant therapies. A potential complication of percutaneous endoscopic gastrostomy tubes is the metastatic spread from the original head and neck tumor to the gastrostomy site. METHODS: This is a case of a 59-year-old male with a (T4N2M0) Stage IV squamous cell carcinoma of the oropharynx who underwent percutaneous endoscopic gastrostomy tube placement at the time of his surgery and shortly thereafter developed metastatic spread to the gastrostomy site. A review of the published literature regarding the subject will be made. RESULTS: Twenty-nine cases of percutaneous endoscopic gastrostomy site metastasis occurring in patients with head and neck cancer have been previously reported in the literature. The pull-through method of gastrostomy tube placement had been used in our patient as well as in the majority of the other cases reviewed in the literature. CONCLUSION: The metastatic spread of head and neck cancer to the percutaneous endoscopic gastrostomy site is a very rare occurrence. The direct implantation of tumor through instrumentation is the most likely explanation for metastasis; however, hematogenous seeding is also a possibility. To prevent this rare complication, other techniques of tube insertion need to be considered.
Carcinoma, Squamous Cell↗