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PubMed1999

Unusual sites of uncommon endobronchial foreign bodies. Reports of four cases.

Foreign body aspiration occurs most commonly in children and can have serious consequences. In adults, it is associated with surgery, trauma and accidents. We report four unusual cases of foreign body inhalation. In one case a spike of wild barley entered the trachea through a tracheostomy cannula and migrated from the chest wall. In the second case a piece of coarse cloth which was introduced through a tracheostomy stoma aided by a wood sliver was retained in the trachea. In another patient an inhaled sewing needle migrated to the pericardium, and in the fourth case the head of a metal stud penetrated the trachea percutaneously through the neck and lodged in the right main bronchus. The incidence, causes, complications and management of such cases are discussed and the literature is briefly reviewed.

Adolescent↗

PubMed1998

Wooden foreign bodies in soft tissue: detection at US.

PURPOSE: To evaluate the use of ultrasound (US) for detection of wooden foreign bodies implanted in cadaveric specimens. MATERIALS AND METHODS: Wooden foreign bodies were randomly placed in the plantar soft tissues of three cadaver feet by using 5-mm-long incisions. Ten foreign bodies were 2.5 x 1.0 mm (length x diameter); 10 were 5.0 x 1.0 mm. Ten incisions were performed without implantation of foreign bodies. Three musculoskeletal radiologists independently performed US in blinded fashion and recorded the presence of a foreign body. Each used 7.5- and 10-MHz linear-array transducers and was informed of the possible presence of a foreign body. RESULTS: Sensitivity and specificity for detection of 2.5-mm-long foreign bodies were 86.7% and 96.7%, respectively. Sensitivity and specificity for detection of 5.0-mm-long foreign bodies were 93.3% and 96.7%, respectively. Overall sensitivity was 90.0%, with specificity of 96.7%, accuracy of 92.3%, positive predictive value of 98.0%, and negative predictive value of 83.0%. CONCLUSION: US can be used effectively to locate wooden foreign bodies as small as 2.5 mm in length. Given that many foreign bodies are radiographically undetectable, the accuracy and availability of US make it an excellent modality for evaluation of radiolucent foreign bodies.

Cadaver↗

PubMed1995

Pyopneumothorax associated with unsuspected endobronchial foreign body: a case report.

Chronic foreign body aspiration may cause a variety of complications. Nonspecific clinical presentations and chest radiographic manifestations often result in misdiagnosis or delayed diagnosis. We report an unusual complication of chronic foreign body aspiration--pyopneumothorax--in a 52-year-old patient presenting with productive cough and intermittent fever for more than 3 months. Obstructive pneumonia was highly suspected from the computed tomographic scan of the chest. Flexible fiberoptic bronchoscopy demonstrated a fish bone in the bronchial tree. The bone was successfully removed by forceps. Thoracotomy was done later to ensue adequate drainage of the pyopneumothorax. We report this case for ongoing education to increase the index of suspicion.

Bronchi↗

PubMed1989

[Removal of an intracardiac foreign body].

Four patients with intracardiac foreign body, in whom central venous catheter was accidentally cut and its fragment was migrated into the cardiovascular system, are presented. One patient was surgically treated. Other patients were treated using transvascular catheter technique. In one of three patients, however, a chorda of tricuspid valve was hooked by a grasping catheter and the patient was forced to surgical removal of both a catheter fragment and the grasping catheter. We discussed the method and problems to remove intra-cardiovascular foreign body.

Aged↗

PubMed1976

[Clinical treatment of tracheoesophageal fistulas due to foreign bodies (author's transl)].

Swallowed foreign bodies, fixed in the esophagus, are not uncommon in childhood. Their symptoms, complications, diagnosis and treatment are discussed. An expectant attitude is justified in regard to smaller fistulas and in big fistulas due to foreign bodies up to the remission of the localized inflammatory reaction. The present surgical methods are reviewed in the light of recent literature and a case study of a child cured by segmental resection of the trachea.

Child↗

PubMedDate not supplied

Nonmetallic foreign bodies in the foot: radiography versus xeroradiography.

Nonmetallic foreign bodies were embedded in cadaver feet. Standard x-rays and xerograms were taken and compared. The results appear to indicate that standard x-rays remain the more clinically practical means of screening for foreign bodies. The literature regarding xeroradiography suggests that this is superior to radiography in detection of nonmetallic foreign bodies. By embedding nonmetallic foreign bodies in cadaver feet and comparing standard x-rays to xerograms, the examiner should be able to confirm or disprove this premise.

Evaluation Studies as Topic↗

PubMed2003

[A case of an uncommon foreign body in the esophagus].

Esophagial foreign bodies are mostly located in the sites of the physiological and pathological narrowings. A case of 58 year old patient with profound mental impairment, who swallowed a stone of 3 cm in diameter and a molar tooth has been presented. The treatment and prognosis was complicated by retention of barium contrast in the lungs. The patient underwent the bronchoscopy and double esophagoscopy. Foreign body was successfully removed through external approach (oesophagotomy).

Barium Radioisotopes↗

PubMed1992

Intravesical foreign bodies: five-year review.

All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimise bladder and urethral trauma. Complete extraction should also be confirmed by panendoscopy at the end of the extraction procedure. A 5-year review of our experience in this field has been conducted and the management and complications of intravesical foreign bodies are described. Of the 15 patients presenting to this department, 11 presented acutely and 4 presented with chronic symptoms due to complications which arose later. The possibility of an intravesical foreign body should be considered in any patient with chronic unexplained lower urinary tract symptoms.

Adult↗

PubMed2002

Emergency department management of foreign bodies of the external ear canal in children.

OBJECTIVE: To evaluate the management of foreign bodies in the external auditory canal (EAC) in pediatric patients by emergency department personnel. SETTING: Tertiary care pediatric hospital emergency department. STUDY DESIGN: A retrospective chart review of children with foreign bodies of the EAC over a 12-month period. Age, foreign body type, rate of successful removal, and complication rates were recorded. Foreign bodies were categorized into two groups: objects with smooth surfaces and not easily grasped (nongraspable) and objects with irregularly shaped surfaces and easily grasped (graspable). RESULTS: Thirty-six patients were brought to the emergency department over a 12-month period with foreign bodies of the EAC. Their mean age was 6.5 years (range, 1-16 yr). Numerous foreign bodies were noted; beads were the most common. Successful removal was achieved in 53% of cases, and one or more complications were recorded in 47%. When the foreign bodies were grouped into nongraspable and graspable objects, the success rate for the nongraspable group was 45%, with a complication rate of 70%, whereas for graspable objects the successful removal rate was 64%, with a complication rate of only 14%. The difference in complication rates was statistically significant (p < 0.001.) CONCLUSION: This study demonstrates that certain foreign bodies (graspable type) of the EAC in pediatric patients can be successfully managed by skilled emergency department personnel with low complication rates, whereas other foreign bodies (nongraspable types) may be better managed by early referral to an otolaryngologist.

Adolescent↗

PubMed1997

[Comparison between magnetic resonance imaging and CT in detection and localization of non-magnetic intraocular foreign bodies].

OBJECTIVE: To approach the characteristics of magnetic resonance imaging (MRI) and CT in detection and localization of intraocular foreign bodies. METHODS: Detection and localization of 28 cases (42 foreign bodies) of non-magnetic intraocular foreign body were compared in MRI and CT with criteria of operative results. RESULTS: The positive rates of MRI and CT in detection of 42 non-magnetic intraocular foreign bodies were respectively 90.5% and 95.2% (chi 2 test: P > 0.5). The positive rates of MRI and CT in localization were respectively 89.5% and 60.0% (chi 2 test: P < 0.05). CONCLUSION: MRI could be used in detection and localization of non-magnetic intraocular foreign bodies with high positive rates in detection and superior to CT in demonstrating non-magnetic intraocular foreign bodies with low density and the relationship between foreign bodies and intraocular tissues. MRI was not as believable as CT in detection of foreign bodies in eye wall and not an appropriate modality in examinations of magnetic intraocular foreign body.

Eye Foreign Bodies↗

PubMed2001

Vocal cord paralysis secondary to impacted esophageal foreign bodies in young children.

Impacted foreign bodies in the esophagus can result in respiratory symptoms including stridor and aphonia. Several mechanisms have been proposed to explain these symptoms, but the possibility of vocal cord paralysis and its cause has not been adequately emphasized. Two cases of young children with esophageal foreign body are described; both presented with respiratory symptoms, 1 with aphonia and the other with stridor. In both cases, the symptoms were secondary to vocal cord paralysis. A possible mechanism of recurrent nerve injury is proposed.

Aphonia↗

PubMed2005

[Uncommon foreign body in the respiratory airways].

Foreign body most frequently reaches respiratory airways by act of aspiration. It could be of various origin, most dangerous is vegetables one which inlarges progressively and could obturate airways completelly. Consequences of that is problem with breathing, atelectasis, and futher on if that obstactle is of long duration bronchiectasis and abscess of pulmonum can be developed. The aim od this paper is to present uncommen foreign body located in the right bronchus- plastic tube. Methods of choice: bronchoscopy and extraction.

Aged↗

PubMed1997

Intraorbital wooden and bamboo foreign bodies: CT.

We describe the CT findings of intraorbital wooden and bamboo foreign bodies in the acute, subacute, and chronic stages. We examined four patients using CT a total of seven times. The CT findings were reviewed. There were three dry wooden foreign bodies. CT within a day of the accident demonstrated wooden foreign bodies as low density relative to surrounding orbital fat, while CT 8-29 days after the accident showed them as denser than the extraocular muscles. In the acute stage, dry wooden foreign bodies mimic air bubbles. Wooden foreign bodies in the subacute and chronic stages should be included in the differential diagnosis of intraorbital lesions of soft tissue density or above on CT of traumatised orbits. There was one dry bamboo foreign body. Within a day of the accident it was recognised as linear lesion isodense with fat. Therefore, such foreign bodies may be missed on CT when located in the orbital fat.

Adipose Tissue↗

PubMed2004

Nasal foreign body removal.

Patients with nasal foreign bodies often present to the Emergency Department (ED) for removal. In most cases, successful removal can be performed by the Emergency Physician (EP) using a variety of simple techniques. The EP should be familiar with multiple procedural techniques as a significant number of patients will require multiple attempts and techniques for removal of the nasal foreign body. This article reviews the more common techniques for removal, and provides specific technical tips, indications and contraindications for each technique.

Catheterization↗

PubMed1986

Rectal foreign bodies.

We review the histories of 26 patients who were treated at the Royal Perth Hospital for retained rectal foreign bodies. The foreign bodies that were retrieved and the age, sex and marital status of each patient are recorded and a number of the histories is presented. The complications that arose from either the insertion or removal of the foreign body are discussed, as are the methods of treatment that were employed. The various methods that the practitioner has at his disposal for dealing with this increasing problem are reviewed, and a plan of management of patients with non-perforating rectal foreign bodies is suggested.

Adolescent↗

PubMed2000

Clinical management of foreign bodies of the genitourinary tract.

PURPOSE: The variety of foreign bodies inserted into or externally attached to the genitourinary tract defies imagination and includes all types of objects. The frequency of such cases renders these objects an important addition to the diseases of the urinary organs. MATERIALS AND METHODS: We performed a computerized MEDLINE search followed by a manual bibliographic review of cross-references. These reports were analyzed and the important findings summarized. RESULTS: Our review encompassed approximately 800 single case reports on foreign bodies in the English world literature published between 1755 and 1999. We structured the range of introduced objects, by referring to origin and material as well as the genitourinary organs involved. Furthermore, we noted symptomatology and diagnoses, including psychological involvement, as well as possible treatment options. CONCLUSIONS: The most common motive associated with foreign bodies of the genitourinary tract is sexual or erotic in nature. The most suitable method of removing a urethral foreign body depends on the size and mobility of the object applied to the genitourinary tract. When possible, endoscopic and minimal invasive techniques of removal should be used. However, surgical retrieval of a foreign body may be required, particularly when there is a severe associated inflammatory reaction.

Aged↗

PubMed2004

Comparison of pediatric airway foreign bodies over fifty years.

Prevention and early recognition remain critical factors in the treatment of foreign body inhalation in children. Accidental inhalation of both organic and nonorganic foreign body material continues to be a cause of childhood morbidity and mortality. The University of North Carolina Department of Otolaryngology has collected foreign bodies acquired from the airways of young children since its inception in 1954. The authors reviewed 26 foreign bodies removed bronchoscopically from the airways of children during the years 1955 to 1960, and compared these to 27 foreign bodies collected from 1999 to 2003. Findings showed remarkable similarities in the types of foreign bodies aspirated. Organic foreign bodies were most commonly found. Differences existed in the type of organic foreign body aspirated, with popcorn being retrieved in 15% of cases during the later time period. Also, an increase in bronchoscopically removed small toy parts was found in the later group.

Child↗

PubMed1998

Laparoscopic removal of a foreign body from the jejunum.

Swallowed foreign bodies evacuate spontaneously; therefore, their removal is necessary only if a complication is under suspicion or has ensued. A man of 22 years swallowed, with suicidal intentions, the 9-cm-long and 1.5-cm-wide blade of his pocket knife, which, according to repeated x-ray investigations, was impacted partly through the pylorus into the duodenum. Because of the symptoms, perforation could not be excluded, so laparoscopic removal was decided on. The blade meanwhile passed into the jejunum and was localized intraoperatively with a c-arm fluoroscope. After jejunotomy and removal of the blade, the opening of the small bowel was closed with intracorporeal hand-suturing technique. Postoperative recovery was quick and uneventful. On the evidence of the case history presented, the laparoscopic removal of a foreign body from the gastrointestinal tract can be judged a convenient procedure.

Adult↗