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At least 613 records · Page 34Linked to original sources
PubMed2006

Endoscopic techniques and management of foreign body ingestion and food bolus impaction in the upper gastrointestinal tract: a retrospective analysis of 139 cases.

BACKGROUND: Ingested foreign bodies and food bolus impaction are frequently seen in endoscopic practice. Successful foreign body and food bolus removal may depend on the method used, the choice of device, and the experience level of the endoscopist, although few papers report experience and outcome of tertiary centers. AIM: To investigate the effectiveness of our protocol designed for removal of ingested foreign bodies and food boluses. METHODS: We retrospectively reviewed all patients with a diagnosis of foreign body ingestion and food bolus impaction from 1994 to 2005 identified by computer search. Patients were excluded if medical record was incomplete. RESULTS: The analysis included 171 patients. Foreign bodies and impacted food boluses were found in 77 and 62 patients, respectively. In 32 cases (23%), the foreign bodies passed spontaneously through the gastrointestinal tract. The overall success rate for endoscopic management was obtained in 137 patients (98.6%). Surgical removal of a foreign body was required in only 2 cases (1.4%). According to the type and location of the foreign object and food bolus we used Dormia baskets, retrieval forceps, polypectomy snares, and all sizes of Roth net. No complications relating to the endoscopic procedure were observed; 50 patients (35.2%) had an underlying esophageal disease. CONCLUSIONS: Endoscopic removal of upper gastrointestinal tract foreign bodies and food bolus impaction is efficacious and safe. Especially the Roth net is the best device for safe retrieval of food boluses and button disc batteries.

Child↗
PubMed1994

Clinical characteristics of corneal foreign bodies and their associated culture results.

A prospective study was performed to investigate the clinical characteristics of corneal foreign bodies and to determine if these characteristics were related to the culture results of the foreign body. The clinical characteristics included the type of foreign body, the mechanism of injury, the time present in the cornea, and the presence of a rust ring or an infiltrate. Sixty-three foreign bodies were removed from corneas and cultured for bacteria, and 14.3% cultured positive for bacteria. The major pathogen was coagulase-negative Staphylococcus. The majority of foreign bodies were metallic, and mechanisms of injury were similar for both culture-positive and culture-negative groups. There was no significant correlation between the mean time present in the cornea and the culture results. The presence of a rust ring or an infiltrate was not found to be significant when predicting culture results. No clinical features readily distinguished culture-negative foreign bodies from culture-positive foreign bodies.

Corneal Injuries↗
PubMedDate not supplied

Gastrointestinal foreign bodies and strictures: radiologic interventions.

Food impaction and foreign body ingestion are significant and sometimes life-threatening medical problems. As described in part 1 of this monograph, a variety of techniques and instruments are available to diagnose and treat these conditions. The radiologist interested in interventional procedures can find ample opportunities to participate in the management of esophageal obstructions by applying radiographic and fluoroscopic techniques to the diagnosis and removal of foreign bodies and food impactions. The recommended radiologic procedures are relatively safe, cost-effective, and efficient methods of addressing these serious situations. Stricture formation in the gastrointestinal tract is another significant medical problem that can often be managed nonoperatively by the radiologist. Fluoroscopically guided balloon dilatation has become an accepted method of effectively treating a large variety of strictures. As described in part 2 of this article, the technique is easy to perform, usually with very little inconvenience to the patient, and the risks of complications are very low. The procedure is relatively inexpensive and does not require the acquisition of any specialized or high-technology equipment. Also, the technique can be performed easily by any radiologist with interest in interventional procedures on the gut. A wide use of the fluoroscopic methods for treatment of impacted foreign bodies and strictures of the gastrointestinal tract is recommended.

Adolescent↗
PubMedDate not supplied

[Migration of an intrauterine device. An unusual cause of bladder foreign body].

The origin of vesical and lower urinary tract foreign bodies is very wide, the specialized literature descriptions ranging from urethral dilators to coffee spoons handles through wires, cables and surgical instrumentation. The most frequent entry route of foreign bodies to the lower urinary tract is through the urethra usually by self-introduction or during transurethral surgical procedures. Another access route is that occurring during open or traumatic surgical manoeuvres. Less frequent is that the foreign body migrates from another anatomical structure. These patients present an heterogeneous clinical picture which depends on the location of the foreign body in the urinary tract. Thus, it can be acute if located in the urethra or subacute or chronic if found at vesical level.

Female↗
PubMedDate not supplied

Foreign body ingestions in a schizophrenic patient.

The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and involves subtleties in evaluation and management not usually seen in accidental ingestions. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions ofthis type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid.

Adult↗
PubMed1990

New concepts in the prevention of polymer-associated foreign body infections.

Polymer-associated foreign body infections, especially those caused by coagulase negative staphylococci, have become a problem of increasing importance in modern medicine. Therapy of such infections is often difficult and requires in many cases the removal of a catheter or an implant. On the basis of polymer material modification alternative strategies for the prevention of foreign body infections are presented. By use of high energy radiation or glow discharge techniques polymers can be modified so that new chemical groups with potential antiadhesive or antimicrobial activities can be introduced to the polymer (surface). Another approach is the coupling or incorporation of antimicrobial agents (e.g. antibiotics) to or into polymers. Such polymer-antibiotic systems are obviously not able to prevent initial bacterial adhesion to the polymer material but can effectively eliminate already adherent bacteria from the polymer surface.

Anti-Bacterial Agents↗
PubMed1993

Nasopharyngeal grass foreign body in eight cats.

Nasopharyngeal grass foreign bodies were diagnosed in 8 indoor/outdoor cats. Each cat was anesthetized with xylazine/ketamine, and the foreign bodies were extracted from the nasopharynx by use of mosquito forceps.

Animals↗
PubMed1996

Conservative management of foreign bodies in the gastrointestinal tract.

There are at present no clear guidelines whether foreign body ingestion in the gastrointestinal tract should be managed conservatively, endoscopically or surgically. Retrospectively we have, therefore, analyzed 78 foreign body ingestion's in 42 patients (age 15-72 years) admitted to the Emergency Department of the University Hospital in Vienna. Our intention was to assess the value of a conservative management, defined as daily follow-up visits until the foreign body spontaneously appeared in the feces and to find criteria when endoscopic or surgical management is required. Of 78 foreign bodies, 67 (86%) passed the gastrointestinal tract spontaneously without complications, 9 (11%) were removed endoscopically, and only 2 (3%) required surgery. There were no gastrointestinal perforations. Even foreign bodies with a maximal length of 13.5 cm appeared in the feces spontaneously within a few days. Our data suggests that more than 80% of adults with foreign body ingestion can be managed safely as outpatients by means of conservative treatment. Endoscopic or surgical removal is only indicated in very rare circumstances.

Adolescent↗
PubMed1984

Experimental and naturally-occurring gastric foreign bodies in laboratory rabbits.

Gastric foreign bodies were induced in laboratory rabbits by orogastric infusion of a liquid latex containing radiopaque dye which polymerizes in the acid environment within the stomach to form a solid mass. The rabbits were monitored clinically and radiographically for 6 months at which time gastrotomies were performed to remove the masses, followed by a 4-week observation period. None of the 14 rabbits became ill or anorectic during the 6-month period of clinical monitoring, and all gained weight. At gastrotomy, eight rabbits had both latex bezoars and trichobezoars . Though two rabbits died post-operatively from respiratory complications, the remaining 12 rabbits recovered without complications and regained their pre-operative body weight within 4 weeks. Five of 10 rabbits necropsied 1 month after gastrotomy had gastric trichobezoars . This led to a survey of the stomachs of 208 healthy slaughter-rabbits which revealed that 48 (23.1%) had trichobezoars weighing 1 to 24 g. The data suggested that gastric trichobezoars were common in rabbits and that few animals with these foreign bodies developed chronic anorexia. In addition, there appeared to be a high likelihood that trichobezoars recur in a high percentage of rabbits within several weeks postoperatively.

Animals↗
PubMed1984

Flexible fiberoptic bronchoscopy in the management of tracheobronchial foreign bodies in children: the value of a combined approach with open tube bronchoscopy.

Fifty-two pediatric patients suspected of having a pulmonary foreign body but in whom there was insufficient evidence to warrant open tube bronchoscopy. In 19% of these patients, foreign bodies were found. Twenty-six percent of patients who had previously had foreign bodies removed and who subsequently underwent flexible bronchoscopy for a variety of indications were found to have residual foreign bodies. Clinically unsuspected foreign bodies were found in 1% of 1,054 additional patients who had flexible bronchoscopy for other reasons. The diagnostic use of the pediatric flexible bronchoscope is a safe, definitive, and cost-effective method for the identification of patients with pulmonary foreign bodies when other techniques yield equivocal or negative results. Patients known to have a foreign body should undergo open tube bronchoscopy for foreign body removal.

Bronchi↗
PubMed1988

[Tracheobronchial foreign bodies in childhood].

We report a clinical review of 1,980 cases of tracheobronchial foreign bodies in children aged between 0 months and 14 years old. In all of them the foreign bodies were removed through a rigid bronchoscope. The following conclusions arose: bronchoscopy in childhood must be done under general anesthesia. If the appropriate instruments, are not available, the removal of the foreign body must be postponed; the entire respiratory system must be explored during a bronchoscopy as it is likely to find multiple foreign bodies. We must insist that families keep potential foreign bodies out of reach from their children; in chronic respiratory diseases during childhood, the presence of a foreign body must be considered.

Adolescent↗
PubMedDate not supplied

The use of ultrasonography for the detection of retained wooden foreign bodies in the foot.

The efficacy of ultrasonography for the detection of wooden foreign bodies in the foot was analyzed retrospectively. Twenty patients underwent real-time, high-resolution ultrasound studies (7.5 or 10 MHz, linear array transducers) to rule out the presence of a wooden foreign body in their feet. Ten out of the 20 patients had positive ultrasound findings for a wooden foreign body. With the aid of the ultrasound study and preoperative markings, the subsequent mean surgical time was 20.8 minutes, with a 100% retrieval rate of the foreign body. Ultrasound was found to be 100% sensitive in the detection of wooden foreign bodies in the soft tissues of the foot. Ultrasonography should be considered an important diagnostic modality in the foot and ankle surgeon's armamentarium for the detection of retained wooden foreign bodies.

Adolescent↗
PubMed2001

Management of ingested foreign bodies in children.

This paper reviews the presentation, diagnosis, and management of ingested foreign bodies in children. It may help primary care physicians to recognize the wide spectrum of presentations of ingested foreign bodies in children, therefore emphasizing considering ingested foreign bodies in the differential diagnosis of many respiratory and vague gastrointestinal complaints. It also proposes an approach to handling asymptomatic children with foreign body ingestion and points out certain types of foreign bodies that require special consideration.

Child, Preschool↗
PubMed1997

Projectile metallic foreign bodies in the orbit: a retrospective study of epidemiologic factors, management, and outcomes.

PURPOSE: Intraorbital projectile metallic foreign bodies are associated with significant ocular and orbital injuries. The authors sought to evaluate epidemiologic factors, the incidence of associated ocular and orbital injury, and the nature and necessity of surgical intervention in these cases. METHODS: Charts of all patients with projectile intraorbital metallic foreign bodies seen at our institution (27) over the preceding 7 years were evaluated with respect to age, sex, type of injury, associated ocular and orbital injuries, location of the projectile (anterior, epibulbar, or posterior), postinjury visual acuity, and surgical intervention. RESULTS: The majority of patients were male, between the ages of 11 and 30, and had BB pellet injuries. Thirteen projectiles were lodged anteriorly, 4 were in an epibulbar position, and the remaining 10 were posterior to the equator. Twelve of 13 anterior, and 4 of 4 epibulbar foreign bodies were removed surgically, whereas only 2 of 10 posterior foreign bodies required surgery. No case of surgical intervention resulted in a decrease of visual acuity. Associated ocular injuries were both more common and severe in patients with posteriorly located foreign bodies. Final visual acuity was better at presentation and at discharge in patients with anteriorly located foreign bodies. CONCLUSION: Intraorbital projectile metallic foreign bodies can be a source of significant ocular morbidity. Management of these cases is dependent on the location of the projectile. Ancillary radiographic studies can be helpful. Surgery to remove the projectile should be considered in each case, but foreign bodies that are not readily accessible often may be left safely in place. Closer regulation of the pellet gun industry, with an emphasis on education and protective eyewear use, would be helpful in reducing these injuries.

Accidents, Occupational↗
PubMed1993

[Percutaneous retrieval of intravascular foreign bodies].

PURPOSE: To report our experience on percutaneous vascular foreign body retrieval and to analyse current techniques employed. METHODS: From 1985 to 1991, 15 (0.18%) of 7,963 procedures performed in the Cardiac Catheterization Laboratory-Hospital São Paulo were intravascular foreign body retrieval: 9 (60%) intracath, 4 (26.8%) diagnostic catheters, one Swan Ganz catheter entrapped at superior cava vein and one fragment of angioplasty guide-wire in the circumflex branch of the left coronary artery. The snare technique was used in 11 cases, a endomyocardial bioptome device in 1 case and modified snare technique for the intracoronary wire fragment retrieval was used in 1 case. In two cases of embolized fragment in peripheral arteries, no attempt was done for retrieval. RESULTS: All (100%) of the 13 attempted procedures were successful. The two foreign bodies not removed had an uneventful follow-up. CONCLUSION: The snare technique for percutaneous retrieval of intravascular foreign bodies is safe and has excellent results. The management peripheral fragments is not well defined yet.

Adult↗
PubMed1984

Pathogenesis of foreign body infection. Evidence for a local granulocyte defect.

Implanted foreign bodies are highly susceptible to pyogenic infections and represent a major problem in modern medicine. In an effort to understand the pathogenesis of these infections, we studied the phagocytic function in the vicinity of a foreign body by using a recently developed guinea pig model of Teflon tissue cages subcutaneously implanted (Zimmerli, W., F.A. Waldvogel, P. Vaudaux, and U.E. Nydegger, 1982, J. Infect. Dis., 146:487-497). Polymorphonuclear leukocytes (PMN) purified from tissue cage fluid had poor bactericidal activity against a catalase-positive microorganism. When compared with blood or exudate PMN, they exhibited a significant reduction in their ability to generate superoxide in response to a particulate or a soluble stimulus (72 and 57%, respectively, P less than 0.001). Not only their total contents in myeloperoxidase, beta-glucuronidase, lysozyme, and B12 binding protein were significantly reduced (by 62, 21, 47, and 63%, respectively, P less than 0.01), but also their capability for further secretion of residual B12 binding protein upon stimulation. Ingestion rates of endotoxin-coated opsonized oil particles were reduced by 25% (P less than 0.05). In an effort to reproduce these abnormalities in vitro, fresh peritoneal exudate PMN were incubated with Teflon fibers in the presence of plasma. Interaction of PMN with the fibers led to significant increases in hexose monophosphate shunt activity and exocytosis of secondary granules (P less than 0.01). PMN eluted after such interaction showed defective bactericidal activity, oxidative metabolism, and granular enzyme content similar to those observed in tissue cage PMN. The local injection of fresh blood PMN into tissue cages at the time of, or 3 h after, inoculation with 100 microorganisms (Staphylococcus aureus Wood 46) reduced the infection rate from 50 to 56 cages to 1 of 21 (P less than 0.001) and 3 of 8 cages (P less than 0.001), respectively. These results suggest that the in vivo as well as in vitro interaction of PMN with a nonphagocytosable foreign body induces a complex PMN defect, which may be partly responsible for the high susceptibility to infection of foreign bodies.

Animals↗
PubMed1987

Management of intraocular foreign bodies.

Thirty-five consecutive cases of perforating ocular injuries with retained intraocular foreign body (IOFB) are examined in this retrospective study. Of the 35 cases with injuries, 30 (86%) were due to metallic foreign bodies. Of these, 25 (83%) involved foreign bodies of ferromagnetic origin. Magnetic extraction in combination with pars plana vitrectomy (or when possible, magnetic extraction alone) was successfully used to remove these foreign bodies. Even in cases where posterior vitrectomy is indicated, magnetic extraction allows good control of the foreign body during removal minimizing surgical trauma and the subsequent postoperative inflammatory response.

Eye Foreign Bodies↗