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PubMed2001

Microscopic removal of an embedded foreign body from the hypopharynx: report of two cases.

Incidents of foreign bodies in the hypopharynx, especially fish bones, are very common. In most cases, these bones can be easily located and removed. However, in other cases, they become embedded in the pharyngeal wall and cannot be located, even by fiberoptic endoscopy and rigid esophagoscopy. Left in place, these foreign bodies can eventually cause serious complications. We treated two patients who had an embedded foreign body in the hypopharyngeal wall that we were unable to locate by fiberoptic endoscopy and rigid esophagoscopy. Ultimately, we performed direct laryngoscopy and were able to locate and remove the foreign bodies with the aid of a microscope.

Adult↗

PubMed1977

Removal of foreign bodies: the flexible fiberoptic endoscope.

Three foreign bodies were successfully removed from the upper gastrointestinal tract with a fiberoptic endoscope. They included a food bolus lodged above an esophageal stricture, a metallic nebulizer tip impacted in the mid-esophagus, and a spoon lodged in the stomach. A razor blade could not be removed from the duodenum. Many foreign bodies, including large or elongated objects, can be removed from the upper gastrointestinal tract with flexible fiberoptic endoscopes.

Adolescent↗

PubMed1989

Management of lead foreign body ingestion.

Previous reports of lead foreign body (PbFB) ingestion by children include two cases of lead intoxication and two cases that resulted in death. It is generally accepted, however, that PbFB ingestion does not pose a risk of lead toxicity, provided that the PbFB is not retained in the gastrointestinal (GI) tract. Recent experience with two cases substantiates this belief. On separate occasions, two 9-year old girls ingested a PbFB. The first patient developed only mild, vague GI complaints. The highest reported blood lead level (BLL) was 15 mcg/dl. The second patient did not develop symptoms, and the highest reported BLL was 22 mcg/dl. Both patients passed the PbFB in the stool within two weeks. These cases suggest that PbFB ingestions can be treated in a manner similar to other uncomplicated foreign body ingestions.

Child↗

PubMed1990

Pulmonary hypertensive response to foreign body microemboli.

Pulmonary hypertension and foreign body granulomas are recognized sequelae of chronic intravenous drug abuse. We have recently described the development of transient pulmonary hypertension and increased permeability pulmonary edema after the intravenous injection of crushed, suspended pentazocine tablets in both humans and dogs. To determine the role of vasoactive substances in the development of this transient pulmonary hypertension, we measured pulmonary hemodynamics and accumulation of arachidonic acid metabolites in dogs during the infusion of indomethacin, a cyclooxygenase inhibitor, diethylcarbamazine (DEC), a lipoxygenase inhibitor, and FPL 55712, a receptor antagonist for leukotriene C4/D4 (LTC4/D4). Following the intravenous administration of crushed, suspended pentazocine tablets (3-4 mg/kg of body weight), mean pulmonary artery pressure increased from 14 +/- 2 mmHg to 30 +/- 6 mmHg (p less than 0.05) at 60 secs with a concomitant increase in plasma concentrations of 6-keto-PGF1 alpha from 187 +/- 92 pg/ml to 732 +/- 104 pg/ml and thromboxane B2 from 206 +/- 83 pg/ml to 1362 +/- 117 pg/ml (both p less than 0.05). Indomethacin prevented the increase in both cyclooxygenase metabolites, but had no effect on the pulmonary hypertension. In contrast, DEC had no effect on the increase in cyclooxygenase products, but blocked the pulmonary hypertension. FPL 55712 did not effect either the increase in cyclooxygenase metabolites or the pulmonary hypertension. We conclude that the transient pulmonary hypertension, induced by the intravenous injection of crushed, suspended pentazocine tablets, is not mediated by cyclooxygenase products but may be mediated by lipoxygenase product(s) other than LTC4/D4.

6-Ketoprostaglandin F1 alpha↗

PubMed1999

Management of posterior segment intraocular foreign bodies: 14 years' experience.

BACKGROUND: Penetrating ocular injuries with retained posterior segment foreign bodies are challenging cases requiring urgent attention by vitreoretinal surgeons. Posteriorly located injuries can result in serious immediate and delayed vitreoretinal sequelae, such as retinal detachment and endophthalmitis. We report our experience with posterior segment intraocular foreign bodies. METHODS: We reviewed the records of all patients with penetrating ocular injury with retained intraocular foreign bodies treated at a university-based referral practice in Toronto between April 1981 and December 1995. We noted the pre- and postoperative Snellen visual acuity, type and volume of foreign body, diagnostic technique, surgical management, and pre- and postoperative complications. RESULTS: Forty-one patients (all male with a mean age of 38 [range 8 to 78] years) were treated during the study period. The length of follow-up ranged from 1 to 118 (mean 20) months. Eighteen patients (44%) experienced a delay in diagnosis or management, or both, of 1 day to 3 years. The rates of retinal detachment and endophthalmitis were 41% (17/41) and 17% (7/41) respectively; culture gave positive results in 5 cases. Two of the eyes required enucleation. A final visual acuity of 6/60 or better was obtained in 33 eyes (80%) and of 6/12 or better in 21 eyes (51%). Multiple linear regression analysis showed that only immediate retinal detachment and the presence of a relative afferent pupillary defect had a significant independent effect on final visual acuity. In our previous series (1971-81) the retinal detachment rate was 14% (4/28), and there were no cases of culture-positive endophthalmitis; final visual acuities of 6/60 or better and of 6/12 or better were obtained in 46% and 32% of the eyes respectively. INTERPRETATION: Reasons for the better outcomes in our more recent series may include improved localization of posterior segment foreign bodies with computed tomography, more frequent intravitreal surgery with improved vitrectomy techniques and the use of the intraocular magnet.

Adolescent↗

PubMed1993

Pediatric tracheobronchial foreign bodies. A case report.

Pediatric tracheobronchial foreign bodies (PTBFBs) remain a significant cause of childhood morbidity and mortality. Because physicians do not always obtain a history of aspiration, and because the signs and symptoms of a PTBFB are nonspecific, diagnosis may be delayed, which increases the risk of complications when the foreign body is removed. Flexible fiberoptic and rigid bronchoscopy are often used in tandem for the identification and removal of PTBFBs. Recent advances in bronchoscopic equipment and technique have made removal of PTBFBs safer and more successful. Education of parents, child care providers, and medical personnel can reduce morbidity and mortality due to PTBFBs.

Airway Obstruction↗

PubMed1997

Foreign bodies and intraperitoneal post-operative adhesions.

The presence of foreign bodies is one of the recognized causes of fibrous bands and intraperitoneal post-operative adhesions. The objective of this study was to identify foreign bodies actually present in fibrous bands and intraperitoneal post-operative adhesions. From a series of 211 consecutive patients re-laparotomized by the same surgeon over a period of two years, 193 (91%) showed fibrous bands or adhesions; of these, 133 (69%) also showed reactions to foreign bodies. Comparison with a reference list established in animal work showed than in 127 (66%) of the cases the foreign bodies were of cellulose textile origin; in 3% of the cases, they were of diverse origin--starch powder, synthetic textiles, sutures, or unidentifiable particles.

Animals↗

PubMed1996

[Peroperative contamination of the peritoneal cavity with micro-foreign bodies].

This prospective study examined the presence of foreign bodies in postoperative adhesion specimens and parietal peritoneum removed in a given patient at the same operative site. Fifty-two consecutive patients were enrolled. A significantly larger number of foreign bodies were observed in adhesion specimens than in peritoneum specimens. Inflammatory processes were also found to develop preferentially on the perioneum. In man, foreign bodies participate in the mechanism of development of postoperative intraperitoneal adhesions.

Adult↗

PubMed1979

Fiberbronchoscopic retrieval of iatrogenically introduced endobronchial foreign body.

Although the traditional management of aspiration of foreign bodies has been extraction with the open tube bronchoscope, an expanding array of these have now been removed with the flexible bronchofiberscope. Accidental introduction of a foreign body into the tracheobronchial tree is a poorly recognized, but potentially common hazard of topical anesthetic preparation before endotracheal intubation. We demonstrate that this can be safely and rapidly managed by bedside fiberbronchoscopy. Circumstances favoring the use of the fiberbronchoscope for foreign body extraction are suggested.

Aged↗

PubMed1995

Conjunctival foreign body from a cosmetic facial scrub.

PURPOSE/METHODS: Foreign body sensation in four patients was caused by particles from a cosmetic facial scrub that contained small plastic spheres designed to abrade the skin. The particles were lodged in the superior palpebral conjunctiva 2 to 3 mm from the eyelid margin. RESULTS/CONCLUSIONS: Removal of the particles eliminated the foreign body sensation and there were no lasting deleterious effects.

Adult↗

PubMed2004

Head and neck cancer after foreign body ingestion.

INTRODUCTION: Ingestion of a foreign body is a common occurrence in our population. We present 2 cases that illustrate an unusual outcome of an otherwise usual occurrence. CLINICAL PICTURE: Two patients who presented with a history of ingestion of fish bones were worked up. The radiological findings were suspicious of a foreign body and both underwent examination under general anaesthesia. The endoscopic findings were normal. After further evaluation for persistent calcifications with computed tomography, a thyroid malignancy was found in the first patient and tongue cancer in the second patient. TREATMENT: The first patient underwent elective hemithyroidectomy and the second underwent wide excision of the tumour with neck dissection. OUTCOME: Both recovered uneventfully with regular follow-up in the outpatient clinic. CONCLUSION: There should be a high index of suspicion in patients with persistent calcifications.

Calcinosis↗

PubMed1994

Button battery as a foreign body in the nasal cavities. Special aspects.

Alkaline batteries as foreign bodies in the nasal cavities are dangerous because they can cause liquefaction necrosis with subsequent severe local tissue destruction. Batteries found in the nasal cavities should be removed immediately to prevent sequelae such as septal perforations or nasal meatus stenosis. Due to the common use of these batteries (e.g. watches, electronic toys and games, calculators) physicians and the general public should be more aware of this type of foreign body and the peculiarities in their management. We present five cases of button battery foreign bodies in the nasal cavities and review 12 cases described in the literature and discuss the special aspects of these foreign bodies.

Burns, Chemical↗

PubMed1997

[Tracheotomy in the child with a foreign body in the lower respiratory passages].

In 15 years period, 137 children with foreign bodies of inferior respiratory tracts were admitted in the otorhinolaryngology and head and neck department of the University of Dakar. For 48 of them, generally late admitted, a tracheostomy was performed. Male children were most affected. About 81% of the removed foreign bodies were organic, dominated by peanuts. 76% of the foreign bodies were found in the larynx. Tracheostomy had been realized before extraction of foreign body for 90% of the cases and after extraction for the others 10%. One case of death was to be deplored. This critical place of tracheostomy increases the morbidity and the mortality in relation with the inhalation of foreign body. This unusual practice of tracheostomy illustrates the arduousness of our working conditions.

Adolescent↗

PubMed2000

[Treatment of patients with foreign bodies in rectum].

The analysis of treatment results in 112 patients with foreign bodies in the rectum, aged from 16 to 80 years, was carried out. 99.1% of the patients were men. All the patients were examined and treated in proctology department of the Moscow municipal clinical hospital N 67 from 1969 to 1998. The examination was made by standard scheme, including rectal touch, rectoromanoscopy, X-ray and ultrasonic examinations. In 107 patients the foreign body was removed without surgery, 5 patients required laparotomy. When possible it was removed by fingers and also with use of forceps. When small foreign bodies could not be reached by finger, they were removed through rectoscope. Foreign bodies of big sizes, proximal end of which was in the sigmoid colon, were removed under anasthesia with the help of the assistant who fixed the foreign body through the abdominal wall in the left ileac region. In impossibility of the subject removal by these methods and presence of complications (perforation, peritonitis), laparotomy with subsequent transanal subject removal without colon section was performed, in case of perforation--with wound suturing or colostomy.

Adolescent↗

PubMed1999

Foreign body aspiration in childhood: management algorithm.

Foreign body inhalation is still a major cause of morbidity and even mortality in the under-fives. To reduce its frequency, more severe preventative measures must be imposed and to allow for early diagnosis, a low threshold for bronchoscopy is necessary. This retrospective study is based on 33 children referred to us for suspicion of inhaled foreign body. Symptomatology, clinical and paraclinical data are reviewed. Based on our practice and on the experience gained from the literature, we propose a management algorithm which will need to be further assessed by a prospective study.

Algorithms↗

PubMed2004

[Vegetable foreign body in the testis].

A vegetable foreign body located inside the testicular parenchyma is presented. It's about an unexpected pathological finding in an orchidectomy sample, performed on account of testicular atrophy secondary to very advanced funicular twist. The finding of a vegetal material inside the testis is outstanding. In our knowledge we don't know about another similar case. Pathologic aspects, including granulomatous reaction, regarding arguments of testicular atrophy and the foreign body eruption mechanism are discussed. The handling of the scrotum by paramedical people could justify his presence.

Acute Disease↗

PubMed1999

Foreign body granulomas due to injectable aesthetic microimplants.

We present two types of "new" foreign body granulomas caused by the injectable aesthetic microimplants Bioplastique and Artecoll. We report the clinical and histopathologic findings in five patients who had undergone treatment of mainly facial contour abnormalities with one of these implants. All patients were women, and the mean age was 45 years (age range 24-72 years). Two patients presented after treatment with Bioplastique; in three patients, augmentation was achieved by using Artecoll. Unsatisfactory cosmetic effects led to excision of the implants in four patients; in one patient, parts of the implant were excised during another cosmetic intervention. Subsequent histopathologic examination showed features of foreign body granulomas with distinctive cystic spaces. The clue to the diagnosis is the particular configuration of these cystic spaces and the characteristic shape of the foreign bodies. Bioplastique granuloma presents with irregularly shaped cystic spaces of varying size containing jagged, translucent, nonbirefringent foreign bodies whereas Artecoll granuloma shows numerous round vacuoles nearly identical in size and shape enclosing round and sharply circumscribed, translucent, nonbirefringent foreign bodies. These specific histopathologic findings unequivocally allow the correct diagnosis in spite of sparse clinical information.

Adult↗

PubMed1998

A rare foreign body impaction: a case report.

A case of unusual foreign body impaction of 6 years' duration is reported. The foreign body was retained in the right infraorbital region, extending to the ethmoid sinus. The importance of careful history taking and clinical examination and the problems encountered in evaluation of relatively radiolucent foreign bodies with magnetic resonance imaging are discussed.

Adult↗