Ultrasound-Guided Percutaneous Removal of Foreign Body Using Hydrodissection and Serial Dilators

Abstract

High-resolution ultrasound of the painful, swollen left heel of a 54-year-old man, who reported that his symptoms had lasted 4 months, showed retention of a wooden foreign body in the heel. After administering local anesthesia and making a 5-mm skin incision, we performed hydrodissection of the foreign body from the adjacent soft tissue under real-time ultrasound guidance, using a 1% lidocaine solution. Then, we introduced an 18-gauge spinal needle and inserted a guide-wire through the needle. After we removed the needle, we introduced serial dilators in sizes ranging from 7 French to 12 French along the guide-wire to create a tract for mosquito forceps. Then, we introduced the mosquito forceps and removed the wooden foreign body. Ultrasound-guided percutaneous removal of foreign bodies is quick and safe. We believe that hydrodissection makes removal easier and that use of serial dilators minimizes soft-tissue injury and makes it easier to introduce mosquito forceps.