Foreign Body Insertion Research Articles

200. THE PENETRATION OF THE THYROID GLAND BY A FISH BONE: A CASE REPORT AND REVIEW OF THE LITERATURE

Abstract Background Penetration of the thyroid gland by a fish bone is rare, and there is no literature describing a patient with hyperthyroidism at initial examination in whom the thyroid gland was penetrated by a fish bone. Case presentation A 51-year-old woman visited our hospital with left-sided neck pain. She had sensed a foreign body in her throat when eating a fish the previous day, but no abnormality was found by endoscopy. Blood examination revealed hyperthyroidism, and ultrasonography (US) revealed enlargement of the bilateral lobe with multiple adenomatous nodules and heterogeneous hypoechoic areas. The presumptive diagnosis was subacute thyroiditis, and treatment with prednisolone was initiated. Pain was reduced and tenderness moved to the right lobe. The phenomenon was diagnosed as creeping thyroiditis. However, computed tomography (CT) on day 4 demonstrated a linear hyperdense body in the left lobe. Esophagogastroduodenoscopy was repeated and revealed a fissure at the cervical esophagus. Her condition was then diagnosed as penetration of a fish bone into the thyroid gland. She was treated conservatively with monitoring to observe the course. Inflammatory signs significantly improved, so she was discharged on day 15. Subsequent CT and US did not show the presence of the fish bone. After three years have passed since discharge, there has been no recurrence of symptoms. Conclusions Penetration of the thyroid gland by a fish bone could result in a clinical course resembling subacute thyroiditis. CT and careful endoscopic inspection should be performed for patients with hyperthyroidism if foreign body insertion is not ruled out from the medical history.

Evaluation of the Quality and Readability of Web-Based Information Regarding Foreign Bodies of the Ear, Nose, and Throat: Qualitative Content Analysis.

Foreign body (FB) inhalation, ingestion, and insertion account for 11% of emergency admissions for ear, nose, and throat conditions. Children are disproportionately affected, and urgent intervention may be needed to maintain airway patency and prevent blood vessel occlusion. High-quality, readable online information could help reduce poor outcomes from FBs. We aim to evaluate the quality and readability of available online health information relating to FBs. In total, 6 search phrases were queried using the Google search engine. For each search term, the first 30 results were captured. Websites in the English language and displaying health information were included. The provider and country of origin were recorded. The modified 36-item Ensuring Quality Information for Patients tool was used to assess information quality. Readability was assessed using a combination of tools: Flesch Reading Ease score, Flesch-Kincaid Grade Level, Gunning-Fog Index, and Simple Measure of Gobbledygook. After the removal of duplicates, 73 websites were assessed, with the majority originating from the United States (n=46, 63%). Overall, the quality of the content was of moderate quality, with a median Ensuring Quality Information for Patients score of 21 (IQR 18-25, maximum 29) out of a maximum possible score of 36. Precautionary measures were not mentioned on 41% (n=30) of websites and 30% (n=22) did not identify disk batteries as a risky FB. Red flags necessitating urgent care were identified on 95% (n=69) of websites, with 89% (n=65) advising patients to seek medical attention and 38% (n=28) advising on safe FB removal. Readability scores (Flesch Reading Ease score=12.4, Flesch-Kincaid Grade Level=6.2, Gunning-Fog Index=6.5, and Simple Measure of Gobbledygook=5.9 years) showed most websites (56%) were below the recommended sixth-grade level. The current quality and readability of information regarding FBs is inadequate. More than half of the websites were above the recommended sixth-grade reading level, and important information regarding high-risk FBs such as disk batteries and magnets was frequently excluded. Strategies should be developed to improve access to high-quality information that informs patients and parents about risks and when to seek medical help. Strategies to promote high-quality websites in search results also have the potential to improve outcomes.

Coin-cidence? Have cashless payments reduced the incidence of upper aerodigestive foreign body insertion? A study of UK Hospital Episode Statistics.

Insertions of nasal and oral foreign bodies (FB) are common presentations in the emergency department, with coins frequently implicated among paediatric populations. Contactless payments were first introduced in the UK in 2007, and cash payments significantly declined from 2012. This study aims to explore the potential implications of increasing contactless payments on FB ingestion. UK Hospital Episode Statistics (HES) were reviewed between 2000 and 2022. All FB retrieval procedures involving the alimentary tract, respiratory tract and nasal cavity were included. Regression analysis was performed to assess trends in the incidence of FB ingestion before and following the transition to cashless payments in 2012. Following the decline in cash payments in 2012, the frequency of alimentary tract FB removal procedures decreased significantly by 27.78 procedures per year (p < 0.001). Similarly, respiratory FB removal procedure decreased by 4.83 per year (p = 0.009) and nasal cavity FB removal procedures decreased by 52.82 per year (p < 0.001). This study suggests a statistically significant decline in the number of procedures for removal of FB performed in the UK from 2012. Although this relationship is multifactorial, our data suggest an association between the introduction of contactless payments and a reduction in the number of FB retrieval procedures from the of upper aerodigestive tract.

A tale of two stones in nose

Rhinolith is stone formation in nose. It is very rare. Here we discuss 2 cases of rhinoliths along with its management and review the literature. First is a case of giant rhinolith detected in a 41-year-old male patient and second is rhinolith in a 52-year-old lady with no known history of foreign body insertion. This article can enable the attending clinician to diagnose this still prevailing condition with high index of suspicion leading to its appropriate management.

ENDOSCOPIC TRANSANAL REMOVAL OF EGG FROM RECTOSIGMOIDAL JUNCTION

It is not uncommon that we encounter patients with different kinds of foreign bodies in the rectumfor a variety of reasons. Most of the cases reported in the literature reveal that rectal foreign body insertion is mainly for sexual gratification. To avoid the embarrassment and scrutiny, patients often delay seeking medical help which complicatesmedical management. We discuss a case of a 21-year-old male who presented after voluntary insertion of multiple eggs into the anus. Although the suggested protocol and technique was followed to retrieve the egg and the debris, it still required some creativity and careful methodology.

(214) Urethral and Vaginal Injuries Caused by Insertion of Foreign Objects for Sexual Stimulation: A Literature Review of Sexual Emergencies in Males and Females

Abstract Introduction Foreign body genital tract injuries involve injuries to the male or female reproductive organs, including the vagina and urethra, often requiring urgent care from medical professionals. These injuries are associated with autoerotic stimulation, psychiatric disorders, curiosity, self-harm, or lack of knowledge of safe sexual practices. Early diagnosis and management in the emergency department (ED) are crucial to prevent irreversible damage and potential life-threatening complications. This review aims to comprehensively examine sexual emergencies caused by foreign body genital tract injuries, specifically focusing on vaginal and urethral injuries, while also highlighting common complications and contributing factors. Objective 1. Provide a comprehensive review of foreign body genital tract injuries presenting in ED's at national and international levels. 2. Highlight ED management and common complications associated with these emergencies. 3. Improve medical management, enhance understanding of causative factors, and promote patient education to prevent recurrence. Methods A literature review was conducted using PubMed and Google Scholar databases. Search terms included "foreign body," "sexual," "masturbation," "vagina," and "urethra." Out of 53 articles published between 1985–2023, 16 met the inclusion criteria for analysis, focusing on injuries involving the urethra or vagina and autoeroticism. Results The review included 141 cases of genital injuries caused by foreign body insertion during sexual activities. Males accounted for 128 cases, females for 12, and one was a transgender female. Various foreign bodies, such as silverware, glass, batteries, rings, tubes, and beads, were found to have caused injuries and complications. Surgical management was indicated in 19 cases, non-surgical management in 7, while the approach in 115 cases remained unknown. Conclusions The literature review serves as a crucial reminder of the potential dangers of foreign body insertion during sexual activities. It calls for increased awareness, improved clinical recognition, and better patient education to safeguard individuals from these preventable injuries. By understanding and addressing this issue, healthcare professionals and the broader community can work together to reduce the incidence of genital injuries related to foreign body insertion and enhance overall patient safety and well-being. Disclosure No.

Paraphilia Induced Suicide: A Case Report

Paraphilia is a term used to describe different sexual deviations involving unconventional methods of sexual gratification. Paraphili as indulged in abnormal and orthodox sex play by using objects as parts of the body or fantasies in which complete satisfaction is sought and obtained without sexual intercourse. Perversions are acts that are socially prohibited or unacceptable, or biologically undesirable. In sexual paraphilia, usually, person psychopaths suffer from mental aberrations and conflicts, socio-sexual maladjustments, psychosexual imbalance, and abnormalities. Paraphilia-induced suicide is a type of anomic suicide, and anomic suicide is due to a lack of social regulation that occurs during high levels of stress and frustration. Paraphilia may induce suicide even though paraphilia is not punishable. It is just due to fear of social defamation and social taboo. Case presentation: A 59-year-old male committed suicide on the railway track, and thenthe body was sent to the mortuary room for an autopsy examination. History was taken from the police and relatives. He was a widower for the last 15 years. Conclusions: Paraphilia is the form of the insertion of foreign bodies in the rectum, and when a person cannot remove foreign bodies himself, attending a hospital is very humiliating. To prevent the social integrity or selfesteem, the person committed suicide. Where this type of paraphilia is not listed as a crime in India, for sexual gratification, a person may use it by any means, which may be natural or unnatural form. Many unnatural forms of paraphilia are used by many people, which is not punishable. Sexual gratification is done by most of normal people and a few abnormal psychiatric people by any sexual perversion. All paraphilia that is not punishable by the law should not be considered a social taboo.

Comprehensive analysis of power tool injuries: implications for safety and injury prevention

BackgroundPower tools are essential for productivity but carry significant injury risks. Addressing power tool injuries across diverse age groups is vital, as existing research predominantly focuses on specific occupational or non-occupational groups, leaving a gap in understanding various age cohorts within the diverse American population. This study aims to comprehend power tool injury epidemiology, raising awareness about the importance of targeted safety measures for enhancing public health. MethodsUsing a ten-year retrospective approach, this study analyzed National Electronic Injury Surveillance System (NEISS) data from US hospital emergency departments (2013–2022). Demographic and temporal trends were examined, and associations between injury occurrence and categorical variables, including injured body parts, gender, and race, were explored. ResultsIn 2013, power tool injuries were highest in the "51–60″ age group (23.70 %), followed by "41–50″ (17.31 %) and "61–70″ (19.38 %). Injury rates varied across age groups over the years. Notably, the "41–50″ age group showed a significant decrease in injuries over time (χ² = 17.12, p < .05), indicating a notable temporal trend. Hand injuries were predominant (39.08 %), followed by finger (19.19 %), lower arm (11.25 %), upper arm (8.79 %), and face (4.04 %). Lacerations constituted the most frequent injury type (60.89 %), alongside fractures, amputations, foreign body insertions, and contusions/abrasions. Significant associations emerged between injury occurrence and gender (χ² = 6.19, p < .001), as well as race (χ² = 7.42, p < .001). Males accounted for the majority of injuries (95.97 %), while white individuals constituted the largest proportion (91.84 %). Females and domestic settings exhibited increasing proportions of power tool injuries. ConclusionsThe higher incidence among middle-aged individuals in domestic settings, coupled with evolving gender dynamics, underscores the need for targeted safety measures. Our findings contribute crucial novel insights, emphasizing tailored preventive strategies to enhance safety outcomes in the multifaceted landscape of power tool use.

Combined laparoscopic and endoscopic method for foreign body removal from descending colon: A case report

BACKGROUND The majority of published reports on foreign bodies (FBs) involve the rectum and applied a transanal retrieval. Usually, patients with FB above the rectum are subjected to laparotomy for removal. Here, we illustrate the case of a man with an FB that had migrated into the descending colon, and its successful removal via a laparoscopic approach. CASE SUMMARY A 43-year-old man, who had the habit of FB insertion into his anus to aid defecation, presented upon experience of such an FB slipping through and migrating upward to the distal colon. Plain abdominal radiograph revealed a bottle-shaped FB, positioned in the left iliac fossa region. The FB was successfully removed via a laparoscopic-assisted procedure in which we combined diagnostic laparoscopic and endoscopic techniques during surgery. The patient was monitored for 2 d postoperatively and subsequently discharged home. CONCLUSION A minimally invasive approach should be adopted to aid extraction of colorectal FB as it is effective and safe.

IMAGING CHARACTERISTICS AND PREDICTIVE FACTORS OF COMPLICATED GASTROINTESTINAL FOREIGN BODIES IN COMPUTED TOMOGRAPHY

Background: Gastrointestinal foreign body is a frequently encountered problem in daily practice at the Emergency Department. The majority of gastrointestinal foreign bodies will pass spontaneously, but in several cases, severe or even fatal complications can happen. X-rays, endoscopy, and computed tomography are the most common imaging modalities to diagnose gastrointestinal foreign bodies. Method: In our study, twenty-five patients who were diagnosed by CT and treated for gastrointestinal foreign bodies were reviewed retrospectively. The predictive risk factors for complications after foreign body ingestion or insertion were analyzed by multivariate logistic regression, including age, sex, type of gastrointestinal foreign body, and imaging characteristics in CT (location, size, thickening and enhancing bowel wall, fat infiltration, collection, and free gas). Results: All foreign bodies were sharp-pointed, and the average length was 30.56 ± 10.03 mm (11-54 mm). Bones accounted for 64% of cases, toothpicks followed with 16%. The most common location for foreign bodies in digestive tract was the small intestine, followed by the stomach, esophagus, and colon. Thickening and enhancing bowel wall, fat infiltration were both seen in most cases of 84%. Transmural foreign bodies accounted for 56% and perforation, abscess were more frequent complications with 64%, and 16% of cases, respectively. Multivariate analysis showed that size (p &lt; 0.014) and type (p &lt; 0.035) were significant independent risk factors associated with the development of complications in patients with gastrointestinal foreign bodies. Conclusion: CT plays a crucial role in the detection and diagnosis of gastrointestinal foreign bodies and its complications. In patients with gastrointestinal foreign bodies, the risk of complications was increased with bone type and larger size of foreign bodies.

Diagnostic challenge in a case of foul-smelling vaginal discharge in a newly attained menarche girl

Foul-smelling vaginal discharge in adolescents often stems from infectious origin, foreign body insertion, neoplasm, congenital anomaly, and sexual abuse. Diagnosing the causes of the discharge remains challenging, especially in cases where sexual and reproductive health awareness is relatively low in the population from marginalized ethnographies and socio-cultural backgrounds. Suspicion of sexual abuse must be explored carefully and sensitively. A history of sexual exposure might not be forthcoming in adolescents where premarital sex is frowned upon. The process of eliciting the causation may be a challenge to healthcare professionals, delaying the diagnosis and subsequent management. In rare circumstances, imaging studies may help confirm the origin of the infection, giving insight into the presentation’s aetiology. We describe a case of Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome presented with foul-smelling vaginal discharge in a newly attained menarche girl in the North-East region of Peninsular Malaysia. We also discussed the theories and reasons behind the occurrence of such a presentation, along with the diagnostic dilemma in this current case.

FRI509 A Girl With Trisomy 21 Presents With Van Wyk-Grumbach Syndrome

Abstract Disclosure: J. Hayes dorado: None. M. Calla Ayala: None. A. Colque Arias: None. K. Lanuza Gaite: None. M. Rossell Lopez: None. D. Frias Eid: None. Van Wyc-Grumbach syndrome (VWGS) is a rare presentation of long standing prepubertal hypothyroidism characterized by bilateral multicystic enlarged ovaries, vaginal bleeding and delayed bone age. It appeared that high TSH could produce FSH and LH like activity leading to multiple ovarian cysts. A 7-year-old girl with trisomy 21, presented with vaginal bleeding for 2 days prior to admission. Physical exam revealed bradycardia (68 bbm), apathy, sluggishness, as well as dry skin and eyelid oedema. She had no breast development nor pubic hair.Causes of vaginal bleeding such as trauma, possible abuse, foreign body insertion and urethral prolapse were excluded. There was no purpura or bleeding from other sites.The abdominal sonogram revealed bilateral ovarian cystic masses (V:17.29 cm3 and 16.48 cm3, right and left, respectively). Bone age was delayed almost 3 years behind her chronological age. Laboratory tests revealed TSH 860 μIU/mL, T4 0.71 μg/dL, FSH 8.12 mIU/mL, LH &amp;lt; 0.1 mIU/mL, estradiol 193 pg/mL, thyroid peroxidase Abs 184 IU/mL, thyroglobulin Abs 212 IU/mL, Β-hCG &amp;lt; 0.1mU/mL, confirming severe hypothyroidism. The girl was diagnosed with VWGS due to unrecognized chronic lymphocytic thyroiditis and LT4 treatment (75mug/OD) was initiated. The patient responded with complete remission of symptoms and regression of the ovarian cysts one month after initiation of treatment. It is very important to think of VWGS and investigate for thyroid status during the evaluation of ovarian cysts or isolated premature menarche. Early recognition can eliminate unnecessary surgery to remove ovarian cysts, as appropriate treatment with levothyroxine leads to complete remission of symptoms. Even when the diagnosis of VWGS is confirmed, practitioners must be watchful to consider surgical intervention in the presence of uncontrolled vaginal bleeding, hemodynamic instability, or failure of regression of ovarian cysts with exogenous thyroid hormone replacement. Presentation: Friday, June 16, 2023

Peculiar penetrating oropharyngeal foreign body accident: a case report and review of literatures

BackgroundChildren are curious to learn and are always explorative. This exploration is sometimes by keeping things in the oral cavity resulting in cases of foreign body in the aerodigestive tract. Penetrating oropharyngeal foreign bodies can result in significant morbidity and mortality if not treated promptly. The usual objects implicated in children are pens, pipes and toys which are cylindrical. The injury commonly occurs when the child falls with foreign body in the mouth. Here, we present a case report of a peculiar penetrating oropharyngeal foreign body accident.Case presentationA 7-year-old boy was brought to the emergency room with an alleged history of foreign body insertion into the mouth while playing with a rigid metallic rod which was bent in the end. Following a forceful hit on the head of the child by his sibling from behind, the rod got impacted into the mouth. The screening X-ray revealed an impacted foreign body. Non-contrast computed tomography scan was done on an emergency basis. It revealed hook-shaped metallic foreign body in the oral cavity and penetrating the oropharynx at the tongue base region. The effective total length of FB was 30 cm with an embedded intraglossal component of 2.5 cm. To aid in intubation, the extraoral part of the foreign body was cut short preoperatively. C-MAC video laryngoscope was used to aid in intubation. A backup plan for emergency tracheostomy was made in case of failed intubation. The foreign body was held using Kocher’s artery forceps and removed completely under endoscopic visualisation without any significant bleeding from the site of entry.ConclusionThe unusual shape, the relatively narrow space in the patient and the tongue being a vascular structure were challenges in the removal of the foreign body. Due to the hook shape, it had to be withdrawn cephalad for removal. Penetrating oropharyngeal foreign body should not be pulled out either at primary care or in the emergency room but should be referred to experienced ENT surgeons. Critical teamwork between the ENT surgeon and the anaesthetist with well-defined preoperative plans for airway management is necessary. Awareness and ensuring safe play areas for children will prevent a great deal of penetrating oropharyngeal foreign body.

Rectal Foreign Body Causing Perforation: A Case Report

The rectal foreign body is a rare presentation with rising incidence. We present a case of a 26-year-old heterosexual male with an alleged history of sexual assault with insertion of a large foreign body through the anus two days prior with peritonitis. After investigations, the patient underwent an exploratory laparotomy, foreign body removal, primary repair of perforation with a diverting colostomy. Diversion must be considered in cases where the extent of anal sphincter mechanism injury is in question. The patient had a good outcome. Assessment of the shape, size, nature, and location of the object through appropriate imaging is necessary. Exploratory laparotomy is inevitable in cases of perforation.

The key role of hepatology providers in optimizing reproductive care in patients with liver disease: A call to action.

The key role of hepatology providers in optimizing reproductive care in patients with liver disease: A call to action.

Analysis of Nasal Foreign Bodies in South Korea: Over 10-Year Experience

Foreign bodies (FBs) in the nasal cavity are commonly encountered in otorhinolaryngology. This retrospective study was conducted between January 2009 and December 2020. The nasal FB frequencies were investigated according to age and sex. The type, shape, and location of the FBs, onset, and clinical features were obtained. In a total of 1228 cases, the average age was 3.9 ± 5.7 years. We found a higher incidence in patients 2–4 years old. The most frequent nasal FBs were beads (24.0%), toys/plastics (17.8%), and beans/corn (15.8%). However, there were some differences in the nasal FB types according to the age group. There was no difference in the location of the nasal FBs according to age group, but nasal FBs were found more frequently in the right nasal cavity in the 1–3-years-old groups. Most patients (97.5%) visited the hospital the same day when the nasal FB insertion was suspected, and most were asymptomatic. After the removal of the nasal FBs, most patients were free of complications. Of the nine cases involving button batteries, septal perforation was observed in two patients who visited the hospital one or two days after the FB insertion. There were specific age-based characteristics of the nasal FBs that may serve as a basis for specific precautions.

P16 Endoloop ligatures in the retrieval of urethral foreign bodies: a narrative review

Abstract Introduction Self-insertion of foreign bodies into the urethra has been described previously in patients presenting to hospital emergency services. Treatment typically involves procedural retrieval under local anaesthesia using basket or forceps, cystoscopy, or open surgery. An Endoloop is a device designed to snare colonic polyps during endoscopy with nylon loops. It is not traditionally used for retrieval of urethral foreign bodies. Our objective was to determine the incidence, safety and efficacy of this approach. Methods A narrative review was performed. Primary outcomes were technical success, defined as uncomplicated retrieval of foreign body, and adverse events related to pain, bleeding, infection, and damage to structures. Electronic searches were performed using PubMed, Embase and Google Scholar. Reference lists of selected studies were searched manually. Results 2 case studies met inclusion criteria for analysis, both describing self-insertion of urethral foreign bodies for purposes of sexual arousal. These comprised a 30-year-old male (magnets) and a 29- year-old female (metal urethral sound). Both patients underwent successful retrieval of foreign body using an Endoloop ligature. There were no symptoms post-operatively and no procedural complications were reported. Conclusion An Endoloop ligature should be considered in conjunction with endoscopy when difficulties are experienced or anticipated with basket or forceps retrieval. Follow-up is mandatory to monitor for complications due to foreign body insertion such as urethritis, incontinence, fistula and diverticulum formation. Referral to psychological services is encouraged to reduce the risk of recurrence. Further studies are required to validate the efficacy and safety of this technique. Take-home message An Endoloop ligature should be considered in conjunction with endoscopy when difficulties are experienced or anticipated with basket or forceps retrieval of urethral foreign bodies.

Management of esophageal perforations in infants by endoscopic vacuum therapy: a single center case series

BackgroundEndoscopic vacuum therapy (EVT) has become a standard treatment method for esophageal perforations in adults. However, experience with EVT in infants is scarce. In this retrospective case series, we report on four very young infants who were successfully treated with EVT for esophageal perforations of different etiology.MethodsFour infants were diagnosed with esophageal perforations on day 7, 32, 35 and 159 of life, respectively. The youngest one was prematurely born in the 31st week of pregnancy weighing 980 g only. Three infants had perforations due to foreign body insertion (nasogastric tube or pulling through of percutaneous endoscopic gastrostomy (PEG) tube through the esophagus). One child had an anastomotic dehiscence after Foker’s surgery for atresia. In three children EVT was applied as first-line therapy for perforation, in one child EVT was a rescue therapy due to persisting leakage after surgical closure involving thoracotomy. Depending on the esophageal diameter, either an open-pore drainage film or polyurethane sponge was attached to a single-lumen 8 Fr suction catheter, endoscopically (or fluoroscopically by wire-guidance) placed into the esophagus (intraluminal EVT) and supplied with continuous negative pressure (ranging between 75 and 150 mmHg). The EVT system was exchanged twice per week.ResultsComplete closure of the perforation/leakage could be achieved in all four infants (100%) after 22 days of continuous EVT (median value; range 7–39) and 4.5 EVT exchanges (median value; range 1–12). No serious adverse events occurred.ConclusionsEVT is an effective and safe addition to our therapeutic armamentarium in the management of esophageal perforations irrespective of its etiology. Here we prove the feasibility of EVT even in very young infants. The use of an extra thin vacuum open-pore drainage film is helpful to cope with the small esophageal diameter. EVT settings and exchange rates similar to those known from adult treatment were used.

Characterization of Pediatric Genital Injuries Due to Consumer Products From 2011 to 2020

ObjectiveTo describe demographic trends of consumer product-related injuries in the pediatric cohort from 2011 – 2020. MethodsThe National Electronic Injury Surveillance System (NEISS) database surveying emergency department visits was retrospectively searched for all pediatric genitourinary injuries from 2011 to 2020. Data on demographics, diagnosis, products, disposition, and anatomy injured were collected on patients between the ages of 0-19 years. Statistical analysis was performed using linear regression. ResultsThere were 12,953 reported pediatric cases involving injuries of the genital region from 2011 to 2020 with a national estimate of 324,636 (95% CI 241,527 – 407,746) pediatric genital injuries, comprising 0.76% of total pediatric injuries in the past decade. Of these patients, female (54.2%), white (39.7%) individuals sustained the most injuries, and items most commonly responsible included bicycles (9.4%), playground equipment (6.9%), toilets (4.6%), beds (4.5%), bathtubs and showers (4.4%), soaps (4.4%), chairs (4.1%), and razors and shavers (2.3%). Urethral injuries were due to chemical injuries from soaps (22%), furniture (17%), playground injuries (17%), insertion of foreign bodies into the urethra (13%), bicycles (10%), and swimming related injuries (4%). Genital injuries in children 0-5 years old were primarily caused by furniture (47.8%), while injuries in the 6-10, 11-15, and 16-19 age groups were attributed to sports and recreation (41.2%, 24.6%, 12.2% respectively). There was no significant change in the annual number of pediatric genital injuries from 2011 to 2020 (R2 = 0.38, P = 0.057). ConclusionIdentifying factors involved in pediatric genital trauma can allow for increased legislation, surveillance, and prevention of such injuries in targeted age groups.

Self-Inserted Urethral Foreign Body

Self insertion of foreign body in a male urethra is rare. Foreign bodies are mostly inserted by intoxicated, confused, and sexually curious individuals. In addition to a suitable method of surgical removal, counseling and psychiatric evaluation are often necessary to prevent recurrences.