History Of Foreign Body Research Articles

Impacted Toothbrush in the Oropharynx: A Case Report

Background
 Foreign body impaction in the throat is a common presentation in the Ear, Nose and Throat emergency room and may be associated with dare consequences.
 Case Report
 A nineteen-month-old female was rushed to the Accident and Emergency Unit, University of Benin Teaching Hospital (UBTH), Benin City with a history of foreign body in the throat of three hours duration. Examination revealed a broken toothbrush impacted the posterior oropharyngeal wall.
 She had impacted foreign body removed under local anaesthesia.
 Conclusion
 Foreign bodies in the throat can be fatal if not promptly managed. Impacted toothbrush in the throat could be life-threatening due to respiratory embarrassment. Therefore, a good toothbrush should be used, caution should be taken while brushing and toddlers should have their teeth brushed by adults.

A Case of Foreign Body Esophagus in a Six Year Old Child Previosly Operated for Esopageal Atresia: The Anesthetic Management

Foreign body ingestion is quite common in the pediatric age group. A six year old boy was brought by his parents to the hospital with history of foreign body (marble) ingestion. The child had been previously operated for the esophageal atresia. Imaging revealed a foreign body of 1.5cm size in the esophagus at the atretic part. The foreign body removal was initially attempted via rigid esophagoscopy but could not succeed. Hence, the procedure was changed to right thoracotomy for foreign body retrieval in the same sitting. Patient also had intraoperative itragenic trachea-esophageal fistula formation. General anesthesia was planned using single lumen cuffed ETT of 5.0mm ID for ventilation. Caudal catheter was inserted for postoperative pain management and early recovery following thoracotomy. Such cases of foreign body ingestion in an atretic esophagus should always be planned considering the unexpected extend of surgical procedure and peri-operative complications.

Should Psychiatry Be Consulted When Facing a Self-Inflicted Foreign Body in the Urinary Tract?

BackgroundOn encountering a self-inflicted foreign body in the urinary tract, it is common that emergency physicians only consult the department of urology, and no further evaluations from other specialties are sought. Psychological conditions can also involve people with psychiatric disorders who perform self-harming or sexual practices. Many case reports of foreign bodies have been reported in the literature. However, there is little information regarding which specialties to consult in this situation within the emergency department (ED).MethodologyThis case series study gathered information on 10 cases from patients who attended the ED from 2005 to 2020 with the diagnosis of genital or lower urinary tract foreign body.ResultsIn total, 10 patients were analyzed with a mean age of 37.3 (SD: ±14.1) years. Of the 10 patients, seven (70%) were males, and three (30%) were females. Overall, four (40%) patients presented with lower urinary tract symptoms (dysuria, tenesmus, hematuria, urinary frequency), five (50%) patients had a significant psychiatric history, and eight (80%) patients admitted having these practices for sexual gratification.ConclusionsForeign bodies in the lower urinary tract pose a significant challenge to ED physicians and urologists because some patients do not admit or do not recall inserting foreign bodies. Patients should be interrogated for mental illness, medication use, and a history of foreign bodies in the urinary tract or genitals during the initial evaluation. There is no consensus or screening method for such patients presenting to the ED. Hence, the use of complementary imaging studies and cystoscopy is fundamental for diagnosis. Further, it is essential to perform a psychiatric evaluation to diagnose or address any underlying psychiatric conditions that could cause this behavior.

A case of a large intraorbital wooden foreign body perforating the lateral orbital wall of left eye in a child

A 6-year-old child visited our institute with a history of foreign body that stuck in her eye. Computed Tomography (CT) scan report revealed hypodensity embedded in the left lateral orbital wall, abutting and compressing the globe of the left eye with displaced comminuted fracture. We performed a procedure of removal of foreign body from the eye, a procedure that was performed with great difficulty and precision given the sensitivity. On the postoperative day, nil foreign-body was noted in CT scan and there was chemosis and full eyeball movement. The cornea was clear, anterior chamber quiet, the pupil normally reactive. Dilated fundoscopy was normal. We report here a challenging case of a large intraorbital wooden foreign body in the left orbit of a child perforating the lateral wall of the left orbit, which on surgical removal the entire eyeball was found intact and normal. The patient's injury could be considered novel as it was unseen at the hospital and post operatively the anterior and posterior segment was found to be normal. This explain the rarity of the case and hence it hit our inquisitiveness.

A retrospective review of complicated foreign bodies of upper aerodigestive tract

<p class="abstract"><strong>Background:</strong> Inhalation/aspiration of foreign bodies (FB) into upper aerodigestive tract are very commonly encountered by otorhinolaryngologists. Most foreign bodies in adults are manageable, but sometimes can lead to fatal consequences in children. However, despite significant advances in instrumentation, they remain a therapeutic and diagnostic challenge. The aim was to study the clinical presentation, site of impaction, complications and management of foreign bodies in upper aerodigestive tract.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted in department of ENT-Head and Neck Surgery, Rajarajeswari Medical College and Hospital, Bangalore. A total of 50 eligible patients were reviewed who got operated for foreign body in upper aerodigestive tract under general anaesthesia. </p><p class="abstract"><strong>Results:</strong> History of foreign body was present in 86% of cases and 25% of the patients had complaints of difficulty in breathing. Nose being most common site in 74%, 70% of the patient belongs to 0-10 age group and male: female ratio was 1.7:1. Complications were seen in 12% of patients. Foreign body removal rate was 100%.</p><p class="abstract"><strong>Conclusions:</strong> Early diagnosis is the key to successful and uncomplicated management of FB in upper aerodigestive tract. An orderly and systematic approach along with proper history and clinical examination is keystone in diagnosis and early management.</p>

Acquired Tracheo-Esophageal Fistula : A Rare Case Report of the Neglected Denture

Introduction: Dentures are common accidental ingested foreign body (FB) especially among the elderly. It is frequent to have foreign body impacted at esophagus in adults however it is very unusual to have Tracheoesophageal fistula (TEF) caused by the denture. The diagnosis of TEF is challenging due to two reasons. Firstly, most of the dental prosthesis is radiolucent and not visible in the routine radiological investigation. Secondly, a patient with a history of swallowed dentures prosthesis may be asymptomatic initially and develops symptoms over time. On the contrary, the prolonged history of FB in the esophagus with TEF has a higher risk of developing serious complications such as pneumonia and lung abscess.Case Presentation: We report a case of a 62-year-old gentleman with a background history of hypertension and temporal lobe epilepsy presented with a history of choking on taking solid and liquid associated with significant weight loss past 2 months. He had lost his denture for almost 1 year during sleep. Endoscopic examination of the larynx showed normal anatomy but pooling of saliva. CT thorax showed a foreign body within a tracheoesophageal fistula. OGDS showed denture within a well-formed tracheoesophageal fistula. He had acquired TEF secondary to the dentures. Conclusion: Symptomatic elderly who lose their denture during sleep should not be neglected. They need immediate medical assessment thus will reduce further debilitating complications. Failing to identify and treat this condition urgently, the patient will suffer acquired trachea-oesophageal fistula on which the treatment is challenging and the morbidity and mortality are high.

Advantage of Computed Tomography (CT) Virtual Bronchoscopy in the Evaluation of Children with Suspected Foreign Body Airway

Background & Objectives: Foreign body aspiration (FBA) into the tracheo bronchial tree is a frequent and serious cause of respiratory distress and visit to the pediatrics emergency, principally in patients under 3 years of age. Most foreign bodies are not radio opaque and approximately one third of the children admitted will show normal chest X-ray. Virtual bronchoscopy is a relatively new and non-invasive procedure that provides a three dimensional view of the internal walls of the tracheobronchial tree through the reconstruction of axial images. The objectives of the study are, 1) to study the diagnostic accuracy and advantage of virtual bronchoscopy over rigid bronchoscopy in the evaluation of children with suspected FBA and to plan for early management as it is a non-invasive technique; 2) to study the clinical spectrum of children attending with suspected FBA. Methods: An observational study of 37 patients of age 12 yrs and below who underwent Virtual Bronchoscopy for suspected foreign body aspiration in the department of pediatrics and Otorhinolaryngology at MGM Hospital, Warangal is carried out for a period of 1.5 years during 2012-2013. Results: The common age of presentation was 1 - 3 years with male preponderance. History of foreign body was obtained in 64.86% of cases. Normal X-ray was found in 27.02% of cases. In 75.67% FB detected on rigid bronchoscopy was also revealed on virtual bronchoscopy. False positive percentage was 5.40% and false negative was 2.70%. Sensitivity and specificity was 96.5% and 75% respectively. Ground nuts were the commonest foreign bodies aspirated. Conclusion: Virtual bronchoscopy should be considered in cases with suspected foreign body aspiration, when chest X-ray is normal, to avoid needless rigid bronchoscopy. Virtual bronchoscopy is useful in screening cases of occult foreign body as it has sensitivity, specificity, and validity.

Foreign Body In Airways

A 13 year old girl presented with history of foreign body (metallic pin) inhalation/ingestion the day before, which was associated with an episode of choking and cough. Patient was asymptomatic at the time of presentation and had no relevant finding on chest examination and I/L examination. Chest radiograph revealed foreign body in the periphery outside the main bronchus and secondary bronchus giving an impression of the foreign body in left lower lobe lung parenchyma (Fig. 1) following which CT chest was ordered. JMS 2014;17(1):36

Value of helical computed tomography in the early diagnosis of esophageal foreign bodies in adults

PurposeTo investigate the relationship between early use of computed tomography (CT) and complications associated with esophageal foreign body impaction in adults. Material and MethodsA retrospective study was performed on 120 patients (63 females, 57 males, median age 50 years) with a history of foreign bodies. All had negative findings on clinical examination. All cases underwent unenhanced helical CT, and patients with positive findings underwent esophagoscopy within 6 hours. All patients were followed up postoperatively. ResultsCT demonstrated 100% sensitivity, 92.6% specificity, 100% negative predictive value, and 97.9% positive predictive value. Esophageal foreign bodies were associated with a high incidence of complications in adults, and there was a significant difference in the incidence of complications between different durations of impaction (P < .01). In total, 37 patients presented with complications: 32 patients with grade I, 3 with grade II, 2 with grade III, and 0 with grade IV. ConclusionsEsophageal foreign bodies were associated with a high incidence of complications in adults. CT could detect foreign bodies accurately in the early stages, and then FBs could be removed as early as possible, which may reduce the incidence of complications. Moreover, the great majority of complications were of lower grades. Thus, CT may be a useful first-line radiological tool for the early diagnosis of esophageal foreign bodies in adults.

A sterile acute retropharyngeal abscess.

A 12-year-old male admitted to ENT ward on an emergency basis with history of foreign body in throat. It came out along with induced vomiting, followed by fever, Odynophagia and restricted Neck movements. It is proved as a case of acute retropharyngeal abscess. But it turned out to be the sterile abscess, which is rare and new thing for us. Hence presented herewith-brief review of literature.

Urethral self‐insertion case report and review of the literature

AbstractSelf insertion of foreign bodies into the urethra is an unusual cause of presentation to the emergency department. In this case, a 36 year old man inserted a safety pin into his urethra. Medical advice was sought 10 hours after the pin became lodged in an open position with the point facing distally. After local anaesthetic gel was instilled into the urethra, the pin was closed with external pressure and removed.An open safety pin in the urethra has previously been reported only once in the medical literature. This appears to be the only definite description of a safety pin with such an unfavourable orientation being easily removed.Though removal of foreign bodies in the emergency department is likely to be an exceptional occurrence, there are important implications for emergency department staff. These include the diagnosis of foreign bodies presenting with complications, where the history of foreign body may not be given, and the issue of psychiatric review.

The management of ingested foreign bodies in children--a review of 663 cases.

Over a 3-year period, 663 children aged under 13 years were seen with a history of foreign body (FB) ingestion. Seventy-six per cent of the children were less than 6 years old. Coins and chicken or fish bones were the most common objects ingested. In 27 (4%) children, the FB had been expelled or removed before arrival, and in a further 133 (20%), no FB could be identified. Three patients required emergency airway management. Less than 50% of the children presenting with dysphagia or vomiting had identifiable FBs lodged in the oropharynx or proximal oesophagus, whilst 22% of the children with FBs requiring removal from these sites were asymptomatic. Oesophageal FBs were removed under direct vision (six cases), by rigid oesophagoscopy under general anaesthetic (77 cases), or using a balloon catheter under sedation (26 cases). All 224 FBs detected in the stomach or beyond were allowed to pass naturally, and delayed passage occurred in only one case. Passage of 11 alkaline disc batteries occurred without complication. No patient required surgical removal of an FB.

A prospective study of ingested foreign bodies in Singapore.

To evaluate the following: the symptoms, physical signs, investigation, and treatment of impacted foreign bodies (FBs); the dimensions of FBs according to site of impaction; and epidemiology, risk factors, and complications of FB ingestion. Prospective analysis of 397 patients with a history of FB ingestion. Department of Otolaryngology, Tan Tock Seng Hospital, Singapore, a referral center with institutional practice. Of the 397 patients treated between May and December 1991, ingested FBs were found in 197 patients. Foreign bodies were removed with forceps under direct or indirect vision; if this was impossible, removal was done endoscopically. Dysphagia, positive laryngeal rub, and drinking water tests had high sensitivity and specificity for esophageal FBs. Large and rigid FBs of various shapes tend to lodge in piriform fossae and esophagus and might cause complications if not removed early. The risk factors of FB ingestion were use of dentures and Chinese method of cooking and eating. The complication rate of impacted FBs was 5.1% and increased with the delay in seeking treatment. Flexible esophagoscope was found to be as effective as rigid esophagoscope in retrieving esophageal FBs. Lesions simulating impacted FBs were found in nine patients. In 162 patients in whom no FB was found, the symptoms resolved spontaneously within 16 days. Dysphagia, positive laryngeal rub, and drinking water tests are indicative of impacted FBs that must be removed early to prevent complications. Ability to use both rigid and flexible esophagoscopes is advantageous in FB retrieval.