Iatrogenic Foreign Body Research Articles

Posttraumatic and iatrogenic foreign bodies in the heart: report of fourteen cases and review of the literature

Objective Our experience with posttraumatic and iatrogenic foreign bodies in the heart is presented and discussed along with a review of the literature on this subject. Summary background data Posttraumatic or iatrogenic foreign bodies in the heart can be treated either conservatively or surgically. Controversy exists about optimal management. Methods Fourteen cases of posttraumatic or iatrogenic foreign bodies in the heart observed between 1955 and 2000 were studied. Our series includes the following: bullets into the right or left ventricle (4 cases); needles in the left ventricle, atrium, and pulmonary artery (3 cases); retained catheter fragments in the right ventricle, right atrium, or in the pulmonary artery (4 cases); a grenade fragment into the right atrium (1 case); a circular saw fragment into the right ventricle (1 case); and a commissurotomy ring into the left atrium (1 case). Results Foreign bodies were removed when in the cardiac cavities (1 case); when in the presence of associated risk factors like embolism, arrhythmia, or infection (3 cases); and when in the presence of associated signs or symptoms including cardiac tamponade (2 cases), arrhythmia (1 case), fever (2 cases), or anxiety (1 case). Removal was accomplished by a thoracotomy (7 cases) or sternotomy (2 cases), with (3 cases) or without cardiopulmonary bypass, or percutaneously (1 case). Four asymptomatic patients were conservatively treated and have no evidence of complications at a median follow-up of 20 years. Conclusions The management of foreign bodies in the heart should be individualized: (1) symptomatic foreign bodies should be removed irrespective of their location; (2) asymptomatic foreign bodies diagnosed immediately after the injury with associated risk factors should be removed; (3) asymptomatic foreign bodies without associated risks factors or diagnosed late after the injury may be treated conservatively, particularly if they are completely embedded in the myocardium or in the pericardium.

Missing washer of the rib approximator? An easily overlooked foreign body

Iatrogenic Foreign bodies especially Gauze swab following surgery are well reported. We report a very unusual case of a loose washer from SELLARS rib approximator, which came out loose in a thoracotomy wound. It was not recognised till reported missing by the central surgical supply department. The foreign body was identified and removed successfully. This case highlights the importance of checking the small connections of the instrument as a routine and especially if an instrument become loose.

抜歯器具の破折片が下顎骨内に迷入した２例

Reports of iatrogenic foreign bodies in the jaw are rare. Two cases of accidental insertion of broken extracting instruments into the mandible are reported. These accidents occurred during removal of impacted mandibular third molars. One patient was referred on the day of the accident, and the other was referred 2 months after the accident. Radiographs revealed metal foreign bodies in the mandible, separate from the tooth sockets. The objects were removed by enlargement of the tooth sockets. They were a broken elevator and a broken root tip elevator. Healing was uneventful, but one patient had prolonged sensory nerve disturbance of the lower lip.

Artifacts and pitfalls in sonographic imaging of the breast.

1261 onography is an increasingly important tool to the breast imager both for evaluation of breast lesions and for guidance of percutaneous interventions. Although sonography has historically been used for differentiating cystic from solid breast masses, there has been growing interest in using sonography to differentiate benign from malignant solid masses [1, 2] and for screening the breasts of women with dense tissue [3]. Sonographic image quality has improved dramatically since its early use for breast imaging during the 1970s because of advances in technology such as the use of all-digital high-frequency transducers of up to 13 MHz, color and power Doppler imaging, and harmonic imaging. Despite these advances, the potential remains for encountering artifacts or unexpected, spurious findings during breast sonography. The artifacts and pitfalls associated with breast sonography are important to recognize because they may result in the failure to recognize a breast cancer or prompt unnecessary biopsy of a benign finding. Common sources of error include the failure to recognize the sonographic appearance of normal breast anatomy, the improper setting of instrumentation controls, peculiarities of sonography physics, and the presence of iatrogenic air and foreign bodies in the breast. To minimize confusion and misdiagnosis, we review and illustrate characteristic artifacts and pitfalls encountered during sonographic imaging of the breast.

The Echocardiographic Diagnosis, Characterization, and Extraction Guidance of Cardiac Foreign Bodies

Echocardiography is ideal for localizing cardiac foreign bodies and for characterizing associated cardiac and vascular injury before and during extraction. We report 5 cases of traumatic and iatrogenic cardiac foreign bodies that illustrate the central role of transthoracic and transesophageal ultrasonography in the management of these patients.

The echocardiographic diagnosis, characterization, and extraction guidance of cardiac foreign bodies

Echocardiography is ideal for localizing cardiac foreign bodies and for characterizing associated cardiac and vascular injury before and during extraction. We report 5 cases of traumatic and iatrogenic cardiac foreign bodies that illustrate the central role of transthoracic and transesophageal ultrasonography in the management of these patients.

Percutaneous transluminal retrieval of intravascular iatrogenic foreign body by loop-snare technique

Percutaneous transluminal retrieval of intravascular iatrogenic foreign body by loop-snare technique

Iatrogenic Penile Foreign Body

British Journal of UrologyVolume 67, Issue 5 p. 555-556 Iatrogenic Penile Foreign Body S. D. MARK, Corresponding Author S. D. MARK Department of Urology, Waikato Hospital, Hamilton. New ZealandDepartment of Urology, Christchurch Hospital, Private Bag, Christchurch, New Zealand.Search for more papers by this authorJ. M. GRAY, J. M. GRAY Department of Urology, Waikato Hospital, Hamilton. New ZealandSearch for more papers by this author S. D. MARK, Corresponding Author S. D. MARK Department of Urology, Waikato Hospital, Hamilton. New ZealandDepartment of Urology, Christchurch Hospital, Private Bag, Christchurch, New Zealand.Search for more papers by this authorJ. M. GRAY, J. M. GRAY Department of Urology, Waikato Hospital, Hamilton. New ZealandSearch for more papers by this author First published: May 1991 https://doi.org/10.1111/j.1464-410X.1991.tb15211.xCitations: 13AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume67, Issue5May 1991Pages 555-556 RelatedInformation

Delayed Socket Granuloma Formation Following Evisceration

We report a rare granuloma of the socket that simulated a conjunctival squamous cell carcinoma in a patient treated with evisceration six and a half years earlier. An excisional biopsy revealed loose connective tissue with marked capillary proliferation and lymphocytic infiltration. The cut end of a silicone exoplant, used to treat a preceding traumatic retinal detachment, was found at the base of the lesion. Prior operative procedures should be reviewed in patients presenting with socket lesions to exclude the presence of an iatrogenic foreign body.

Non-surgical retrieval of iatrogenic foreign bodies from the heart and great vessels

Non-surgical retrieval of iatrogenic foreign bodies from the heart and great vessels

Iatrogenic foreign body

Iatrogenic foreign body

Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies

Intravascular embolization of polyethylene catheter fragments continues to occur, the majority from intravenous indwelling catheters. Sixty-nine nonsurgical retrievals of embolized fragments have been reported. The various recorded retrieval techniques are reviewed as well as their respective successes and limitations. Complications of snare techniques, unsuccessful retrieval attempts, and factors influencing the choice of local surgical removal versus snare techniques are discussed. The fate of patients from whom embolized catheter fragments were not removed is reviewed in depth. Our figures indicate a 71% incidence of death or serious complication, which is significantly higher than previously reported.

Iatrogenic foreign body

Iatrogenic foreign body

Acupuncture needles: a "new" foreign body in the ear

With the recent popularity of acupuncture therapy and anesthesia in the United States, patients are having temporary needles placed in the external ear. These matallic radiopaque needles appear on routine skull and mastoid examinations. This article is written to familiarize radiologists with this ""new'' iatrogenic foreign body.

Iatrogenic intravesical foreign body following Marshall-Marchetti procedure

as reported is 1 : 3. The fetus in this case was male; the other two fetuses were female. This fetus was born alive but died shortly thereafter; our other two fetuses were stillborn. Beischer reported 54 stillborn and 38 live births with 19 survivors, Ultrasound was not used in our case as the convulsive state necessitated speed) resolution; however, it was disappointing in our other cases. One was reported as negative, and the other was inconclusive until the presence of a fetus was confirmecl by amniography. Ultrasound might be expected to help make the diagnosis but the molar transformation would have to be extensive for this to be made. With a coexistent fetus the molar transformation may be only minimal.’ A urinary chorionic gonadotropin level of 350,000 I.U. per liter, or a serum level of more than 320 I.U. per milliliter, after day 100, has been found to be consistently accurate in diagnosing the presence of a mole. Our patient had a titer of at least 3,000,OOO I.U. per liter of urine. Titers of greater than 350,000 I. U. per liter of urine were also present in our other two cases. It would seem, then, that in any case of toxemia with an early onset a titer of urinary chorionic gonadotropins should be done. It is an inex’pensivc and rapid test and would undoubtedly uncover manv cases without extensive molar transformation which might be missed at delivery.

Iatrogenic Foreign Bodies in Air Passage

So far, iatrogenic foreign bodies were somewhat hesitated to report in medical journals. Recently, following cases of iatrogenic foreign bodies in air passage were seen in our clinic; adenoid mass, a piece of a fractured metal stylet, an injection needle, tooth, a damaged electric bulb for bronchoscopic illumination and a cotton ball. These foreign bodies seem to be unpredictable to occur. Intense precaution during surgery by physicians involved in upper air way (otolaryngologists, anesthesiologists, dentists, chest surgeons etc) and constant inspection of medical instruments by operation room staffs could avoid these unhappy accidents.

A Case Report of an Iatrogenic Bronchial Foreign Body Extraction, using the Flexible Fiberoptic Bronchoscope

A 48 year old male who 20 years ago underwent a right upper lobectomy with thoracoplasty for pulmonary tubercuiosis, since then he did'nt have any symptom, however recently complained of repeated episodes of sudden high fever, cough, putrid sputum and occasionally bloody sputum, and was diagnosed as having a broncho-fistula. When he was examined by preoperative fiberoptic bronchoscopy (F.F.B.), he was discovered to have a gauze lodged in his right upper bronchus. The second and the third F.F.B. were done for the purpose of extracting the gauze from his bronchus. Because of our experience, the author would like to emphasize the following:1) A bronchoscopist should pay attention to local changs in the air-way, sometimes local changes tells where the foreigh body is lodged.2) There are at present, two kinds of flexible forceps which can be used but not specially made, for foreign body extraction. Thus, a bronchoscopist should know it's extractive force before operation.3) The tip of the flexible forceps should be improved for the express purpose of foreign body extraction.4) The F.F.B. can be used for limited foreign body extraction. This limited use must be appreciated and the indications must be carefully considered before the flexible fiberoptic bronchoscope is used.

Removal of ectopic intrauterine contraceptive devices aided by laparoscopy: A report of 3 cases and a review of the literature

Eight instances of intraperitoneal intrauterine contraceptive devices (IUD's) extracted with the aid of laparoscopy are reported. Five different types of devices were removed with accessory instruments. Laparoscopy is a good surgical procedure for observing the location of the intraperitoneal IUD and enables their extraction under observation. It is safer to remove an iatrogenic foreign body (an open or closed loop device) than to await the onset of clinical symptoms.

Techniques of nonsurgical retrieval of latrogenic foreign bodies from the heart

Methods of retrieving fragments of polyethylene catheters and guide wires from the heart without chest surgery utilize wire snares or endoscopic forceps. The literature concerning these methods is reviewed. Choice of technique depends on the intracardiac site of the fragment, which in turn is determined by its length, its stiffness and whether it enters the heart from the superior or inferior vena cava. Preparation of the snare is detailed and particular emphasis is placed on the methods of freeing the sharp trailing end of the fragment and testing for its encirclement in the snare. The endoscopic forceps technique has limited value. Thrombosis, rather than further migration, necessitates urgent removal of iatrogenic foreign bodies from the heart. Nonsurgical retrieval is simple, rapid and safe.

Iatrogenic Foreign Bodies of the Urinary Bladder

Retention of ruptured fragments of catheter in the urinary bladder occurs infrequently. Three cases were seen in a six-month period. Diagnosis depends upon observation and awareness that the catheter has ruptured. Removal at endoscopy is the treatment of choice although prevention is best accomplished by the use of new catheters.