Metallic Foreign Body Research Articles

Design of a system for detection of non-ferromagnetic metallic foreign bodies based in eddy currents and GMI magnetometer

A portable magnetic mapping system was designed to determine the three-dimensional location of non-ferromagnetic metallic foreign bodies to ensure fast and successful surgical procedures for their removal. The system is based on the induction of eddy currents in the foreign body by an excitation stage and the measurement of the magnetic field generated by these currents employing a commercially available high-resolution magnetometer based on the Giant Magneto-Impedance effect. The instrument topology is based on decoupling the excitation and measurement stages with a configuration that produces a high primary magnetic field in the foreign body region and a weak one in the GMI sensor region. This feature allows increasing the primary excitation magnetic field without saturating the GMI magnetometer, making it feasible to overcome relevant limitations evidenced in a previously developed instrument proposal. Computational simulations were built considering four possible configurations, with two models of excitation and two options for the magnetometer GMI sensitivity axis orientations. International guidelines for exposure limits to non-ionizing radiation and the principles of biometrology, besides constructive and electrical aspects, were also considered in the system design. The performance analysis of the most promising settings confirmed the viability of the proposed measuring instrument, optimizing the linear operation of the magnetometer during the measurement procedure and contributing to the construction of a complete measurement system prototype, with performance and safety characteristics ensured for the intended biomedical application.

Incidental Quiescent Metallic Foreign Body in a Case of Penetrating Neck Injury

Incidental Quiescent Metallic Foreign Body in a Case of Penetrating Neck Injury

Occupational Nerve Injuries due to Metallic Foreign Bodies: A Case Series of Eighteen Patients.

Peripheral nerve injuries (PNIs) remain an important health problem. PNIs mostly affect young men as this age group is mostly involved in road traffic accidents and other injuries at workplace. PNI can occur from foreign bodies like metal chips while working in industries using lathe machines. Among PNI's, injuries to the ulnar nerve, the brachial plexus and the median nerve are the most frequent lesions encountered. This presentation is on a series of 18 cases of nerve injuries among industrial workers located from finger level up to the arm excluding the brachial plexus due to metallic foreign bodies entering while operating lathe machines over a period of two years with patients being followed-up over a one year period. Mean age in this series was 31.3 years with age range 16-40 years and all were males. Two patients had more than one nerve involvement and one patient had associated vascular injury. All the patients showed functional improvement. Most common nerve injured was median nerve. Most common site for nerve injury was forearm. Combined lesions most commonly involved the ulnar and median nerves. Social cost of traumatic peripheral nerve injuries is significant since it has a higher incidence in young, previously healthy, and economically active people.

Comparing forceps and self-assembled intraocular rare earth magnet in removing metallic intraocular foreign bodies in 25-guage vitrectomy

PurposeTo compare the efficacy and efficiency of self-assembled intraocular rare earth magnet and forceps in removing intraocular foreign bodies(IOFBs) undergoing 25-gauge(G) pars plana vitrectomy.MethodsA total of 30 patients with metallic IOFB underwent 25-G PPV were enrolled into this study. Self-assembled intraocular rare earth magnet were used in 15 patients(bar group), and forceps were used in 15 patients(forceps group). Success rate of removing IOFB, time taken to remove IOFB, incidence of IOFB slippage and fall, iatrogenic retinal damages were compared between the two groups.ResultsThere was no significant difference in success rate of removing IOFBs between the groups(93.3% and 100%, P > 0.99). The median time taken of removing FB was significantly shorter in bar group than in forceps group(112 and 295 s, P = 0.001). None of the patients in bar group had IOFB slippage and fall, or related iatrogenic retinal damage in the process of removal. In forceps group, IOFB slippage and fall during removal were observed in 7 of 15(47.6%) patients, related iatrogenic retinal injuries were recorded in 6 of 15(40.0%) patients, both were significantly higher than bar group(P = 0.003 and P = 0.017, respectively).ConclusionsCompared with forceps, the assembled intraocular magnet can greatly reduce the possibility of IOFB slippage and fall, prevent related iatrogenic retinal damage, and shorten the time taken to remove IOFB. The assembled intraocular magnet can be an useful tool in removing metallic IOFBs in PPV.

Ocular trauma from Lawn mower accidents: Clinical insights, visual outcomes and microbial profiles

AimsTo characterize the clinical features of ocular trauma resulting from lawn mower, identify determinants of unfavorable final visual acuity (FVA), and assess the spectrum of microbial in posttraumatic endophthalmitis. MethodsThis retrospective study enrolled patients who experienced ocular trauma due to lawn mower at Zhongshan Ophthalmic Center from January 2013 to August 2021. Demographics, clinical features, isolated microorganisms, risk factors influencing reduced visual acuity, treatment regimens, and utilization of eyewear were collected. ResultsThe study included 140 participants (140 eyes) (49.47 ± 12.03 years, 95% male). The predominant injury manifestations were penetrating globe injuries (75.7%) and intraocular foreign bodies (51.4%). Endophthalmitis occurred in 35 cases (25%) and Bacillus cereus (23.5%) was the primary pathogen, followed by Staphylococcus epidermidis (11.8%) and Streptococcus species (11.8%). Following the initial assessment, where 77.9% of patients had initial visual acuity (IVA) at grade IV (ranging from light perception to 4/200) and only 0.7% attained grade I (better than 20/40), post-treatment results revealed that 5.7% achieved FVA at grade I, with a concurrent decrease in patients with grade IV vision to 64.3%. Multivariate logistic regression revealed that injury protection (p < 0.001, OR = 0.237, 95% CI = 0.126–0.446), IVA (p = 0.001, OR = 4.102, 95% CI = 1.730–9.729), and retinal detachment (p = 0.042, OR = 8.105, 95% CI = 1.075–61.111) were significant independent risk factors impacting FVA. ConclusionLawn mower often cause severe ocular injuries, with high-velocity metal foreign bodies that can lead to infections, most commonly caused by Bacillus cereus. Correct use of protective gear, initial vision assessment, and detecting retinal detachment are crucial for visual prognosis.

Multiple Retained Needles in the Neck of a Drug User: A Case Report.

Retained needles are frequently observed in intravenous drug users. However, an incidental discovery of multiple needles at the neck seldom occurs. These foreign bodies remain either asymptomatic or cause local and central complications that can be fatal. We report the case of a 43-year-old male having a medical record of human immunodeficiency virus and hepatitis C who presented to our department with a 3-day history of a febrile lateral neck swelling. He reported a history of repetitive intravenous drug use and previous abscesses that were surgically drained. We noted a left and tender 8 cm neck swelling with torticollis. Computed tomography scan showed a collected myositis of the sternocleidomastoid muscle in association to multiple metallic foreign bodies at the neck that were compatible with the aspect of broken needles. Imagery also showed a thrombosis of the ipsilateral jugular vein. No central embolism of a foreign body was noted. We performed a surgical drainage of the muscular abscess and managed to retrieve a 1 cm broken needle that was retained at the level of the collection. We did not retrieve the other needles since they were asymptomatic. The patient was placed under intravenous antibiotics for 1 week followed by oral amoxicillin-clavulanate with a total regression of the cellulitis. At the further follow-ups, the rest of the foreign bodies remained asymptomatic. Our study emphasizes on the importance of suspecting a retained foreign body in intravenous drug users to ensure an adequate management of the possible complications and to protect the medical team from incidental needle injuries.

PANOPHTHALMITIS SECONDARY TO RETAINED INTRAOCULAR FOREIGN BODY , SETTING IN RURAL AREA

Introduction : IOFB can be serious and result in vison threatening complication. We report IOFB presenting with panophtalmitis secondary to delay in seeking medical attention and misdiagnosed in emergency ward by general practitioner.&#x0D; Case Illustration : A 40-years-old male presented with pain and outward bulging of his right eye with no light perception after trauma to his right eye by a small metallic object while working as electric grasscutter. He presented to our department 3 days following the incident. Systemically, he had a fever, headache and nausea. 2 days after incident, he visited to emergency ward but he was given eye drop only. On Slit lamp examination, corneal melting with keratinization and lacerated wound in cornea at 12 o'clock about 3 mm. Non-contrast CT showing a linear hyperdense foreign body in the right globe likely metal, measuring 3 mm x 4 mm was found. The patient was admitted ceftriaxone intravenous, twice daily. No light perception of visual acuity, ocular penetrating, persistence of the active inflammation, and risk of spread, a decision was made to eviscerate the eye. A metallic foreign body was found in eviscerated tissue.&#x0D; Discussion : &#x0D; Conclusion : Important to suspect foreign body in all cases ocular trauma. Detailed examination and imaging should be performed. Delay treatment from the time of injury, result in poor prognosis. Surgical treatment such as evisceration, should be informed to patient about the visual prognosis.

PANOPHTHALMITIS SECONDARY TO RETAINED INTRAOCULAR FOREIGN BODY , SETTING IN RURAL AREA

Introduction : IOFB can be serious and result in vison threatening complication. We report IOFB presenting with panophtalmitis secondary to delay in seeking medical attention and misdiagnosed in emergency ward by general practitioner.&#x0D; Case Illustration : A 40-years-old male presented with pain and outward bulging of his right eye with no light perception after trauma to his right eye by a small metallic object while working as electric grasscutter. He presented to our department 3 days following the incident. Systemically, he had a fever, headache and nausea. 2 days after incident, he visited to emergency ward but he was given eye drop only. On Slit lamp examination, corneal melting with keratinization and lacerated wound in cornea at 12 o'clock about 3 mm. Non-contrast CT showing a linear hyperdense foreign body in the right globe likely metal, measuring 3 mm x 4 mm was found. The patient was admitted ceftriaxone intravenous, twice daily. No light perception of visual acuity, ocular penetrating, persistence of the active inflammation, and risk of spread, a decision was made to eviscerate the eye. A metallic foreign body was found in eviscerated tissue.&#x0D; Discussion : &#x0D; Conclusion : Important to suspect foreign body in all cases ocular trauma. Detailed examination and imaging should be performed. Delay treatment from the time of injury, result in poor prognosis. Surgical treatment such as evisceration, should be informed to patient about the visual prognosis.

Frequency of Anterior Inferior Cerebellar Artery Vascular Loops Using CISS Sequence on 3.0T MRI in the Otologic Symptomized Patients

Aim: To estimate the frequency of vascular loops in the anterior inferior cerebellar artery in the otologic symptomized patients using CISS sequence on 3.0 Tesla MRI” in Pakistani populations. Methodology: Cross sectional descriptive study was conducted in Armed Forces Institute of Radiology and Imaging, Military Hospital Rawalpindi from 12th April 2019 to 11th October 2019. One hundred patients of both genders between age of 20-60 years were presented with otologic symptoms i.e. tinnitus, dizziness and hearing loss (unilateral/bilateral) and advised MRI brain. Patients with any diagnosed arterial, venous and arterio-venous cause of otologic symptoms, severe claustrophobia and with internal cardiac pacemakers or any other metallic foreign body were excluded. Patients were undergone MRI brain on 3.0 Tesla. TIWS, T2WS and CISS sequences were taken along with post-contrast T1WS images. Results: There was 20 to 60 years of patients range of age having mean age of 38.38±12.05 years and majority of patients 65% between 20-40 years. There were 53(53%) males and 47(47%) females and having 1.2:1 ratio of male to female. Frequency of anterior inferior cerebellar artery vascular loops in the otologic symptomized patients using CISS sequence on 3.0 Tesla MRI was seen in 59(59%) patients. Conclusion: The frequency of anterior inferior cerebellar artery vascular loops in the otologic symptomized patients using CISS sequence on 3.0 Tesla MRI is very high. Keywords: Anterior inferior cerebellar artery vascular loops, Magnetic resonance imaging, Otologic symptoms

Perforating Ocular Sickle Knife Trauma: a Case report

Introduction : Perforating ocular injury can lead to disability or even mortality. Most individuals sustaining eye injuries are male in young age. This is a report of an extreme case when a sickle knife stabbed in the right eye of a young male cause perforating of the eyeball.&#x0D; Case Illustration : Seventeen years old young male presented to Emergency Room of Sukabumi Regional Public Hospital with pain and bleeding in his right eye an hour before. He had been hacked during a brawls. There was a wound in the right supraorbita area and a big sickle knife stuck in the head and tear the eye ball. Visual acuity was no light perception in his right eye. Anterior segment examination of the right eye revealed perforated sclera and cornea. X-ray examination showed fracture of the roof of the right orbit and a metal object had stuck into the Orbits. The sickle knife extraction, enucleation and superior orbit reconstruction of the right eye was done.&#x0D; Discussion : Identification of wounds caused by sharp metal foreign body is very important for the subsequent treatment of injuries. If the eyeball cannot be preserved, then enucleation can't be avoided. In this case, hard impact of sharp object around of the eye are also cause fracture of superior orbital rim. Reconstruction of the orbital roof using titanium and micro screws given the most stable and effective results.&#x0D; Conclusion : Removing a metal foreign body and anatomical defect management is important for a good outcome.

Imaging Mismatch of Nail in the Eyeball: What’s next?

Introduction : A retained foreign body (FB) can lead to severe complications, the most devastating of which is eye loss. We present a discrepancy of imaging that resulted in a dilemma in the approach management of a mixed global-adnexal FB case.&#x0D; Case Illustration : A 31-year-old man came to the emergency room with blurry vision for 1.5 hours after a nail hit his right eye (RE). The visual acuity of RE is light perception. Ophthalmological examination revealed a central Y-shaped full-thickness corneal laceration with iris and vitreous prolapse. The lens appeared cloudy, and the posterior segment was difficult to assess. Imaging showed a foreign metal object asa nail in the oculi to intraconal without penetration to the orbital wall. He was planned to undergo FB extraction with corneal laceration repair and aspiration of lens mass irrigation. However, the nail was hard to find intraoperatively because the vitreous and choroid kept coming out. Hence evisceration with DFG was performed. The nail was found more posteriorly and attached to the bone.&#x0D; Discussion : While primary repair is the standard practice for open globe injury, managing retained intraocular metallic foreign bodies is controversial. Imaging such as CT scans can help determine the location of FB and approach management. In this case, imaging showed the FB was in the iris plane and not penetrating the orbital wall, so primary repair and FB extraction were planned.&#x0D; Conclusion : The imaging may not always be accurate in determining the exact location of FB, and the surgical approach may need to be adjusted accordingly.

Safety beyond Sight: Handheld Metal Detectors as Diagnostic Allies in the Management of Children Suspected to have Ingested Foreign Bodies.

Foreign body (FB) ingestion remains a common cause of pediatric emergency department referrals, and the gold standard for detection is whole-digestive-tract radiographic examination. Our study explores whether handheld metal detectors (HHMD) can effectively identify the presence and location of ingested metal objects, potentially reducing the need for additional radiographic examination. We collected medical data from children with suspected metal FB ingestion who were referred to our emergency department (October 2017-March 2023), focusing on object type and correlating metal detector findings with radiographic images. Data from 43 children (39.5% female; mean age: 4 y) referred to our emergency department were analyzed. Coins (32.6%), button batteries (18.6%), and hairpins (11.6%) were the most common ingested objects. Metal detectors detected the presence of FBs in 81.4% of cases (sensitivity: 89.7%; specificity: 100%). Radiographs, taken for 40 children, showed that the most common locations were the stomach (37%) and intestine (33%). The metal detector signals matched the radiography results in 69.8% of cases. According to HHMD, 34.9% of objects were accessible via endoscopy, contrasting with 51.2% via radiography (p < 0.05). While the findings obtained using handheld metal detectors often correlate well with radiograph findings in detecting metal FBs, for an important number of children, this confirmation is lacking, especially when determining the exact location of an object.

Handheld Magnetometer-Assisted Localization andRemoval ofa Foreign Body From the Chest Wall.

Foreign bodies fully embedded in soft tissues present a unique challenge to surgeons attempting excision. Small fragments can be nonpalpable, and many prove difficult to visualize intra-operatively by means of classic radiologic techniques. A 35-year-old active duty soldier presented requesting excision of ballistic fragment embedded in his chest wall that had previously failed a previous attempt at removal. The metallic foreign body was successfully localized intra-operatively using a handheld magnetometer probe and removed without complication. This case demonstrates the utility and cost-effectiveness of the handheld magnetometry for intra-operative localization of metallic foreign bodies. Metallic foreign bodies may be localized intra-operatively using inexpensive and reusable equipment that does not require radiation or bulky radiographic imaging equipment.

Preventing Ocular Surface Foreign Body Complications: Enhancing Awareness and Precaution

Background: Ocular surface foreign bodies are the second most common emergency condition in the ophthalmology department OPD, which can be easily prevented through proper precautionary measures. Also, they can be either superficial or embedded into the cornea or conjunctiva. In this study, we aimed to create awareness regarding the prevention and management of such cases to reduce ocular complications. Methods: This prospective cross-sectional study was carried out in the Ophthalmology department of Ziauddin University Hospital Karachi. The study duration was 4 years from 16th November 2019 to 15 November 2022. Patients presented to the ophthalmology department OPD with complaints of ocular foreign bodies were examined clinically and a total of 427 patients were included in the study who fulfilled the inclusion criteria. The data was collected and analyzed on SPSS 23. The chi-square test was used to compare the variables. Results: Our study analyzed that ocular surface foreign bodies had a strong association with the profession. The metallic foreign bodies were found in 283(66.3%) patients and the remaining 144 (37.7%) were non-metallic. There was a strong correlation found between the type of foreign body and the site of ocular involvement. The p-value was significant with 0.0001. Conclusion: The majority of ocular surface foreign bodies were workplace-related due to a lack of awareness of protective measures. A counseling workshop should be arranged regarding its importance for workers in their workplaces which will improve their work capacity, and health and reduce economic burden.

Fluoroscopy-guided metallic foreign body removal: A case report

A foreign body (FB) was detected in the right lower zone on the chest X-ray of a 24-year-old woman who presented to the OPD with a cough and sputum. With the help of virtual bronchoscopy, the FB was localized in the posterior segment of the right lower lobe. It was located with the help of a flexible bronchoscope and fluoroscopy and retrieved with the help of snare and endobronchial biopsy forceps. After ensuring clinical stability, the patient was discharged the next day. Bronchoscopic FB removal from segmental and subsegmental bronchi is difficult. Fluoroscopy permits the bronchoscopic retrieval of FB from these relatively inaccessible regions and of the lung and averts the need for thoracotomy.

Radiographic grid for locating foreign bodies in maxillofacial emergency trauma

ObjectivesThe accurate localization of the foreign bodies (FBs) is essential. This work presents a new noninvasive technique for subcutaneous metallic FBs under a radiographic grid, a system that simplifies the localization of facial FBs removal using a grid with embedded reference points.MethodsThis work designed a retrospective study to evaluate the effect of a radiographic grid on FBs removal surgery. All patients who met the inclusion criteria and attended the Hospital of Stomatology of China Medical University from January 2022 to June 2023 were enrolled and randomly divided into grid and non-grid groups. The assessment of facial swelling, the primary indicator, was conducted on days 2 and 7 post-surgery. The variables were analyzed using the Student t test and a repeated-measures general linear model.ResultsThe study sample consisted of 20 patients, with 14 males (70%) and 6 females (30%), who had an average age of 30.30 ± 5.38. The average time of operation was 1.85 ± 0.66 h (range 0.7 to 3.2). In the present cases in this report, of the 20 patients’ FBs, 14 were metal, 5 were glass, and 1 was residual root. And the FBs were surgically removed with no postoperative complications. Through comparison, it was found that the degree of swelling on day 2 postoperatively was significantly different between the grid group and the non-grid group (P < 0.05).ConclusionsThis study demonstrates that a radiographic grid with mark points is a more efficient approach compared with traditional methods for FBs removal, and this surgical method is more accurate, fast and noninvasive.

Assessment of deeply embedded metallic corneal foreign bodies by anterior segment optical coherence tomography

Assessment of deeply embedded metallic corneal foreign bodies by anterior segment optical coherence tomography

Subconjunctival deferoxamine for corneal rust deposits associated with ocular siderosis: A case report

Introduction: Ocular siderosis is a vision-threatening condition resulting from intraocular iron toxicity. This case re-establishes a role for subconjunctival deferoxamine, a chelating agent uncommonly used in ophthalmology, as an adjunctive treatment for ocular siderosis. Case Report: A 37-year-old healthy male presented two months after an injury at work with intermittent pain and blurry vision in the right eye. Presenting visual acuity (VA) was 20/100 in the right eye. With delayed presentation, the patient already had ocular siderosis with corneal rust deposits and retinal damage. The patient underwent pars plana vitrectomy (PPV) with surgical view impaired by corneal deposits and intraocular metallic intraocular foreign body (IOFB) that disintegrated upon attempted removal. At six months postoperatively, VA was 20/70 in the right eye, and examination revealed worsened diffuse, pigmented subepithelial deposits in the central cornea, iris atrophy, cotton wool spots, optic nerve pallor, and a residual IOFB in the anterior vitreous, consistent with worsened ocular siderosis. Superficial keratectomy was performed in combination with repeat PPV to improve surgical visualization and aid in IOFB removal. An amniotic membrane was placed and a subconjunctival injection of deferoxamine was administered. The cornea was well-healed with significantly improved siderosis and no epithelial defects on 2-week postoperative follow-up. Visual acuity was 20/60 at last follow-up two months postoperatively after second surgery. Conclusion: In treating ocular siderosis, subconjunctival injection of deferoxamine can be a useful addition to surgical IOFB removal to prevent the accumulation of iron deposits in the anterior segment of the eye.

Rate of metallic foreign bodies found on orbital radiographs prior to MRI

ObjectiveThe purpose of this research is to more precisely quantify the positivity rate for conventional radiographs (CR) of the orbit performed for the purpose of pre-MR screening in patients at risk of having a radio-opaque orbital foreign body (ROFB). MethodsBy review of electronic medical records, we identified 47,237 patients who had undergone orbital CR for clearance of ROFB prior to MRI. The reports from these examinations were manually reviewed, and the examinations with positive findings were re-interpreted by a CAQ-certified head and neck radiologist. The rate of ROFB found in these examinations was reported and compared to historical estimates in the literature. Results328 of the 47,237 examinations (0.69 %) were originally interpreted as positive for ROFB. Upon re-review, only 39 of the 47,237 examinations (0.083 %, 95 % CI 0.06 %-0.11 %) contained ROFB that were in locations that posed a risk to ocular or vascular structures or were in an equivocal location. Almost all of the patients with false-positive initial interpretations had been denied MRI. DiscussionThe rate of ROFB discovered on clearance CR of the orbits prior to MRI is far less than previously estimated in the radiology literature. More conservative guidelines for MR clearance may be useful to reduce costs, mitigate imaging delays, and avoid unnecessary denial of imaging.

Successful emergency surgery for accidental ingestion of multiple neodymium magnets in an Argentine tegu (Salvator merianae).

A large Argentine tegu (Salvator merianae) presented with anorexia. Initial radiographs revealed a metallic foreign body in the stomach. The tegu vomited and became inactive two days later. A follow-up radiograph revealed the persistence of the foreign body in the same region. The foreign body was identified as a cluster of multiple magnets resembling neodymium magnets reported missing by the owner. An emergent laparotomy was performed due to gastrointestinal perforations caused by the multiple magnets. The surgical intervention revealed perforations in the walls of the stomach and small intestine and progressing acute peritonitis. Three magnets were extracted from the abdominal cavity and the tegu showed recovery. At 200 days postoperatively, the tegu continued to demonstrate good appetite and energy levels.