Method For Removal Of Foreign Bodies Research Articles

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.

Analysis of the diagnosis and treatment of 10 cases of complex respiratory foreign bodies in children

Objective:To explore the diagnosis and treatment experience of complex respiratory foreign bodies in children. Methods:The clinical data of 1 243 cases of respiratory foreign bodies in children were retrospectively analyzed, among which 10 cases（0.8%） were complicated respiratory foreign bodies. Results:Among the 10 cases of complex respiratory foreign bodies, 2 cases were removed by open thoracotomy, 1 case was removed by tracheotomy, 1 case was removed by lobectomy, 1 case was removed by fiberoptic bronchoscopy because of difficult airway caused by the accompanying congenital pulmonary artery sling, and the pulmonary artery sling correction was synchronized with the fiberoptic bronchoscopic removal, 3 cases were removed by fiberoptic bronchoscopic holmium laser and/or freezing method to make the foreign body deformed and fragmented and then taken out by the sound gate, and 2 cases were removed because of the In 3 cases, the foreign bodies were deformed and fragmented by fiberoptic bronchoscopy, and in 2 cases, the foreign bodies were removed through the vocal folds because of their special characteristics. Two cases were intubated and sent to ICU after surgery because of obvious vocal edema and difficulty in deoxygenation, two cases were transferred to ICU after cardiac or thoracic surgery, and the rest of them returned to ordinary wards after surgery, and all 10 cases recovered well after surgery. Conclusion:Respiratory foreign body combined with airway stenosis, when the foreign body type, shape, embedded location of special foreign body, foreign body is too large, need to rationally choose the method of foreign body removal. If necessary, a combination of methods can be used to ensure that the airway obstruction is quickly relieved with the best program.

Beyond the Norm: Tracheostomy's Vital Role in Unconventional Foreign Body Removal.

Foreign Body Aspiration (FBA) is one of the paediatric emergencies which require timely diagnosis and management. The inherent tendency of children to explore small objects with their mouths often prove to be fatal as they are difficult to remove once aspirated. We present the case of a 5-year-old boy who presented with dyspnea and vomiting following the aspiration of a pen cap. Chest radiograph and Rigid Bronchoscopy helped to identify the foreign body but it couldn't be removed by Rigid Bronchoscopy alone due it's wedge-shaped nature. Hence, an unconventional method of foreign body removal was performed by making a tracheostoma, pushing the foreign body to the level of tracheostoma and thereby taking it out from the tracheostoma under strict monitoring of anesthesia team. Alternative approaches like this are required for prompt intervention in a difficult case as it helps to reduce complications produced by repeated failed attempts.

Optimal intervention: Flexible Fiberoptic Bronchoscopy’s Role in Chronic Aspiration Foreign Body Removal

Foreign body aspiration in the lower airway is prevalent among children under 5 years old and rare among adults, except in cases of neurodegenerative or neuromuscular conditions. This condition is linked to substantial morbidity, necessitating awareness of potential complications. Flexible bronchoscopy stands as a primary method for foreign body removal. We present a case of a 56-year-old male who aspirated a denture 15 years ago. Recent symptoms encompassed persistent hemoptysis, worsening over two weeks, accompanied by mucopurulent sputum, fever, chest pain, and dyspnea. Physical examination indicated shortness of breath with positive rhonchi. X-ray revealed tubular opacities and atelectasis. Two days post-admission, flexible bronchoscopy exposed moderate mucopurulent secretion in both bronchial trees, with multifocal hyperemic edematous mucosal changes in the right bronchial tree. A denture was successfully extracted from the lower left lobe during the procedure. Treatment included antibiotics, bronchodilators, and mucolytics. Flexible fiberoptic bronchoscopy's adaptability allows local anesthesia usage, reducing costs and risks. The integration of high-definition imaging in flexible bronchoscopes enhances airway visualization and foreign body localization, ensuring precise and safe removal.

A RETROSPECTIVE STUDY ON EVOLVING TRENDS IN LOWER AIRWAY FOREIGN BODIES IN INDIAN CHILDREN AT A TERTIARY CARE HOSPITAL

Introduction Foreign body (FB) in the pediatric airway is a prevailing and crucial emergency with presenting symptoms often overlapping with other common pediatric conditions.[ ] The best way to manage it is an early diagnosis and a rigid bronchoscopy removal under general anesthesia used by fully trained staff . Lack of proper health education, superstitions, negligence from parents side and lack of availability of timely and expert medical help results in delayed or inadequate management. . A foreign body aspiration into the respiratory tract is a serious condition of the respiratory [2 ] system, characterised by a variability of medical history, symptoms and prognosis. Methodology This study was a retrospective conducted from Jan 2018 to Dec 2022.We selected a series of 50 patients under the age of 5 yrs conducted in the Department of ENT of M.G.M Medical College and M.Y.Hospital Indore(MP). Discussion In our study highest incidence of FB was seen in the children between the age group of 1-3years which is more common because toddlers of this age group are prone to put anything coming in their hands in mouth as they explore the world. This is clearly evident in our study that the incidence of FB is more in rural areas. Tracheobronchial metallic foreign bodies early detection and removal is necessary to avoid life threatening respiratory complication. Foreign body aspiration is Conclusion a common but largely preventable problem and every case of a respiratory distress should be suspected for foreign body. Rigid Bronchoscopy is the gold standard for the diagnosis and the most safe treatment method for foreign body removal. Use of optical forceps is advantages not only for foreign body removal but also for educational, teaching, learning, record keeping & medicolegal purpose also.

Different Modalities Used in the Art of Managing Tracheobronchial Foreign Bodies.

Foreign body aspiration is a commonly encountered and challenging emergency. Foreign body aspiration causes significant morbidity and mortality in the paediatric population. In adults, it is usually encountered in patients with impaired consciousness and in young females using pins to secure their veils. We aimed to analyse the incidence, type and site of foreign body, radiological presentation, complications and different modalities used in managing tracheobronchial foreign bodies (FBs). A prospective single centre cross-sectional study between December 2010 and December 2011 in the Department of Cardiothoracic Surgery at the University of Alexandria, Egypt. Seventy-eight patients were included. The age of the patients ranged between 1.3 and 32 years, with a mean of 13.37± 7.67 years. Inorganic FBs were the most common aspirated FBs (66 patients, 84.62%). FBs were more frequently located in the left versus the right bronchial tree (44.9% vs. 43.6%). Rigid bronchoscopic extraction of foreign bodies was the most common modality of extraction and was seen in 60 patients (76.9%), followed by thoracotomy and postural drainage in eight patients each (10.3%). Complications were observed in 12 patients (15.4%). Most of the patients who presented with pin aspiration were teenagers (> 10 - 20 years) and adults (> 20 years). At the same time, nut aspiration was common in children below 10 years. The location of FBs in the tracheobronchial tree depends on the patient's age and physical position at the time of aspiration. Rigid bronchoscopy offers better manipulations inside a secured airway and is the preferred method for foreign body removal. If failed, then surgical extraction should be done as soon as possible.

Use of Flexible Bronchoscopy in Foreign Body Aspiration.

Objective:Foreign body aspiration remains a serious health problem with a potential for severe consequences, and acute and chronic problems in children. It therefore demands immediate intervention. Rigid bronchoscopy has long been the method of choice for foreign body removal but is now being replaced by flexible bronchoscopy which offers reduced trauma and the ability to access distal bronchial regions. In the presented study we assessed the patients who underwent flexible bronchoscopy for foreign body removal in our clinic.Methods:We reviewed the records of 20 patients who underwent flexible bronchoscopy due to suspected foreign body aspiration and had a foreign body removed in our clinic. Patients were analyzed in terms of sociodemographic data, foreign bodies removed, method of foreign body removal, foreign body location and time to diagnosis.Results:Our study group included nine females and 11 males. The removed foreign body was organic in 19 of the 20 patients and inorganic in one patient. Hard organic food, such as hazelnuts, peanuts, seeds, almonds, and raw corn kernel were identified in 12 patients, a piece of fishbone in one patient and a piece of gelatin in another. The pieces of soft organic food identified were apple in one patient, egg in one patient, and boiled corn kernel in one patient and removed by suction. The foreign body was removed using forceps in nine patients, and a basket was used successfully in seven patients.Conclusion:Foreign bodies can be removed with minimal complication using flexible bronchoscopy, basket, and forceps in children.

Foreign body removal in children: Recommendations versus real life-A survey of current clinical management in Germany.

Task forces of the European Respiratory Society (ERS, 2003) and the American Thoracic Society (ATS, 2015) both recommend rigid bronchoscopy for foreign body removal in children. However, there is an increasing number of publications recommending flexible bronchoscopy as primary method for foreign body removal in children. We therefore initiated a nationwide survey, investigating the routinely used method of foreign body removal in children in different centers in Germany. In total, 259 centers took part in the survey. Twenty percent used flexible bronchoscopy as primary method of choice for foreign body removal. Of note, only 40% of the respondents reported that they had attended formal training courses in flexible bronchoscopy, 15% in rigid bronchoscopy, and 42% had never attended a formal training. Twenty-five percent indicated that they had already encountered an emergency situation during or after foreign body removal, requiring intensive care. Published data shows that rigid bronchoscopy involves fewer complications and is more successful in foreign body removal in children. It is consequently questionable, why 20% of the medical centers report a preference for the flexible method. One reason might be the poor availability of rigid bronchoscopy and the difficulty gaining sufficient expertise in rigid bronchoscopy in Germany. Pediatr Pulmonol. 2017;52:656-661. © 2016 Wiley Periodicals, Inc.

Percutaneous Retrieval of Foreign Bodies Around Vital Vessels Aided with Vascular Intervention: A Technical Note.

To describe a new interventional technique to remove foreign bodies (FBs) embedded in soft tissues around vital vessels. Under fluoroscopic guidance and using local anesthesia, percutaneous removal of FBs was performed using forceps in nine patients. All patients suffered from a metallic soft tissue FB located in close proximity to important vessels and one also had a small traumatic pseudoaneurysm adjacent to the FB. Prior to removal of the FB, the position of the nearest vessel was identified using a guide wire or catheter placed into the vessel. Balloon catheter was also simultaneously used to temporarily stop the blood flow of the nearest artery during the FB removal in three of the nine patients. All of the nine FBs with 0-2 mm interval to the nearest vessel were successfully removed in the nine patients without any serious complications. The removed FBs measured 3-12 mm in length and 1-3 mm in width. The total fluoroscopic time of retrieval of each FB was 5-9 min (mean, 6.4 min). The volume of intraoperative bleeding ranged from 5 to 12 ml (mean, 7.5 ml). The length of hospital stay for each patient ranged from 4 to 8 days (mean, 5.5 days). Vascular intervention-aided percutaneous FB removal is minimally invasive and an effective method for removal of FBs around vital vessels.

Esophageal foreign bodies and eosinophilic esophagitis—the need for esophageal mucosal biopsy: a 12-year survey across pediatric subspecialties

Esophageal foreign body impaction (EFBI) is a common problem requiring urgent endoscopy. EFBI may be the first sign of underlying esophageal pathology, yet mucosal biopsies are rarely performed. We report a retrospective analysis of 572 children requiring removal of an EFBI over a 12-year period by pediatric otolaryngologists (ENT), surgeons (PS), and gastroenterologists (PGI). The method of removal [direct laryngoscopy (DL), rigid endoscopy (RE), flexible endoscopy (FE)], type of foreign body (inanimate or food), whether mucosal biopsies were performed, and histologic findings of biopsy samples were recorded for each patient. Foreign body removal was most commonly performed by PGI (298 [52 %]); the remaining were equally distributed between ENT (136 [24 %]) and PS (138 [24 %]). The method of foreign body removal used by ENT was RE (89 %), DL (8 %), and FE (3 %). Pediatric surgery preferred FE (62 %), followed by RE (27 %) and DL (11 %). Pediatric gastroenterology used FE exclusively. Esophageal biopsies were never performed by ENT or PS; PGI performed esophageal biopsies more commonly in children with meat bolus impactions (50 %) than in children with inanimate foreign bodies (12 %). Mucosal pathology was more common in children with meat bolus impaction (100 %) than in children with inanimate foreign bodies (45 %). Esophageal mucosal biopsy should be considered for all children with EFBI not attributed to stricture, particularly those with meat bolus impaction.

Percutaneous retrieval of intravascular venous foreign bodies in children

The use of vascular lines both venous and arterial in children has significantly increased in the last decade with the potential risk that an intravascular device may become an intravascular foreign body. Percutaneous retrieval by interventional radiology has become an accepted method of foreign body removal. The objective of this study is to describe a single center's experience of percutaneous intravascular foreign body removal in pediatric patients. Between January 2000 and December 2008, 18 patients underwent percutaneous intravascular foreign body retrieval as a complication of venous access devices. The mean catheter days were 181.2 catheter days (1 to 1,146 days). A retrospective review was performed and demographic data and clinical information were recorded, including type, duration, location of access device, embolization location and retrieval technique. Eighteen of 19 (94.7%) retrievals were performed with single-loop snares and 1/19 (5.3%) was a triple-loop snare. Seventeen of 19 (89.5%) retrievals were successful. One unsuccessful retrieval was successfully removed by surgery, while the other was retained. Percutaneous intravascular foreign body retrieval by interventional radiologists is a safe and effective method of retrieving embolized fragments from venous access devices in pediatric patients.

Systematic review of gastrointestinal injury caused by magnetic foreign body ingestions in children and adolescence

To study the diagnosis and treatment of gastrointestinal injury caused by magnetic foreign body ingestions in children. A literature search was performed to identify all the studies related to gastrointestinal tract injury caused by ingesting magnetic foreign body using databases including Google, Medline, ISI Web of Knowledge, Ovid, Wanfang data, VIP, CNKI, degree dissertation, meeting abstracts, and request for document delivery. Language was limited to English, Chinese, Japanese, and Korean. Parameters studies were age at diagnosis, gender, country, regional distribution, number of magnetic foreign bodies, source of magnetic foreign bodies, clinical features, diagnosis, and method for foreign body removal. A total of 98 cases of magnet ingestion were identified from 17 countries and regions. There were 94 patients under the age of 18, with most children younger than 5 years old(62.2%,61/98). The age at peak incidence was 3 years old (16.3%, 16/98). Magnetic foreign bodies ingested included toys(74.5%), medical apparatus(8.2%), accessories(4.1%), and others(6.2%). The number of bodies ranged from 2 to 100. Eleven (11.2%) patients were complicated with allotriophagia or autism. Delay diagnosis and treatment existed in all the patients to varying extents, of whom one died from severe infection. Exploratory laparotomy showed a wide range of bowel damage from the esophagus to the colon, including perforation and intestinal fistula. Intestinal damage was the most common injury (51.0%), followed by intestine-colon fistula (15.3%). All the patients required bowel resection with anastomosis or fistula repair except for 2 children who were managed by endoscopic removal of the foreign bodies. Ingesting more than one magnet will lead to severe gastrointestinal injury. Early diagnosis and surgical intervention are important. More precautious measures should be taken for children aged younger than 5 years old.

Bimanual, intra-operative, fluoroscopy-guided removal of nasopharyngeal migratory fish bone from carotid space

We report a rare and unusual case of a patient with an ingested fishbone which migrated from the oropharynx to the anterior compartment of the retropharyngeal space and then to the deep neck space in the nasopharynx (i.e. the carotid space). This report aims to describe a successful, minimally invasive method of foreign body removal which avoided both major skull base surgery and any potential life-threatening complications. A secondary aim is to highlight the role of intra-operative fluoroscopy, an under-used tool. We present a 67-year-old man with a history of fish bone impaction but no fish bone visible on plain X-ray or flexible endoscopy. The diagnosis of fish bone lodged in the retropharyngeal space was confirmed by computed tomography. Surgical exploration of the anterior retropharyngeal space failed to locate the fish bone, as it had migrated to a new, unknown location. Intra-operative fluoroscopy was vital for the removal of the fish bone, as it was impossible to see with the naked eye and had migrated from its previously imaged position. The fish bone was finally retrieved bimanually using external pressure on the submandibular region, which displaced the fish bone, and fluoroscopic guidance, which assisted its removal from the nasopharyngeal lumen. To the best of our knowledge, this is the first reported case of bimanual, intra-operative, fluoroscopy-guided, intra-luminal removal of a migratory fish bone from the deep neck space in this region of the nasopharynx.

Foreign Body Removal by Flexible Fiberoptic Bronchoscopy in Infants and Children

Rigid bronchoscopy is the preferred method for removal of foreign bodies lodged in the airways, but some studies found that flexible bronchoscopy can also achieve a high success rate. The aim of the present work was to report our experience in using flexible bronchoscopy for foreign body retrieval in infants and children. Reports of all bronchoscopies performed from 1994-2003 at a tertiary-level pediatric hospital in Mexico City were reviewed. Those with a final diagnosis of foreign body aspiration were analyzed. Of 2,376 bronchoscopies performed during the study period, 59 (2.5%) yielded a final diagnosis of foreign body aspiration: 28 lodged in the right bronchi, 15 in the left bronchi, and those remaining, in the larynx or trachea. Foreign bodies were organic in nature in 38 (64.4%), mainly peanuts, pumpkin seeds, and beans, while 21 (35.6%) were inorganic, mainly pen caps and pins. In 23 cases, flexible bronchoscopy was attempted as the initial therapeutic procedure. Among these latter patients, the procedure was successful in 21 (91.3%). Ages of these 21 patients ranged from 9 months to 16 years (median, 5 years). The only two patients in whom foreign bodies could not be removed through flexible bronchoscopy were males, 2 years of age, both with a peanut lodged in right main bronchus. In conclusion, flexible bronchoscopy must be taken into account as initial therapeutic method for foreign body removal in infants and children.

Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department

Patients frequently present to the emergency department for removal of foreign bodies from the nose or ear. Early descriptions of foreign body removal from Roman times include “An insect must...

Results of hysteroscopic method of foreign body removal out of uterus cavity

Recognition of foreign bodies in the uterine cavity is of great importance for successful treatment of secondary infertility: e.g. a piece of intrauterine contraceptive (after a removal failure), suture after cesarean section, or cylindrical and flat small bones after abortions. Sixty-nine foreign bodies were removed with a hysteroscope during 1992-93. Sixty-one of the foreign bodies were intrauterine devices. Twelve patients (19.7%) had had several unsuccessful removal attempts. The remaining eight women (11.9%) underwent fetal bone removals. Removal of ligatures in the area of scar on the uterus after cesarean section was carried out in two patients and both were done under hysteroscopic control. Hysteroscopy allows exact determination of foreign body position in uterus and for their atraumatic removal.

Surgical method of removal of foreign bodies in children from the airways through the bronchoscope

Providing care to children who have aspirated foreign bodies into the airways is often a difficult task. Its solution depends on the nature, forms, localization, fixation of foreign bodies and the duration of their stay in the tracheobronchial tree. As a rule, it requires individualization of the treatment tactics and the choice of the optimal instrument. Currently, bronchoscopy is the main method of foreign body removal, but when they are firmly embedded in the walls of the tracheobronchial tree it becomes necessary to perform surgical intervention.