Removal Of Foreign Body Research Articles

Cranial gunshot wounds: comparative analysis of management and outcomes in a United Kingdom Major Trauma Centre and the United States

Objectives Cranial gunshot wounds (CGSW) are a rare subtype of traumatic brain injury in the UK without recognised guidelines. We aimed to investigate and compare the emergency surgical management of such injuries and their outcomes between the UK and US. Methods A retrospective analysis of CSGW presenting to an adult Major Trauma Centre in the UK between 1999 and 2024 was conducted. Demographic data, clinical presentation, radiological findings, treatment methods, and Glasgow Outcome Scale Extended at three months (GOS-E) were collated and examined to highlight any trends in the surgical management and review favourable outcomes for this cohort. Results were compared to data from the US. Results Thirteen patients were identified (all male aged between 16 and 82). Self-inflicted GSW was the most common aetiology (seven patients). Presenting Glasgow Coma Score (GCS) was >8 in seven patients with non-dilated reactive pupils. There were four (30%) deaths in our series, all with GCS <8 and dilated unreactive pupils at presentation. Seven patients had right sided fronto-parietal entry wounds without exit wounds. Six patients had bullet fragments crossing the midline, including all four mortalities. Of the survivors, two patients underwent decompressive craniectomy, one underwent external ventricular drain insertion, five underwent wound debridement and craniotomy to remove bullet fragments, and one patient underwent ICP bolt insertion only. GOS-E at three months for the survivors was 8 for six patients and 6 for the remaining patients. Multivariable regression analysis revealed GCS at presentation (p = .005) and pupil reactivity (p = .001) were significant in determining favourable outcomes. Conclusions CGSWs are associated with significant mortality. In our series, surgery was undertaken for wound debridement including removal of foreign body and to treat high ICP. Favourable GCS (>8) and pupil reactivity on presentation were significant determinators of functional outcome. Therefore, any future clinical guidelines established in the UK should account for these factors.

Clinical Resolution of Recurrent Sinusitis after Removal of Surgical Drill in the Maxillary Sinus: Case Report

This report describes the clinical resolution of recurrent sinusitis after removing a surgical drill from the maxillary sinus (MS) using the modified Caldwell-Luc technique. A 52-year-old male presented at the Oral and Maxillofacial Surgery Clinic of Araçatuba School of Dentistry - UNESP, complaining of recurrent headaches, sinusitis, and facial edema for one year, following the extraction of tooth #26 and subsequent oroantral communication. Physical examination revealed edema in the left midface, effacement of the fornix fundus, erythema, and an active fistula near tooth #23. A panoramic radiograph showed a radiopaque foreign body in the left MS. Cone beam computed tomography (CBCT) revealed hyperdense material resembling a surgical drill, bone fenestration, and residual roots. The MS was accessed using the modified Caldwell-Luc technique, expanding the previous bone fenestration to remove the drill, perform curettage, and irrigate the sinus. The fistula was excised, and residual roots of tooth #24 were extracted. The patient remained under clinical and radiographic follow-up with no complications. Complementary imaging is crucial for diagnosis and surgical planning, and the modified Caldwell-Luc technique is effective for foreign body removal in the MS, offering a low-cost solution, complete sinus cleansing, and prevention of oroantral fistula recurrence.

A new automated snare for the removal of intraocular foreign bodies.

A new automated snare for the removal of intraocular foreign bodies.

Application-Based Education for Corneal Foreign Body Removal in an Emergency Medicine Residency.

Application-Based Education for Corneal Foreign Body Removal in an Emergency Medicine Residency.

Case Report: an unusual case of a penetrating intracranial metallic foreign body removed via surgery

Background and importanceIntracranial foreign bodies resulting from criminal assaults that cause penetrating trauma are relatively rare. Such cases are often accompanied by significant complications, including intracranial hemorrhage, cerebral contusion, major vascular injury, and cerebrospinal fluid leakage, which pose substantial challenges in clinical management. Herein, we report a successful case of surgical treatment for an intracranial metallic foreign body, aiming to provide valuable insights for similar clinical scenarios.Clinical presentationA 38-year-old male patient was urgently admitted to our emergency department following an intentional assault with a sickle, which resulted in an intracranial penetrating injury. Computed tomography (CT) scanning revealed the presence of a metallic foreign body that traversed the left temporal lobe and extended to the sphenoid bone and the posterior region of the right orbit. In response to this critical situation, an emergency surgical procedure was promptly initiated. The treatment strategy involved a combination of craniotomy and transnasal approaches to remove the metallic foreign body and reconstruct the skull base. Postoperatively, the patient exhibited no obvious adverse reactions, and his condition remained stable throughout the follow-up period.ConclusionIntracranial foreign bodies often penetrate neural structures via the orbit or nasal cavity. When dealing with a long foreign body predominantly situated within the brain parenchyma, it is crucial to avoid blindly extracting it. Instead, shortening the length of the foreign body may be a more feasible approach to facilitate its safe removal and transportation. Preoperative acquisition of comprehensive imaging data is of utmost importance, as it aids in delineating the spatial relationship between the foreign body, major intracranial vessels, and cranial nerves, thereby enabling the formulation of a rational surgical plan. Whenever possible, the removal of intracranial foreign bodies should be carried out within 6–8 h post-trauma. Additionally, reliable skull base reconstruction is essential to prevent cerebrospinal fluid (CSF) leakage and mitigate the risk of infectious complications.

Anaesthetic Management of Foreign Body Bronchus: Profile of Cases Appearing at Tribhuvan University Teaching Hospital: An Observational Study

Introduction: Rigid bronchoscopy is the preferred method for extracting airway foreign bodies, as it allows grasping forceps to extract foreign bodies while maintaining ventilation through a side port. The main challenge to the Anesthesiologists is to maintain oxygenation and ventilation while sharing the common field with the surgeons. This study intends to evaluate our current practices, challenges, and intraoperative events to enhance patient safety during these procedures. Methods:This is a prospective observational study that included patients with suspected or confirmed bronchial foreign bodies who underwent rigid bronchoscopy from February 2023 to February 2025. Data were collected by the anesthesiologists using the structured proforma, covering the anesthetic technique, complications, and details of foreign bodies. SPSS version 22 was used for analysis. Results: A total of 41 rigid bronchoscopies were performed, including three repeat procedures. Intraoperative complications included desaturation in 29, vocal cord edema in 16, slipping of foreign body in 8, bradycardia and airway bleeding in 6 cases each. Postoperatively, 23 patients required mechanical ventilation, and one patient experienced cardiac arrest. During preoperative preparation, intravenous glycopyrrolate and steroids were used in 38 and 34 cases, respectively. For induction and maintenance, Intravenous anesthesia was the most common technique, with muscle relaxants used in 39 cases. Of the 41 bronchoscopies, 30 achieved successful foreign body removal, while five required thoracotomy referrals. Conclusions: Anesthetic management of rigid bronchoscopy requires careful planning, vigilant monitoring and collaboration. Deasturation is the most frequent complication during removal of a foreign body bronchus.

SURGICAL RETRIEVAL OF A POSTERIOR NECK METALLIC FOREIGN BODY WITH A MINIMAL INCISION: A CASE REPORT

A 21-year-old male, self-employed, was admitted to our hospital. Three days prior to admission, the patient fell onto a steel fence, hitting the right side of his face against the fence. After the accident, the patient regained consciousness but presented with an open wound on the right cheek and pain in the posterior right neck region. He was initially brought to a local emergency facility, where the wound was cleaned, and X-ray examination revealed a metallic foreign body in the posterior neck region. After 3 days of treatment of local hospital, the patient requested to transfer to 108 Military Central Hospital for better treatment. We performed a computed tomographu with 3D reconstruction of the patient’s cervical spine which allowed for precise localization of the foreign body and assessment of its relationship with nearby structures, aiding in surgical planning. Considering the risk of potential complications, including vascular injury and nerve damage, early intervention was crucial. The foreign body removal surgery was performed with the patient under endotracheal anesthesia. The surgical procedure involved a 2 cm incision directly over the foreign body, ensuring its safe removal without damage to major blood vessels.

Application of ophthalmic magnets in the removal of magnetic intraocular foreign bodies

The aim of this study was to explore a new surgical method for removing magnetic intraocular foreign bodies(IOFB). We systematically reviewed 48 patients (48 affected eyes; 44 males and 4 females; aged 23–74 years, with a mean age of 44.8 ± 12.3 years) with magnetic IOFBs who were admitted to the Department of Ocular Trauma of Hebei Eye Hospital from January 2024 to June 2024. The most common cause of injury was ferrous foreign bodies resulting from working with metallic tools. Thirty-seven of the injuries were sustained in the patient’s workplace, and 11 injuries occurred domestically. The patients presented to the clinic 40 min to 60 days after injury. The time from injury to surgery ranged from 1 h to 14 d. In the preoperative examinations and postoperative routine follow-ups, the basic conditions of the patients’ eyes were evaluated through visual acuity examination using an international standard chart, slit lamp microscopic examination, anterior and posterior segment examinations with anterior slit lamp lenses, and intraocular pressure measurements. Before surgery, the foreign bodies were properly localized via horizontal and coronal localization CT scans, and type-B ultrasound scans were performed for patients with closed wounds. Ophthalmic magnets were used to remove magnetic IOFBs from 48 cases (48 eyes); in 44 cases, the foreign body was removed successfully during the stage I operation, representing a success rate of 91.7%. Among the included cases, 10 cases of anterior chamber IOFBs and crystalline lens IOFBs were all successfully removed during stage I surgery, for a success rate of 100%; in 38 cases of intravitreal IOFBs, 34 were successfully removed during stage I surgery via pars plana vitrectomy, and 4 cases failed to be removed in stage I surgery and were subsequently removed via stage II vitrectomy, for a stage I surgery success rate of 89.5%. Owing to their strong magnetic force, ophthalmic magnets have been demonstrated to be effective tools for the removal of magnetic IOFBs, enabling simple and time-conserving surgical procedures that are associated with less surgically induced trauma and fewer complications.

Knife to Meet You, Embedded and Endangered: A Case Report of Hemopericardium from Penetrating Chest Trauma

Penetrating chest trauma carries a high risk of life-threatening complications, requiring rapid assessment and intervention. We present a 42-year-old male with a stab wound to the sternum, complicated by a retained foreign body and hemopericardium. The injury sustained is classified grade IV - based on the American Association for the Surgery of Trauma (AAST) heart injury scale. Despite hemodynamic instability, early imaging revealed a mediastinal hematoma without active bleeding. The patient underwent emergency sternotomy for foreign body removal, preventing potential cardiac tamponade. Postoperative recovery was uneventful with minimal ventilatory and inotropic support. This case underscores the importance of early imaging, timely surgical intervention, and a multidisciplinary approach in managing penetrating cardiac injuries to improve survival and long-term outcomes.

A novel approach to nasopharyngoscopy in canine and feline cadavers: development and application of 3-dimensional-printed instrument guides.

To develop and evaluate the use of 3-D-printed instrument guides for nasopharyngoscopy, focusing on maneuverability, the ability to biopsy the nasal choanae, and foreign body retrieval. Various sizes of 3-D-printed guides (small, medium, large) and angles (160°, 170°, 175°, and 180°) were tested alongside retroflex nasopharyngoscopy in cadavers. Four cadavers representing different sizes and species (3 canines and 1 feline) were utilized to evaluate the success of the 3-D-printed instrument guides. The study evaluated the maneuverability of each guide within the nasopharynx, along with their effectiveness in facilitating choanal biopsies and retrieving a simulated grass foreign body. Performance was compared across guides to determine the most effective design. The 180° guide had limited maneuverability and was unable to facilitate biopsies or foreign body retrieval. The 175° guide showed moderate maneuverability and successfully performed biopsies and foreign body removal, although with mild resistance to movement. The 170° guide demonstrated high maneuverability, enabling smooth access in all directions and consistent procedural success. The 160° guide exhibited the greatest flexibility and procedural success, providing superior maneuverability and ease of use. Three-dimensional-printed instrument guides with more acute angles improve nasopharyngeal access and procedural efficiency. The 160° guide showed the greatest potential for clinical application in facilitating biopsies and foreign body removal. Three-dimensional-printed nasopharyngoscopy guides enhance diagnostic and therapeutic procedures by improving access, biopsy collection, and foreign body retrieval. More acute angles offer greater maneuverability, supporting their clinical use for minimally invasive nasopharyngeal interventions in veterinary medicine.

Foreign body removal in a paediatric patient: Attract to extract!

Foreign body removal in a paediatric patient: Attract to extract!

Preoperative septic peritonitis, hypotension, and reason for surgery are risk factors for small intestine dehiscence in dogs: a directed acyclic graph approach.

To evaluate risk factors for postoperative intestinal dehiscence, adjusting for potential confounders identified through directed acyclic graphs (DAGs). A retrospective cohort study was conducted of dogs undergoing small intestinal surgery at a private referral center between July 2011 and July 2024. Directed acyclic graphs were used to identify risk factors, confounders, and mediators, with regression models developed to adjust for these confounders. A total of 55 dogs were included in the study. Of these, 11 dogs (20%) developed postoperative intestinal dehiscence. After adjusting for the time from clinical signs to surgery and the reason for surgery, dogs with preoperative septic peritonitis (PSP) had higher odds of dehiscence compared to those without PSP (OR, 40.7; 95% CI, 4.4 to 2,142). After adjusting for PSP, dogs with hypotensive events during hospitalization had higher odds of dehiscence compared to those without hypotension (OR, 15.6; 95% CI, 1.2 to 975). Additionally, dogs undergoing surgery for foreign body removal had lower odds of experiencing postoperative intestinal dehiscence compared to those with other reasons for surgery (OR, 0.2; 95% CI, 0.0 to 0.9). Serum albumin concentration, enterectomy, and vasopressor use were not independently associated with dehiscence. DAGs identified multiple risk factors for dehiscence, along with potential confounders and mediators. Regression analysis confirmed that PSP, hypotensive events, and surgery type were independent risk factors for postoperative dehiscence. Close monitoring of dogs with PSP and careful blood pressure management may help reduce the risk of postoperative dehiscence.

Workshop 1 “Foreign Body Removal in the Oral Cavity, Pharynx, Trachea, and Esophagus -Are You Prepared?” -Introduction

Workshop 1 “Foreign Body Removal in the Oral Cavity, Pharynx, Trachea, and Esophagus -Are You Prepared?” -Introduction

Unusual Case of Fishhook Lodged in the Neck: A Case Report and Literature Review.

Fishing constitutes a widely practiced sport considered pleasant and harmless. Yet, there are specific risks associated with fishhook injuries specifically in the neck. To the best of our knowledge, only few articles on fishhook injury in the neck were reported in the literature. We present the case of a 57-year-old previously healthy male coming to the emergency department with a J fishhook accidentally lodged in his neck. Prompt management with bedside removal of the sharp foreign body from the neck was achieved with no subsequent complications. In this case report, literature review of fishhook types and injuries as well as management options of such penetrating injuries will be detailed.

Appendicitis with perforation caused by metal dental graft: A case report.

Under normal circumstances, foreign objects in the digestive tract can be expelled naturally through the anus via the digestive tract's peristalsis mechanism. In clinical practice, foreign bodies ingested orally seldom pass through the cecum into the appendiceal lumen, potentially leading to secondary appendicitis or even perforation - a highly infrequent but severe complication. This article aims to share our experience and insights in managing such rare cases, exploring diagnostic pathways and treatment options, and serving as a reference for colleagues. A 57-year-old male patient may have accidentally ingested a tooth graft, resulting in right lower quadrat pain. Based on the physical examination and imaging findings, the likelihood of AA with perforation is high. Acute appendicitis (AA) with perforation. Laparoscopic appendectomy (LA) and removal of foreign bodies. After surgical treatment, the patient recovered well, and there were no recent complications such as wound infection, incisional hernia, and massive hemorrhage. In the diagnosis of appendicitis caused by foreign bodies, clinical history, physical examination, and imaging are crucial to the diagnosis of the disease. Once diagnosed, surgery should be taken quickly. LA offers several advantages, including minimal trauma, excellent visualization, precise treatment outcomes, and swift patient recovery. Therefore, we recommend it as the preferred treatment for appendiceal perforation caused by foreign bodies.

Foreign bodies in the gastrointestinal tract of children: A clinical analysis and guidelines for management.

Objective: In this paper, we analyzed the outcomes of foreign bodies in the digestive tract of 42 children who were hospitalized in the pediatric department of a tertiary hospital in a medium-sized city in China. The focus is on discussing the indications for removal of foreign bodies via digestive endoscopy. Methods: Forty-two children with foreign bodies in the digestive tract, hospitalized from June 2020 to October 2022 were selected. Results: (1) The majority of the children (52.4%) who had coins in their digestive tracts were between the ages of 3 to 6 years. (2) Symptoms were most commonly observed in the esophagus (62.5%), and gastroscopy was used to remove all foreign bodies. (3) There were 13 cases with foreign bodies in the stomach, and only 4 required removal of the foreign bodies. (4) Among 4 cases where imaging was unable to detect the foreign bodies, gastroscopy revealed the foreign bodies in the esophagi of 2 symptomatic cases, and were removed; the other 2 asymptomatic cases excreted the foreign bodies in the stools. Conclusion: The timing for foreign body removal via digestive endoscopy depends on factors such as location, nature, and symptoms. Single foreign bodies that migrate within the stomach and intestine may be observed without intervention if asymptomatic. Sharp foreign bodies usually pass spontaneously if beyond the esophagus. Emergency gastroscopy is recommended for symptomatic cases; otherwise, clinical observation is suggested.

Live Foreign Body - Interarytenoid Fold.

Laryngeal Foreign Body (FB) are common in ENT practices. 40 year old male presented to ENT OPD with FB sensation in the throat following water intake, Video Direct Laryngoscope showed FB in the interarytenoid fold. Under Topical Anesthesia, FB removal was done with Hartman's forceps, found to be live Ant.

Surgical Techniques for Optimal Lens Management of Posterior Segment Metallic Intraocular Foreign Body Removal: A Case Series.

We describe three different approaches for lens management in cases of metallic intraocular foreign bodies (IOFBs) involving the posterior segment. All consecutive posterior segment metallic IOFB cases from 2012 to 2023 at a single institution were included in this retrospective case series. Surgical outcomes and surgical videos are presented. A total of 25 metallic IOFB cases were included. In 9 cases, there was no significant lens involvement, therefore, not requiring lens extraction at the time of IOFB removal. In 8 cases with traumatic cataract, lens extraction sparing the anterior lens capsule was performed with IOFB removal. In 8 cases, both lens extraction and lens capsule removal were required at the time of IOFB removal. We demonstrate our algorithm to capsular management in patients who present with IOFB with good visual outcomes in follow-up.

Current New Approach in Thoracoscopic Surgery: Non-Intubated Uniportal Video-Assisted Thoracoscopic Surgery (NI-UniVATS).

Background and Objectives: Non-intubated uniportal video-assisted thoracoscopic surgery (NI-UniVATS) is a minimally invasive technique performed using a single port, allowing the entire surgical procedure to be completed with spontaneous breathing without the need for general anesthesia. Materials and Methods: This retrospective study included 51 patients who underwent NI-UniVATS between 2020 and 2023. The intraoperative and postoperative data of patients who underwent NI-UniVATS were evaluated. Results: Among the cases, 37 (72.5%) were male, and 14 (46.6%) were female, with a mean age of 47.73 ± 20.43 years (range: 18-78 years). The mean operative time was 25.92 ± 7.31 min. No perioperative complications were observed in any patient. The mean postoperative hospital stay was 4.17 ± 1.76 days (range: 2-9 days). A right hemithoracic approach was performed in 28 patients (54.9%), whereas a left hemithoracic approach was used in 23 patients (45.1%). The procedures performed included wedge resection in 27 patients (52.9%), biopsy in 22 patients (43.1%), pericardial window creation in one patient (2%), and intrathoracic foreign body removal in one patient (2%). Conclusions: NI-UniVATS allows for safer surgery by preventing the adverse effects and complications associated with general anesthesia. NI-UniVATS can be recommended as a safe and feasible approach for both minor and major thoracic procedures.

Microscopic endonasal transsphenoidal approach for repair of sellar defect from penetrating trauma during wartime: illustrative case.

Penetrating head trauma caused by blast injuries can result in intracranial foreign bodies (FBs), which pose significant risks, including CSF leaks, pneumocephalus, and infections, particularly when paranasal sinuses are involved. A 54-year-old male sustained a blast injury in Ukraine, resulting in shrapnel embedded in the sella turcica. The trajectory of the shrapnel traversed the right medial orbital wall into the ethmoid and sphenoid sinuses, ultimately reaching the sella and causing a skull base defect with CSF rhinorrhea. CT imaging revealed subarachnoid hemorrhage and severe pneumocephalus. Because of the FB's proximity to the cavernous sinus and pituitary gland, the decision was made to leave the FB and repair the defect via a microscopic endonasal transseptal transsphenoidal approach with a fascial and muscle graft given that a nasoseptal flap was not possible. The patient experienced no neurological or endocrinological sequelae with complete resolution of the pneumocephalus. The microscopic endonasal transsphenoidal approach is a safe and effective technique for managing skull base defects resulting from penetrating trauma, achieving resolution of pneumocephalus, and preventing meningitis. Decisions regarding FB removal should be individualized, prioritizing patient recovery while minimizing neurovascular risks. https://thejns.org/doi/10.3171/CASE24875.