Removal Of Metallic Foreign Body Research Articles

Removal of Metallic Foreign Bodies with Complete Penetration of the Cornea: Introduction of a New Approach.

The purpose of this study was to present a new ab interno approach and relevant case series using a polymer-tipped cannula for the removal of metallic foreign bodies that penetrate the full thickness of the cornea and are located in the posterior corneal region. Corneal foreign bodies located on the posterior side of the cornea were gently pushed toward the epithelial side with a polymer-tipped cannula placed using a side-port incision, to be removed without damaging the corneal endothelial layer. The polymer-tipped cannula is specially angled to keep it at a distance from the corneal endothelial layer. In this way, unnecessary endothelial contact and the risk of possible endothelial loss are minimized. The foreign body was held by the epithelium with forceps and carefully removed along the corneal perforation line. This technique was performed in 5 eyes of 5 patients. The mean patient age at the time of surgery was 38.0 ± 12.1 years (range, 28-59 years). Anterior segment optical coherence tomography showed a metallic foreign body and its shadow that completely penetrated the cornea with the deterioration of the endothelial layer in all cases. In all cases, the corneal foreign body was successfully removed. While preoperative corneal endothelial cell density was 3040.0 ± 512.8 cells/mm2, postoperative corneal endothelial cell density was 2927.2 ± 608.1 cells/mm2 at the third postoperative month, and there was no significant corneal endothelial cell loss in any of the cases (P = 0.31). The ab interno approach, performed with a polymer-tipped cannula for the removal of corneal foreign bodies that penetrate deeply, stands out as an important surgical method. This method offers a reliable and effective solution by preventing the foreign body from falling into the anterior chamber and minimizing endothelial damage.

Right Middle Lobectomy on Metallic Foreign Body Using the Uniportal Video Assisted Thoracoscopic Surgery: A First Experience in the Democratic Republic of Congo

The removal of metallic foreign bodies in the lower airways, a source of recurrent pneumonia, is not currently performed in the Congolese population using video-assisted thoracoscopy surgery (VATS) under unipulmonary ventilation. Multiple failures of rigid and/or flexible bronchoscopy are likely to be a cause of morbidity and mortality. To the best of our knowledge, we report a first experience in DRC, of right middle lobectomy on metallic foreign body by VATS in a 14-year-old girl after two years of accidental inhalation of a metallic key, in the face of two bronchoscopy failures. A partial transverse bronchotomy successfully performed under VATS allowed extraction of the foreign body followed by bronchial reconstruction with resection of the right middle lung lobe. The aim of the multidisciplinary team was to determine whether lobectomy by VATS would result in shorter hospital stays, fewer complications and faster recovery than lobectomy by thoracotomy, to review the key stages of case management using an unusual approach in the region, and to draw a conclusion based on this first experience.

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.

Surgical removal of metallic foreign body in buffalo teat

Surgical removal of metallic foreign body in buffalo teat

Retrospective evaluation of the clinical course and outcome of zinc toxicosis due to metallic foreign bodies in dogs (2005-2021): 55 cases.

To describe the overall clinical course of zinc toxicosis in dogs including source, time to source control, incidence of hemolytic anemia, acute liver injury (ALI), acute kidney injury (AKI), and pancreatitis. Retrospective case series from 2005 to 2021. Six university veterinary teaching hospitals. Fifty-five client-owned dogs with known zinc toxicosis due to metallic foreign body (MFB) ingestion. The most common source of zinc was US pennies minted after 1982 (67.3%). Forty-five of 55 (81.8%) dogs survived and 10 of 55 (18.2%) died or were euthanized. Median length of hospitalization for survivors and nonsurvivors was 3days. The most common clinical sequelae of zinc toxicosis were anemia (87%), ALI (82%), coagulopathy (71%), thrombocytopenia (30.5%), AKI (26.9%), and acute pancreatitis (5.5%). Most dogs (67.3%) required blood products and 83% of dogs achieved a stable HCT or PCV in a median of 24hours after MFB removal. The median duration of illness prior to presentation was 48hours for both survivors and nonsurvivors and there was no impact of time to presentation on the incidence of ALI, AKI, or pancreatitis. Zinc toxicosis secondary to MFB ingestion should be considered a differential diagnosis for dogs with gastrointestinal signs, hemolytic anemia, ALI, hemostatic abnormalities, AKI, and pancreatitis. AKI may be a more common sequela of zinc toxicosis than previously suspected. Acute pancreatitis is a rare but potentially serious sequela to zinc toxicosis.

Successful removal of metallic foreign body in the neck-mediastinum via the parapharyngeal space approach.

Neck-mediastinum foreign body (FB) is a common emergency in otorhinolaryngology head and neck surgery departments, and it can be lethal. We present a case of an uncommon foreign body in the neck-mediastinum. The FB was metallic and about 12 cm long. A 74-year-old male accidentally swallowed a metallic FB that lodged in his throat for > 3 days. The intake of the object was associated with smoking a peace pipe, and was an indication for surgery. Aerodermectasia was observed in the neck upon physical examination, and a high-density foreign body was found in the neck-mediastinum through cervicothoracic computed-tomography (CT) scan. Electronic laryngoscopy showed a white pseudo-membrane adhering to the surface of the bilateral piriform fossa in the right laryngeal vestibule, and the root of the tongue, and mucosa were swollen. Cervicothoracic CT revealed dense shadows in the neck-mediastinum. However, electronic laryngoscopy showed no FB in the larynx or piriform fossa. The metal FB was removed by surgery via the parapharyngeal space approach instead of endoscopy. After preoperative assessment and preparation, we successfully removed the metal FB from the neck-mediastinum via the parapharyngeal space approach. The patient was doing well at one-month follow-up. Neck-mediastinum FB is an emergency but rare case necessitating otorhinolaryngology head and neck surgery. It can easily lead to mediastinal and lung infection; given its location in the body, it may lead to aortic arch rupture if not handled promptly.

When is the Appropriate Time for Superficial Corneal Metallic Foreign Body Removal?

When is the Appropriate Time for Superficial Corneal Metallic Foreign Body Removal?

Removal of Orbital Metallic Foreign Bodies With Image-Guided Surgical Navigation.

To describe the use of an image-guided 3-dimensional surgical navigation system for the removal of metallic foreign bodies from the human intraorbital region. Between January 2016 and June 2019, 30 patients with metallic foreign bodies in the orbital area underwent image-guided 3-dimensional surgical navigational removal at the authors' center, and their data were retrospectively analyzed. Patients' age, gender, complaints, cause of initial injury, location, interval between injury, and surgery were recorded. Preoperative CT scans of the orbits were obtained and used for preoperative planning. The 3-dimensional navigation system was used for intraoperative navigation. In all 30 patients, the foreign bodies were removed by minimally invasive access without any severe complications. The intraoperative average depth of foreign bodies was 19.98 ± 11.47 mm which was consistent with the depth measured in preoperative planning. The mean length, width, and height of foreign bodies determined in preoperative planning were confirmed by postoperative measurements. There was no significant difference between preoperative and postoperative mean logarithm of Mininal Angle Resolution (logMAR) best-corrected visual acuity. According to the postoperative CT scan, all 30 patients' metallic foreign bodies were successfully removed by surgeries using the surgical navigation system. Most patients who presented with diplopia, eye movement pain, and paresthesia were improved after surgery. This study demonstrated that computer-assisted image-guided 3-dimensional surgical navigation had the advantages of accurate real-time localization of foreign bodies, minimizing collateral damage, determining the appropriate surgical path, and increasing the successful rate of foreign body retrieval.

Retrieval of a Broken Sewing Needle from the Sacrum Aided by a Permanent Magnet: A Case Report and Literature Review.

Penetrating sacral injuries are very rare, but foreign bodies that penetrate the sacrum often cause pain, cerebrospinal fluid leakage, and neurological symptoms. Careful preoperative medical and imaging examinations, determining the position of the foreign body, and surgical exploration are essential in the management of such cases. We present the case of a woman who visited our emergency department with a broken sewing needle in her sacrum. The incident occurred when the patient accidentally sat on the needle while sewing by hand. Pain while sitting was the main clinical finding after the accident. The patient was treated successfully by surgical exploration aided by a permanent magnet. At follow-up a few months later, she was symptom-free. In clinical practice physicians often encounter patients with metallic foreign bodies. Permanent magnets play an important role in the removal of metallic foreign bodies, and emergency department physicians should master the methods and techniques.

Magnetic Force: An Attractive Solution for Penetrating Metallic Foreign Body Removal in Neck and in ENT

A year young boy presented to our ENT department OPD with history of a penetrating metallic foreign body in the neck since yrs On wound exploration under local anesthesia the foreign body was not identified It was removed with the help of a magnet after years nbsp

Surgical removal of metallic foreign body (shrapnel) from the lumbosacral spine and the treatment of chronic osteomyelitis: a case report.

We report a case of a retired soldier who was severely injured by an explosion in 1993 during the war in Bosnia and Herzegovina. Among other wounds, he suffered an explosive wound in the lumbosacral spine with steel foreign body (shrapnel). A year after primary wound treatment, a purulent fistula appeared which was treated and stopped with antimicrobial therapy. Subsequently, fistula which was activated several times after the antibiotic therapy was discontinued, but in the last eight years, the fistula has been continuously present so the patient decided on surgery. During surgery, the shrapnel was removed from the lumbosacral spine and there was debridement of necrotic bone. During two weeks of peri-operative and postoperative period, chronic osteomyelitis was treated by intravenous ciprofloxacin and gentamycin, and after that by a combination of rifampicin and trimethoprim-sulfamethoxazole orally, for six months. The patient did not show any signs of infection after two years of follow-up.

Removal of metallic foreign bodies embedded in soft tissues by stereotaxic approach.

A trial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke and death. Patients with hypertensive have an increased risk of developing atrial fibrillation. RDW (Red blood cell distribution width) levels are elevated in cardiovascular disorders including heart failure, stable coronary disease, acute coronary syndrome, slow coronary flow and stroke. To investigate the relation between RDW and AF in patients with hypertensive. We retrospectively examined 126 consecutive hypertensive patients (63 hypertensive patients with AF and 63 hypertensive patients without AF matched with age and sex. The mean age of the study population was 71,09± 8,50 (af group) and 70,97±8,24 (non-af group) years. RDW level was different among patients with atrial fibrillation and without atrial fibrillation.(15,13±1,58 and 14,05±1,15 p<001). Logistic regression analysis showed that RDW and left atrial dimension were only independently risk factory associated with atrial fibrillation. (Rdw odds ratio:1,846 CI; 1,221-2,793 p<0,05). Roc curve analyses were applied to determine the cut-off point. Cut-off point was at 14,195 and Sensitive, specificity was %71,4, %56 respectively. RDW levels were higher in hypertensive patients with atrial fibrillation. An increased RDW level in the patient with hypertension may alert physician on developing or presence of atrial fibrillation.

Comparison of Metallic Foreign Body Removal between Dynamic Ultrasound and Static Radiography in a Pigs’ Feet Model

IntroductionWe compared the immediate cosmetic outcome of metallic foreign-body removal by emergency medicine (EM) residents with ultrasound guidance and conventional radiography.MethodsThis single-blinded, randomized, crossover study evaluated the ability of EM residents to remove metallic pins embedded in pigs' feet. Before the experiment, we embedded 1.5-cm metallic pins into numbered pigs' feet. We randomly assigned 14 EM residents to use either ultrasound or radiography to help remove the foreign body. Residents had minimal ultrasound experience. After a brief lecture, we provided residents with a scalpel, laceration kit, a bedside portable ultrasound machine, nipple markers, paper clips, a dedicated radiograph technician, and radiograph machine 20 feet away. After removal, 3 board-certified emergency physicians, who were blinded to the study group, evaluated the soft-tissue model by using a standardized form. They recorded incision length and cosmetic appearance on the Visual Analog Scale.ResultsIn total, 28 foreign bodies were removed. No significant difference in the time of removal (P = 0.12), cosmetic appearance (P = 0.96), or incision length (P = 0.76) was found.ConclusionThis study showed no difference between bedside ultrasound and radiography in assisting EM residents with metallic foreign-body removal from soft tissue. No significant difference was found in removal time or cosmetic outcome when comparing ultrasound with radiography.

Comparison of Metallic Foreign-Body Removal between Dynamic Ultrasound and Static Radiography in a Pigs' Feet Model

Introduction: We compared the immediate cosmetic outcome of metallic foreign-body removal by emergency medicine (EM) residents with ultrasound guidance and conventional radiography.Methods: This single-blinded, randomized, crossover study evaluated the ability of EM residents to remove metallic pins embedded in pigs’ feet. Before the experiment, we embedded 1.5-cm metallic pins into numbered pigs’ feet. We randomly assigned 14 EM residents to use either ultrasound or radiography to help remove the foreign body. Residents had minimal ultrasound experience. After a brief lecture, we provided residents with a scalpel, laceration kit, a bedside portable ultrasound machine, nipple markers, paper clips, a dedicated radiograph technician, and radiograph machine 20 feet away. After removal, 3 board-certified emergency physicians, who were blinded to the study group, evaluated the soft-tissue model by using a standardized form. They recorded incision length and cosmetic appearance on the Visual Analogue Scale.Results: In total, 28 foreign bodies were removed. No significant difference in the time of removal (P¼ 0.12), cosmetic appearance (P ¼ 0.96), or incision length (P ¼ 0.76) was found.Conclusion: This study showed no difference between bedside ultrasound and radiography in assisting EM residents with metallic foreign-body removal from soft tissue. No significant difference was found in removal time or cosmetic outcome when comparing ultrasound with radiography.

Arthroscopic Removal of Metallic Foreign Body from the Talocrural Joint Using a Magnetic Retriever in a Horse

To report use of a magnetic retriever for arthroscopic removal of a metallic foreign body from the equine talocrural joint. Clinical report. A 2-year-old Warmblood stallion. A metallic foreign body was removed from a talocrural joint using a 10-mm magnetic retriever under arthroscopic guidance. Preoperative radiographs were used to locate the intra-articular position of the foreign body. Six months after surgery, the horse was no longer lame. A magnetic retriever can be used for arthroscopic removal of metallic foreign bodies from the equine talocrural joint. A magnetic retriever may be useful for arthroscopic retrieval of metallic foreign bodies from synovial cavities in horses, especially when direct observation is impeded by inflamed synovial villi and fibrin.

The diagnosis and treatment of rapidly growing non-tuberculous mycobacterial keratitis

To study the clinical features, diagnosis and treatment of non-tuberculous mycobacterial keratitis (NTMK). It was retrospective case series study. Twelve eyes in 12 patients with NTMK following corneal foreign body trauma in 2007 were studied retrospectively including the case histories, clinical findings, laboratory examinations, diagnosis, treatment and prognosis. The main laboratory examination included corneal scrapings by culturing, polymerase chain reaction (PCR) and transmission electron microscopy (TEM), corneal lesions by histopathologic examinations and TEM. The patients received local and systemic antibiotics therapy, lesion cleaning followed by cauterization with tincture of iodine (5%) and (or) keratoplasty. All cases had a history of corneal trauma, there was corneal metallic foreign body removal at one hospital in 11 cases, corneal reed trauma in 1 case. The characteristic signs involved grayish-blue crystalloid keratopathy, multifocal infiltrates, satellites, radical form changes in the Descemet's membrane. The results of laboratory examinations of the scrapings of the cornea infection were as follows: all cultures (12/12) were positive for rapidly growing mycobacteria, and isolates from 5 patients were all diagnosed as mycobacterium chelonae subspecies abscess; acid-fast staining revealed positive bacilli in all the 4 patients; seven of 8 patients were positive for bacterium by PCR. Transmission electron microscopy in all the 3 specimens showed many slender rod-shaped or short coarse-shaped bacteria which were phagocytized by monocytes, and some necrotic tissue. Infections in 10 eyes were resolved by combined treatment regimen including a combination of antimicrobial agents (amikacin, rifampin, gatifloxacin, ciprofloxacin, azithromycin and/or ofloxacin, etc.) and local lesion cleaning followed by cauterization with 5% tincture of iodine within 2-5 months; two cases resolved by keratoplasty which poorly responded to antibiotic therapy for 6 months. NTMK is a rare, recalcitrant opportunistic infection which can occur in an epidemic fashion following corneal foreign body trauma. The diagnosis of NTMK is difficult, and may easily be misdiagnosed as fungal keratitis. Acid-fast staining, TEM, especially bacterial culture can help to obtain definitive diagnosis. NTMK has a long response period to medical management. The majority of patients can be cured by local and systemic antibiotics therapy, and the recalcitrant infections could be resolved by keratoplasty.

350: Metallic Foreign Body Removal with Ultrasound Guidance

350: Metallic Foreign Body Removal with Ultrasound Guidance

Removal of metallic foreign body with three-dimensional reconstructed computed tomography

Objectives: Safe removal of foreign bodies in the area of the skull base needs meticulous preoperative planning. Three-dimensional (3-D) reconstruction from CT imaging helps make preoperative planning by simulating the process of removal of foreign bodies. We report the role of 3-D reconstruction for removal of the nail lodged in the maxillary sinus and penetrating into the skull base, the tip of which was lodged in the brain. Methods: A 5-inch long metal nail was found, the tip of which was lodged in the brain, penetrating the posterior wall of the maxillary sinus in a 32-year-old male patient. 3-D reconstruction with volume rendering technique was made. The precise location and direction of the nail was defined using the reconstructed images. The positioning of the head of the patient and the direction of intraoperative orientation for removal of the nail was decided preoperatively with 3-D reconstructed images. Results: The nail was removed safely using the same way as preoperatively simulated with volume rendered 3-D images through the Caldwell-Luc approach. Conclusion: Volume rendered 3-D reconstructed images are useful for preoperative simulation for the removal of foreign bodies located in the dangerous area of the head.

Metallic foreign bodies in the stomach: fluoroscopic removal with a magnetic orogastric tube.

Thirty-six patients with 37 cases of metallic foreign bodies in the stomach were referred for fluoroscopic removal with a magnet coupled to an orogastric tube. Removal was successful in 34 of the cases. No complications occurred. No patient required hospital admission, endoscopic or surgical intervention, or general anesthesia. Fluoroscopic removal of metallic foreign bodies in the stomach with an orogastric magnet is an alternative to endoscopic or surgical removal.

The use of a metal locator in an accident and emergency department.

Abstract During the past year the removal of metallic foreign bodies in an accident and emergency department has been aided by the use of a metal locator.