Removal Of Such Foreign Bodies Research Articles

Unusual Migration of Bullet from the Right Scalp to Left Pyriform Fossa.

Spontaneous migration of a retained bullet is rare. Foreign bodies like bullets will be found at the distant site from the region of wound of entry in case they migrate. We report a case of a 17-year-old female with spontaneous migration of bullet from right temporo- parietal scalp to the posterior wall of left pyriform fossa. Twelve years back she had received a gunshot in right temporal region, no exploration was done to remove the bullet. She started complaining of discomfort in the upper neck of two months duration. Rigid laryngoscopy revealed smooth bulge with thinning of overlying mucosa. Radiographs of the neck showed bullet along the posterior pharyngeal wall in the region of the pyriform fossa. CT scan of the head and neck region was done to exclude the presence of any other foreign bodies. Microlaryngoscopy suspension of the larynx was done and CO2 laser was used to incise the mucosa over the bullet and it was retrieved with the help of long artery forceps. Our case illustrates that bullets may take an unexpected course from the site of entry, probably by migration. Trans oral CO2 laser microsurgery is the recommended approach for removal of such foreign bodies.

A Novel Tool to Treat a Pediatric Patient with a Spherical Foreign Body in the External Auditory Canal

Introduction: Foreign bodies (FBs) in the external auditory canal (EAC) are common in pediatric otorhinolaryngology. Although clinicians have tried many methods and tools to treat these patients, removing the spherical FBs embedded deep in EAC is still a challenge. Occasionally successful removal of such FBs requires local or general anesthesia. Case Presentation: Here, we developed a simple and novel 3-dimensional (3D) printing tool to successfully treat a child suffering from a spherical FB in EAC. The child received no further treatment, and no complications developed afterward. Conclusions: It is challenging to remove spherical FBs in EAC. We developed a tiny, safe, and cheap tool to treat a child with such a FB in EAC. The clinical outcome was satisfactory.

Penetrating Orbitofrontal Foreign Body: Case Report

AbstractOrbitofrontal foreign-body injuries comprise a major cause of all facial injuries referred to a neurosurgeon. The authors hereby present an unusual case of a pressure regulator of a domestic pressure cooker impacted into the orbit and extending through the orbital roof into the basifrontal cortex. The globe was intact externally with no obvious sign of such a large object impacted behind the globe. On imaging, the foreign body was found to have fractured the orbital roof with one end protruding into the basifrontal cortex. A transcranial approach was taken to remove the object with removal of the orbital rim and roof to reach the object. After successful retrieval of the metallic body, all displaced bone fragments were removed and the dural closure was done in a watertight manner. The vision could not be salvaged, most likely due to damage to the optic nerve. However, the globe was left intact and the ocular movements were normal. An important factor to consider in removal of such foreign bodies is that the bone fragments that get impacted should be meticulously removed and the dural tears should be sealed to prevent any intracranial infections and cerebrospinal fluid leaks. Removal of the orbital rim helps in adequate exposure of the retro-orbital space and the basifrontal dura.

An Unusual Foreign Body in a Three Months Old Infant – A Case Report

Foreign body in the aerodigestive tract is common, but ingested foreign body lodging in the nasopharynx is rare and likely to be missed. We present an unusual case of a 3 month old infant who presented with a history of gagging, excessive crying and irritability, drooling of saliva and refusal to suck. A foreign body (mirror) was found lodged in his nasopharynx. The FB was removed under general anaesthesia with no complication. I. Introduction Although unusual aerodigestive tract foreign bodies (FB) are common among children, its lodgment in the nasopharynx is not a usual finding , .The nose is the usual conduit for FB found in the nasopharynx, an unskilled attempt at removal of a nasal foreign body can push it backwards and occasionally may be lodged in the nasopharynx. Most of the foreign bodies entering the oral cavity pass into the esophagus and some are inhaled into the trachea. Report of FB introduced through the oral cavity getting lodged into the nasopharynx is unusual and very rareError! Bookmark not defined. , , this is due to the fact that the nasopharynx is capacious and the presence of nasopharyngeal sphincter prevents regurgitation of FB into the nasopharynx. Patient with FB in the ingestion that got impacted in the nasopharynx may present with initial choking, coughing, bluish colouration and breathlessness, and later with nasal obstruction, nasal discharge and snoring. Sharp foreign bodies can pierce soft tissue and get impacted and removal of such foreign bodies may result in damage to surrounding structure if not carefully done. Perforation of the pharyngeal wall may lead to retropharyngeal abscess formation with all its attendant complication if not adequately and promptly treated. We present a case of an unusual FB (mirror) in an unusual age group -three months old child.

A Bunch of Stapler Pin: An Unusual Nasopharyngeal Foreign Body

ABSTRACT Objective To highlight the occurrence of unusual foreign bodies in the nasopharynx in the pediatric age group. Introduction Foreign bodies are common in ENT practice universally. At times they may present as emergency requiring urgent intervention and many a times they go unnoticed as these are not suspected. Nasopharyngeal foreign bodies are rare in any age group. Case Report A 10 months old female child was brought with the history of persistent drooling of saliva and refusal to feed after accidental ingestion of a bunch of stapler pin. Plain radiograph showed a bunch of stapler pin in the nasopharynx with enlarged adenoid tissue and prevertebral soft tissue shadow. Conclusion Bunch of stapler pin is an unusual foreign body in the nasopharynx. Care should be taken while removing these foreign bodies. Digital manipulation for removal of such foreign bodies are hazardous and should be avoided at all cost. How to cite this article Das S, Chakraborty S, Mukherjee S. A Bunch of Stapler Pin: An Unusual Nasopharyngeal Foreign Body. Clin Rhinol An Int J 2015;8(3):127-129.

Forgotten Kirschner Wire Causing Severe Hematuria

Kirschner wire (K-wire) is commonly used in the treatment of hip fracture and its migration into pelvis leading to bladder injury is a very rare complication. Nonremoval of these devices either because of lack of followup or because of prolonged requirement due to disease process is associated with this complication. We report a case of a patient who presented with acute onset severe hematuria with clot retention secondary to perforation of bladder by a migrated K-wire placed earlier, for the treatment of hip fracture. Initial imaging showed its presence in the soft tissues of the pelvis away from the major vascular structures. Patient was taken for emergency laparotomy and wire was removed after cystotomy. Postoperative period was uneventful and patient was discharged in satisfactory condition. K-wires are commonly used in the management of fracture bones and their migration has been reported in the literature although such migration in the intrapelvic region involving bladder is very rare. Early diagnosis and prompt removal of such foreign bodies are required to avert potentially fatal involvement of major structures.

Pantoea agglomerans as an indicator of a foreign body of plant origin in cases of wound infection

To investigate the role of Pantoea agglomerans as an infectious agent that causes infection in a wound even after the wound was managed at the emergency department. A retrospective cohort study, reviewing the medical records of patients with traumatic wounds that were admitted to the emergency department from 2007-20 12 and had signs of wound infection for more than I 0 days after the wound was managed. Bacteriological results, clinical picture,and treatment results were obtained. Nine cases were identified. Pantoea agglomerans was detected in all cases. After 1-2 months of ineffective treatment, patients were hospitalised and surgical revisions of the wounds were performed.In all cases, small foreign bodies of plant origin were detected. After surgical revision, wounds were healed in 2-3 days. In cases of prolonged healing of post-traumatic wounds, the presence of foreign bodies of plant origin infected with Pantoea agglomerans should be taken into account. Removal of such foreign bodies leads to rapid healing of the wounds.

Unusual foreign bodies in the orofacial soft tissue spaces: A report of three cases

The ingestion and inhalation of foreign bodies with their associated morbidity and mortality have been widely reported in the literature. However, reports on foreign body impaction in the orofacial region are comparatively fewer. Three unusual cases of foreign body impaction into the buccal and submasseteric spaces are presented. The three patients were adults and they presented with history of painful facial swelling associated with limited mouth opening. Plain skull radiographs revealed the foreign bodies within the facial soft tissue spaces in two patients while it was not helpful in the third patient. Surgical explorations of the left buccal, left submasseteric and the right buccal spaces led to the retrieval of the foreign bodies. Prompt diagnosis and surgical removal of such foreign bodies will greatly minimize the associated complications which may include; cellulitis, facial abscess, allergic reactions, necrotizing fasciitis and osteomyelitis.

Ultra‐low Velocity Penetrating Neck Trauma: Explore/Extract?

Objective: 1) Describe the injury pattern caused by ultra-low velocity (ULV) foreign body penetration of the neck in the context of self-mutilation, and 2) Propose a conservative management strategy for removal of such foreign bodies when the likelihood of serious injury is low. Method: Case series of 8 incidents of self-inflicted ULV penetrating neck trauma in a single patient who presented to a tertiary care hospital between December 2007 and December 2008. Postoperative morbidity was analyzed according to the presenting signs, symptoms, and radiologic findings and to the extent of surgical intervention. Results: Ten foreign bodies were removed on 8 separate occasions. Concerning physical signs were present on one occasion (bleeding); symptoms on 3 (dyspnea or odynophagia); and radiologic findings on 6. Seven objects were retrieved by targeted dissection, with a mean operative time of 27.7 ± 8.4 min. Three objects were removed in the context of formal neck exploration, each with an operative time of 65 min. No significant injuries were found after foreign body removal. Minor transient incisional pain was the only morbidity observed, and this did not vary with preoperative injury assessment or extent of surgical intervention. Conclusion: In our series of ULV penetrating neck trauma, concerning CT findings were more common than signs/symptoms of serious injury. Morbidity from ULV foreign body penetration and from its surgical treatment was low, whether formal exploration or targeted extraction was performed. Imaging tended to overestimate injury but helped with surgical planning.

Heimlich′s maneuver-assisted bronchoscopic removal of airway foreign body

Aspiration of foreign bodies (FBs) by children can lead to serious illness and sometimes even death. Bronchoscopic removal of the FB is necessary to prevent from any catastrophic event. Sometimes bronchoscopic removal is not possible due to the larger size of the FB, sharp FB, or long duration FB. Tracheostomy is normally used for the removal of such FBs. The aim of this case report is to highlight the use of Heimlich maneuver for the removal of such FBs before opting invasive procedures. In the present case, a 5-year-old child was presented with history of FB aspiration 5 h back. After multiple failed bronchoscopic attempts to remove the FB it was decided to use Heimlich maneuver in the supine position. A single attempt of Heimlich maneuver expelled the FB into the oral cavity, which was removed by Magill's forceps. On repeated bronchoscope check, there was no remnant of FB. Child's further course of stay in hospital was uneventful. In conclusion, Heimlich maneuver may be useful in patient with failed bronchoscope removal of airway FBs before proceeding for tracheotomy or other invasive procedures.

Extraction of hollow gastric foreign bodies by flexible upper endoscopy assisted by a through-the-scope balloon catheter for anchoring

Various methods have been used to remove foreign bodies; hollow foreign bodies deserve special consideration. The main difficulty encountered in such situations is the anatomic obstacle of the lower and upper esophageal sphincters along with a risk of perforation. We describe a unique approach by using an esophageal balloon dilator to anchor a hollow foreign body onto an endoscope, which allows for the successful extraction of such objects with minimal risk. Case series. Shands Jacksonville and University of Florida/Jacksonville, Jacksonville, Florida. Two consecutive patients with hollow foreign bodies in the stomach that required removal. A combined approach by using an endoscope and a 20-mm by 8-cm esophageal balloon dilator to remove hollow foreign bodies from the stomach. Nonsurgical removal of hollow gastric foreign bodies. Both foreign bodies were successfully removed from the stomach and extracted by mouth with this technique. There were no complications after both procedures. The inflated esophageal balloon that anchors a hollow foreign body onto a flexible endoscopic technique is a safe and effective alternative to previously described methods for removal of such foreign bodies in the gastric cavity. This method may be applicable to the removal of other hollow objects within the gastric lumen.

Percutaneous removal of migratory intrabiliary surgical clips

To describe the technique of percutaneous removal of migratory intrabiliary surgical clips. Materials and methods: A 33-year-old male was admitted with recurrent cholangitis following choledochojejunostomy formation. Percutaneous transhepatic cholangiography demonstrated stricture at the hepaticojejunostomy and multiple intrabiliary surgical clips, two of which were mobile. Endoscopic retrograde cholangiopancreatography was not feasible due to the previous surgery. Balloon angioplasty of the choledochojejunostomy anastomosis was performed, followed by removal of the mobile surgical clips via a percutaneous tract. After dilatation of the tract, choledochoscopy, steerable catheters and angled tip catheters facilitated placement of a guidewire beyond the clips within a peripheral radicle. A Fogarty type balloon was then placed over the guidewire beyond the clip, enabling withdrawal of the balloon and clip into a sheath. Results: The two mobile migrated intrabiliary surgical clips were successfully removed using this technique. A 14F biliary Cope loop was placed across the choledochojejunostomy stricture for interim management, while the patient’s symptoms settled. Conclusion: Migratory intrabiliary surgical clips are important to detect to prevent stone formation or obstruction. Removal is usually via per oral endoscopy. We describe a percutaneous technique for the removal of such foreign bodies when an endoscopic approach fails or is not possible.

Conduite à tenir face aux corps étrangers œsogastriques chez l'enfant

Various methods have been used to remove foreign bodies; hollow foreign bodies deserve special consideration. The main difficulty encountered in such situations is the anatomic obstacle of the lower and upper esophageal sphincters along with a risk of perforation.We describe a unique approach by using an esophageal balloon dilator to anchor a hollow foreign body onto an endoscope, which allows for the successful extraction of such objects with minimal risk.Case series.Shands Jacksonville and University of Florida/Jacksonville, Jacksonville, Florida.Two consecutive patients with hollow foreign bodies in the stomach that required removal.A combined approach by using an endoscope and a 20-mm by 8-cm esophageal balloon dilator to remove hollow foreign bodies from the stomach.Nonsurgical removal of hollow gastric foreign bodies.Both foreign bodies were successfully removed from the stomach and extracted by mouth with this technique. There were no complications after both procedures.The inflated esophageal balloon that anchors a hollow foreign body onto a flexible endoscopic technique is a safe and effective alternative to previously described methods for removal of such foreign bodies in the gastric cavity. This method may be applicable to the removal of other hollow objects within the gastric lumen.

No-confidence vote on catheter removal of foreign bodies

Since the mid-1960s, the use of the Foley (balloon) catheter to remove foreign bodies from the esophagus has become increasingly popular among many radiologists, general surgeons, family and emergency physicians, and pediatricians. But, according to results of a recent survey reported to the American Broncho-Esophagological Association meeting in Palm Beach, Fla, those physicians who are specially trained in the removal of such foreign bodies find little use for the device, preferring conventional endoscopic extraction techniques in the presence of adequate airway management capability. The survey, conducted among directors of otolaryngology and thoracic surgery residency programs and members of the Society for Pediatric Radiology, was described by W. Frederick McGuirt, MD, associate professor of otolaryngology at Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC. Completed questionnaires were received from 245 physicians reporting on 1,512 cases of Foley catheter use. McGuirt said that of the 84 otolaryngologist respondents, only five

No-confidence vote on catheter removal of foreign bodies

Since the mid-1960s, the use of the Foley (balloon) catheter to remove foreign bodies from the esophagus has become increasingly popular among many radiologists, general surgeons, family and emergency physicians, and pediatricians. But, according to results of a recent survey reported to the American Broncho-Esophagological Association meeting in Palm Beach, Fla, those physicians who are specially trained in the removal of such foreign bodies find little use for the device, preferring conventional endoscopic extraction techniques in the presence of adequate airway management capability. The survey, conducted among directors of otolaryngology and thoracic surgery residency programs and members of the Society for Pediatric Radiology, was described by W. Frederick McGuirt, MD, associate professor of otolaryngology at Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC. Completed questionnaires were received from 245 physicians reporting on 1,512 cases of Foley catheter use. McGuirt said that of the 84 otolaryngologist respondents, only five

Percutaneous Removal of Flexible Foreign Body from the Heart

The complication of catheter embolization has been reported, and several technics have been designed for nonsurgical removal of such foreign bodies from the heart (1, 3, 4). In the case herein reported, a simple percutaneous approach toward removal of the catheter fragment is described. Case Report A 50-year-old psychiatric patient had a catheter fragment sheared off at the needle tip following right subclavian vein puncture for administration of medication. A chest radiograph revealed this fragment lying partially within 'the right ventricle with the other end in the superior vena cava. With the usual catheter materials in the X-ray Department, a simple snare-loop device was made. A 125-cm, 0.025-inch guide wire was passed through a white (opaque) P.E. catheter (0.037 inch I.D. × 0.054 O.D.). This in turn was passed through a 240 P.E. catheter 30 cm long, and the wire with the small P.E. cover was doubled back into the outside sleeve with the loop formed as indicated in Figure 1. The loop wire was then b...

A NEW ELECTRIC CORNEAL DRILL

After being confronted repeatedly with the difficult task of removing particles of emery from the cornea, or of rust after a metallic foreign body had been removed from the eye, I became interested in finding a method for the removal of these particles that would be less traumatic to the delicate structures involved and at the same time would be less time consuming for the oculist. After giving fair and reasonable trial to the many forms of instruments for the removal of such foreign bodies offered by the various instrument houses today, it was decided that the bur used by the dentist was the most satisfactory tool for the purpose. However, such a bur is usually permanently attached in a handle, or a universal handle is provided in which various-sized burs can be introduced. In either case the handle is sufficiently large in diameter that an insufficient amount of

Intracapsular Extraction of the Crystalline Lens Containing a Foreign Body: Report of Three Cases

Intracapsular extraction of the lens containing a foreign body is recommended as the best method of removal of such foreign bodies and the conservation of vision. Three successful cases are reported. Read before the Section on Ophthalmology, College of Physicians, Philadelphia, December 15, 1932.