Site Of Foreign Body Research Articles

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.

A migratory sharp foreign body from the hypopharynx to the deep neck space – A case report

Foreign body (FB) ingestion is a common emergency managed by otorhinolaryngologists. The clinical manifestations and management vary as per the site of FB and its complications. The diagnosis of FB ingestion is often challenging and depends on its clinical presentations and imaging. One of the rare complications of FB ingestion is migration, which has the potential to result in morbidity and mortality. Migration of FB is said to have occurred in the presence of negative rigid esophagoscopy and positive radiography. Migration of FB to the neck requires neck exploration for its successful removal. Here, we report a case of sharp FB ingested, which penetrated through the hypopharyngeal wall by its sharp end and migrated into the deep space of the neck.

Correlation between Nasal Foreign Bodies and Their Presentation in Paediatric Age Group

Objectives: To observe the relationship of nasal foreign bodies in terms of patient’s age as well as the type of foreign body and removal technique.
 Materials and Methods: This retrospective cross-sectional study was conducted in ENT department, Akbar Niazi Teaching Hospital, Islamabad from April 2017 to May 2018. A total of 120 patients selected by non-probability consecutive sampling technique with inclusion criteria of all children less than 12 years with foreign body in nose were recruited for this study after taking written informed consent. Patients who had concurrent nasal infections and trauma were excluded. Children age, gender, site, type of foreign body and removal technique were recorded. Data was analyzed by using SPSS version 21.
 Results: A total of 120 patients were presented with nasal foreign bodies, 107 cases were successfully dealt with in OPD while 13 patients were admitted for removal under general anaesthesia. The commonest affected age group was 2-5 years (78.33%) with more females (55.75%) than males (44.25%). Organic type of foreign body was 55.8% and inorganic type of foreign body was 44.2%. Seeds and small nuts (35%) were found to be the commonest types of nasal foreign body. The correlation between age groups, types of foreign body, removal technique and site of foreign body was significant (p value ≤ 0.05).
 Conclusion: Nasal foreign bodies are commonly faced problem in children, specially in 2-5 years of age. They are largely harmless but complications can occur if neglected. Prevention remains the best option while for non-cooperative and attempted cases, removal under general anaesthesia is safe and preferred.

Frequency of Foreign Body Bronchus in Patients with Pneumothorax

Aim: To determine the frequency of airways foreign body bronchus in children pneumothorax. Study Design: Cross-sectional/descriptive study Place and Duration of Study: Department of Thoracic Surgery, Sandeman Provincial Hospital Quetta from 1st January 2020 to 31st December 2020. Methodology: Forty five patients of both genders and aged between 1 to 15 years were enrolled. Patients details demographics age, gender, residence and body mass index were recorded after taking informed consent. Chest computed tomography and X-ray to bronchus were performed to examine the nature and site of foreign body. Bronchoscopy was performed and outcomes were analyzed. Results: There were 30 (66.67%) males and 15 (33.33%) females. Majority of patients 27 (60%) were ages <6 years. Mean body mass index was 12.08±6.33 kg/m2. Mean time interval between foreign body aspiration and admitted to hospital was 4.08±2.08days. Foreign body bronchus was found in 14 (31.11%) patients. The right main bronchus was the most common site in 9 (64.28%) followed by left bronchus in 5(35.71%).Most common foreign body retrieved was seeds found in 9 (64.28%), piece of plastic in 3 (21.43%), peanut in 1 (7.14%) and nuts in 1 (7.14%) patients respectively. Bronchoscopy performed in 14 patients and none of patients had developed any complication. Conclusion: Foreign body bronchus was found in 31.11% patients presented with pneumothorax and most common foreign body aspiration was seeds. Bronchoscopy was safe and effective with no major complication. Keywords: Children, Foreign body aspiration, Bronchus, Pneumonia

Fishbone foreign body ingestion in duodenal papilla: a cause of abdominal pain resembling gastric ulcer

BackgroundForeign body ingestion is a common clinical problem. The upper esophagus is the most common site of foreign body, accounting for more than 75% of all cases, but cases with a foreign body in the duodenal papilla or common bile duct are rarely reported.Case presentationHerein, we report a rare case that a patient’s abdominal pain resembling gastric ulcer was caused by a 3 cm long fishbone inserted into the duodenal papilla.ConclusionFishbone inserted into the duodenal papilla can cause an abdominal pain resembling gastric ulcer. Endoscopy is useful for the diagnosis and treatment of fishbone ingestion in clinical.

Demographic, clinical features, and outcomes of pediatric non-penetrating ocular foreign bodies.

Data regarding ocular foreign body (FB) in the pediatric population is sparse. The purpose of this study is to describe the demographic features and the outcomes of pediatric non-penetrating ocular FB. The charts of all children with non-penetrating ocular FB who presented at a tertiary medical center between 2011 and 2018 were retrospectively reviewed. Data analyzed included demographics, ocular FB site, the need for general anesthesia, or sedation for FB removal and clinical outcomes. Three hundred and fifty-two children (58.8% boys) with a mean age of 7.7 ± 3.7years were included. Two hundred and fifty-one (71.3%) children presented on the same day of injury. Patients with developmental delay presented more often with restlessness than patients without developmental delay (p < 0.0001). One hundred and forty-six (41.5%) of FBs were found on the conjunctiva, 128 (36.4%) under the eyelid, and 62 (17.6%) on the cornea. In 19 (4.5%) cases, general anesthesia or sedation was required for FB removal. A multivariate analysis identified young age (OR 0.976, 95% CI 0.961-0.992, p = 0.003), corneal FB (OR 50.84, 95% CI 10.08-256.37, p < 0.0001), and developmental delay (OR 18.56, 95% CI 1.22-283.45, p = 0.036), as significant predictors for the need of general anesthesia or sedation. Among patients with corneal FB, in two (3.2%) cases, the corneal FB was complicated by infectious keratitis, resulting in mild corneal scar. The rate of general anesthesia for non-penetrating ocular FB removal in children is low. Children presenting with non-penetrating ocular FB have good prognosis without long-term complications.

Study on Prevalence of Foreign Bodies in ENT

Introduction- Foreign body is a substance that doesn’t belong to a location where it is found. Ear,nose and throat are common location for occurence of foreign bodies. It is a common problem encountered in both adults and children. Objective- 1) To analyse the different kinds of foreign bodies in ear ,nose and throat and their prevalence in different age groups. 2) To analyse the most prevalent site of foreign body among ear, nose and throat.Methods- A cross-sectional study was performed in our tertiary care hospital in Navi-mumbai. The study period was from august 2017 to august 2019. The study population were the patients who came to the out patient department and emergency room of this hospital.Result- A total of 100 patients as sample size with foreign bodies in ear, nose or throat were taken on first come basis. 62 were males and 38 were females. Of the 100 patients, 36 had foreign body in ear, 47 in nose and 17 in the throat. The foreign body was removed under local anaesthesia in 4% patients, with general anaesthesia in 30 % and with no anaesthesia at all in 66% patients. The most common age group affected was less than 10 years among both male and female patients.Conclusion- The most frequent site of foreign body occurrence was found to be nose. The most common site requiring general anaesthesia for foreign body removal was throat. Although most of the foreign bodies could be removed without any anaesthesia in the emergency room or outpatient department.

Ear, nose, and throat foreign bodies in pediatric age

Ear, nose, and throat foreign bodies (FBs) in pediatric age group are one of the most common emergencies managed by otorhinolaryngologists. FB in the ear, nose, and throat may cause significant morbidity and may need costly management if not treated in time. The diagnosis of the FB is based on the history from parents or caregivers, physical examination, and imaging. Successful removal of the FB depends on the site of FB, type of the FB, availability of the instruments, and skill of the clinicians attempting for FB removal. The attempts of the FB removal from the ear, nose, and throat by untrained or inexperienced health professionals may lead to complications. It is a necessity to educate the caregivers or parents for close monitoring their children for close monitoring and avoid such FB insertion. This review article focuses on the prevalence, factors related to the FB insertion into the ear, nose, and throat in pediatric age, clinical presentations, and current management. This article will surely increase awareness among the emergency physicians, pediatricians, family physicians, and otolaryngologists for dealing with pediatric patients with FB in the ear, nose, and throat and help them to resolve this problem to a great extent.

Topical Anesthetic Misuse in Patients Admitted to Sabzevar Eye Clinic in Iran

Abstract Topical anesthetic eye drops are used extensively for ophthalmic examinations but self-treatment and non-technical removal of foreign bodies using tetracaine drops can be hazardous. The present study intended to determine the inadmissible uses of anesthetic tetracaine eye drops, manner of drug obtaining and likelihood of the ocular complications in the patients. This cross-sectional study was conducted on 162 patients with ocular pain and foreign body sensation, red eye or lid edema admitted to the Eye clinic in Sabzevar, Iran. Variables included age, sex, chief compliant, job, site of foreign bodies, diagnosis of problem, use of tetracaine drops, drug provision, times patients referred to the eye clinic, and kinds of treatment. The most common chief complaint for admission to the Eye clinic was lacrimation (55.6%), followed by ocular pain, and foreign body sensation (35.8%). Some patients (30.9%) (mostly welders) inadmissibly used topical tetracaine eye drops; 21.6% of cases obtained tetracaine eye drops from drugstores without doctor’s prescription, and only 3.7% provided drugs by prescription. Corneal site (81.5%) was the most common location of foreign body; metallic foreign body (63%) was the most common. One patient was admitted in hospital for management. Topical inadmissible tetracaine (0.5%) is commonly used by welders, who obtain it from drugstores without prescriptions due to its simple usage and short acting pain relief. Supervision is required over drugstores for denying it if demanded without a prescription. Enhancing clients’ awareness is also suggested.

Foreign bodies in the ear, nose and throat: an experience in a tertiary care hospital in central Nepal.

Introduction A foreign body (FB) is an object or substance foreign to the location where it is found. FBs in the ear, nose, and throat are a common problem frequently encountered in both children and adults. Objective To analyze FBs in terms of type, site, age, and gender distribution and method of removal. Methods A retrospective study was performed in a tertiary care hospital in the central part of Nepal. The study period was from June 2013 to May 2014. The information was obtained from hospital record books. Results A total of 134 patients had FBs in the ear, nose, or throat; 94 were males and 40 were females. Of the 134 patients, 70 (52.23%) had FB in the ear, 28 (20.89%) in the nose, and 36 (26.86%) in the throat. The FB was animate (living) in 28 (40%) patients with FB in the ear and 1 (3.5%) patient with FB in the nose, but the FB was inanimate (nonliving) in any patient with FB in the throat, in 42 (60%) patients with FB in the ear FB, and in 27 (96.4%) patients with FB of the nose. The FB was removed with or without local anaesthesia (LA) in 98 (73.13%) patients, and only 36 patients (26.86%) required general anaesthesia (GA). The most common age group affected was <10 years. Conclusion FBs in the ear and nose were found more frequently in children, and the throat was the most common site of FB in adults and elderly people. Most of the FBs can be easily removed in emergency room or outpatient department.

Accessory Nerve Paresis as a Complication of Foreign Body

Introduction: Pharynx and larynx represents 13.2 and 0.3%, respectively, as a site of foreign body, in upper aerodigestive tract. Complications in these cases are rare, and generally courses with dysphagia and dyspnea.

Unusual presentation of retained foreign body in ocular adnexa of a 3-year-old child

Aim: To report an unusual presentation of retained safety pin in ocular adnexae of a 3 year old child. Methods: A case report. The patient presented within the hour of accident and surgical intervention followed immediately after preliminary investigations. Results: Under general anesthesia, entry site of foreign body was explored. The safety pin was surprisingly lodged subtarsally in the matrix of firmly anchoring tenons. This was at variance to preoperative appearance of actual globe penetration. Conclusion : X-ray of the orbit confirmed by wound exploration correctly localized the foreign body.

Endoscopic management of ingested foreign bodies in children: A retrospective review of cases, and review of the literature

Background: Foreign body (FB) ingestion by children is a common problem worldwide. Management may include endoscopic removal. This paper describes the clinical findings, sites and types of FBs, and outcomes in children who underwent endoscopic management of ingested FBs at our institution. The published literature regarding the management of FB ingestion in children is also reviewed. Methods: We retrospectively reviewed the records of all patients aged Results: The 47 patients with gastrointestinal FBs included 29 males and 18 females with a mean age of 3.5 years. The most common symptoms were difficulty with swallowing and vomiting in 16 patients (34%), chest pain in 10 (21%), and coughing and breathing difficulty in 7 (15%). The most common FB site was the esophagus (36 patients). Most gastrointestinal FBs were metallic, with coins being the most common. Endoscopic removal was successful in 43 patients. The 17 patients with tracheobronchial foreign bodies included 9 males and 8 females with a mean age of 3.2 years. The most common symptoms were breathing difficulty in 12 patients (71%) and coughing in 3 (18%). The most common tracheobronchial FBs were nuts (10 patients). Bronchoscopic removal was successful in all 17 patients. Conclusions: Coins were the most common gastrointestinal FBs, and nuts were the most common tracheobronchial FBs. Clinical presentations were variable, and a high index of suspicion is necessary. Endoscopic removal is safe and effective, and early diagnosis and management result in favorable outcomes.

Food foreign body injuries

Rationale and aimThe purpose of this study is to acquire a better understanding of Food Foreign Bodies (FFB) injuries in children characterizing the risk of complications and prolonged hospitalization due to food items according to patients’ characteristics, circumstances of the accident, Foreign Body (FB) features and FB location, as emerging from the SUSY Safe Web-Registry. MethodsThe present study uses data provided by the SUSY Safe Project, a DG SANCO co-funded project started in February 2005, which was aimed at establishing an international registry of cases of Foreign Bodies (FB) injuries in children aged 0–14 years. The analysis was carried out on injuries due to a food item.FB location was reported according to ICD9-CM code: ears (ICD931), nose (ICD932), pharynx and larynx (ICD933) trachea, bronchi and lungs (ICD934), mouth, esophagus and stomach (ICD935).Age and gender injury distributions were assessed. Data regarding adult supervision and activity before injury were also evaluated. FBs which most frequently cause complications were identified. The association between children age, adult presence, object characteristics and hospitalization/complications was computed using unweighted odds ratios and the related 95% confidence intervals. Results16,878 FB injuries occurred in children aged 0–14 years have been recorded in the SUSY Safe databases. FB type was specified in 10,564 cases; among them 2744 (26%) were due to a food item. FB site was recorded in 1344 cases: FB was located in the ears in 99 patients, while 1140 occurred in the upper and lower respiratory tract; finally, 105 food items were removed from mouth, esophagus and stomach. Complications occurred in 176 cases and the most documented was pulmonary or bronchial infections (23%) followed emphysema or atelectasis and by and asthma (7%). Bones were the commonest retrieved FFB encountered in this study, while nuts seem to be the FFB most frequently associated to complications. ConclusionsOn the basis of this study we make the strong recommendation that parents should be adequately educated and provide age-appropriate food to their children and be present in order to supervise them during eating especially during a critical period ranging from 2 to 3 years of age.

Clinical analysis of bronchial foreign bodies in 246 children

To analyze the characters of bronchial foreign bodies in children and the utilization of bronchoscope in the treatment of bronchial foreign bodies. A total of 246 children were diagnosed with bronchial foreign bodies at our hospital during January 2000 until August 2009. Under local mucosal anesthesia, a bronchoscope was inserted through nasal cavity into bronchi. After identifying the site of foreign body, grasping forceps was guided through bronchoscope to remove the foreign body from airway. Among 246 cases, hard nut and skin of melon seed were found (n = 230, 93.5%). The most common site of foreign body was in right lower lobe bronchi (n = 98, 38.9%). The average operative frequency was 1.9 +/- 1.3 and one-time extraction ratio 58.5% (n = 144). The one-time extraction ratio of patients with foreign body obstructed in main bronchi (91.1%), right middle lobe (60.0%) and right lower lobe (55.1%) was higher than others. The operation frequency of using basket grasping forceps (1.4 +/- 0.9) was lower than those using tooth type forceps (2.1 +/- 1.4). And the difference was significant (P = 0.000). For bronchial foreign body in pediatric patients, hard nut and skin of melon seed are the most common foreign bodies. The right and left lower lobe bronchi are the predilection site. Foreign body in main bronchus is the easiest to be removed by grasping forceps. For massive foreign bodies, basket grasping forceps fares better than tooth grasping forceps.

Carcinomata developing at the site of foreign bodies in the lung.

Carcinomata developing at the site of foreign bodies in the lung.

Acid-Base and Electrolyte Abnormalities in Dogs with Gastrointestinal Foreign Bodies

Gastrointestinal foreign bodies occur commonly in dogs. The objective of the study was to describe the acid-base and electrolyte abnormalities identified in dogs with gastrointestinal foreign bodies and determine if these abnormalities are related to the site or type of foreign body present. Medical records of 138 dogs were reviewed, and information on signalment, initial venous electrolyte and acid-base values, surgical findings, relevant historical information, imaging modalities used, cost of hospital visit, intra- or postoperative complications, and survival was obtained. The site of the foreign body was recorded in 94.9% of cases and the most common site was the stomach (50%), followed by the jejunum (27.5%). The foreign bodies were linear in 36.2% of cases. The most common electrolyte and acid-base abnormalities regardless of the site or type of foreign body were hypochloremia (51.2%), metabolic alkalosis (45.2%), hypokalemia (25%), and hyponatremia (20.5%). No significant association was found between electrolyte or acid-base abnormalities and the site of foreign body. Linear, as opposed to discrete, foreign bodies were more likely to be associated with a low serum sodium concentration (odds ratio, 0.85; 95% confidence interval, 0.75–0.95). Hyperlactatemia (>2.4 mmol/L) was seen in 40.5% of dogs. A wide variety of electrolyte and acid-base derangements are found in dogs with gastrointestinal foreign bodies. Hypochloremia and metabolic alkalosis are common in these dogs. Hypochloremic, hypokalemic metabolic alkalosis is seen with both proximal and distal gastrointestinal foreign bodies.

Acid-Base and Electrolyte Abnormalities in Dogs with Gastrointestinal Foreign Bodies

Gastrointestinal foreign bodies occur commonly in dogs. The objective of the study was to describe the acid-base and electrolyte abnormalities identified in dogs with gastrointestinal foreign bodies and determine if these abnormalities are related to the site or type of foreign body present. Medical records of 138 dogs were reviewed, and information on signalment, initial venous electrolyte and acid-base values, surgical findings, relevant historical information, imaging modalities used, cost of hospital visit, intra- or postoperative complications, and survival was obtained. The site of the foreign body was recorded in 94.9% of cases and the most common site was the stomach (50%), followed by the jejunum (27.5%). The foreign bodies were linear in 36.2% of cases. The most common electrolyte and acid-base abnormalities regardless of the site or type of foreign body were hypochloremia (51.2%), metabolic alkalosis (45.2%), hypokalemia (25%), and hyponatremia (20.5%). No significant association was found between electrolyte or acid-base abnormalities and the site of foreign body. Linear, as opposed to discrete, foreign bodies were more likely to be associated with a low serum sodium concentration (odds ratio, 0.85; 95% confidence interval, 0.75-0.95). Hyperlactatemia (> 2.4 mmol/L) was seen in 40.5% of dogs. A wide variety of electrolyte and acid-base derangements are found in dogs with gastrointestinal foreign bodies. Hypochloremia and metabolic alkalosis are common in these dogs. Hypochloremic, hypokalemic metabolic alkalosis is seen with both proximal and distal gastrointestinal foreign bodies.

Esophageal foreign bodies: a Jordanian experience

Objectives: To study the pattern of esophageal foreign bodies (FB) in Jordan and to compare it with other countries. Methods: This is a retrospective study conducted on all patients (527) who were admitted with esophageal FB during a period of 9 years from January 1992 to January 2000. Two major referral hospitals were involved: the Princess Basma and Al-Bashir hospitals. A data sheet was constructed in which we included: name, age, gender, presenting symptoms, type and site of FB, technique of removal, and complications if present. Results: Of the 527 patients 53% were male and 47% were female.77% were children under the age of 10 years. In children coins were by far the most common FB to be found in the esophagus (68%), while bones were the principal FB to be found in adults (8%). In 89%, the FB was found at the level of cricopharyngeal muscle. Drooling of saliva (72%), dysphagia (71%), and vomiting (24%) were the most commonly presenting symptoms. Both rigid esophagoscopy and Magill forceps techniques were used to remove the FB from the esophagus. The complication rate was 2% which included: esophageal perforation and mediastinitis, esophageal stenosis and esophageal erosions. Conclusion: The pattern of esophageal FB in Jordan is not different from other countries.

Management of intraretinal Metallic Foreign Bodies without Retinopexy in the Absence of Retinal Detachment

In the management of intraocular metallic foreign bodies impacting or embedded in the posterior retina but without retinal detachment, retinopexy can be difficult or dangerous because of surrounding retinal, subretinal, or choroidal hemorrhage, or the proximity of the foreign body to the optic disc and macula. The authors prospectively managed five such cases by pars plana vitrectomy and foreign body removal without intraoperative or postoperative retinopexy. Fluid gas exchange was performed in only one case. No attempt was made to create a posterior vitreous detachment in any of the cases. After follow-up, ranging between 8 and 35 months, all cases had attached retinas and chorioretinal adhesion around the foreign body site. None of the cases had preretinal macular fibrosis. Four of the five cases had a best corrected visual acuity of 20/20 or better. The other, an aphakic 3-year-old patient, was amblyopic. Spontaneous chorioretinal adhesion appears to obviate the need for retinopexy in these selected cases. The avoidance of retinopexy and fluid gas exchange may decrease the risk of retinal detachment and preretinal macular fibrosis.