Cases reported "Foreign Bodies"

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1/62. Numerous transorbital wooden foreign bodies in the sphenoid sinus.

    A very rare case of numerous transorbital wooden foreign bodies penetrating into the sphenoid sinus in a 47-year-old male is reported. His right eye was nonreactive to light, and the oculomotor, trochlear and abducens nerves were completely disturbed. Although a minor injury was observed on the inner side of the right eyebrow, the wound was not serious or infectious. Computed tomographic scanning of the orbit and parasinus revealed an isodense linear shadow to muscle and an irregular shadow of the lamina papyracea. However, the findings were difficult to discriminate from an optic canal fracture preoperatively. We detected foreign bodies penetrating the optic nerve rise, which were successfully removed in combination with an endoscopic transethmoidal and transorbital approach. Various and careful imaging examinations are recommended to diagnose and manage paraorbital trauma, when a penetrating wound of the face is observed.
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2/62. Successful treatment of a hepatic abscess that formed secondary to fish bone penetration by percutaneous transhepatic removal of the foreign body: report of a case.

    We describe herein the case of a hepatic abscess that developed secondary to fish bone penetration which was successfully treated without laparotomy. A 61-year-old man was admitted to our hospital with a high fever that had persisted for 2 weeks in spite of medication. Abdominal ultrasonography (AUS) and computed tomography (CT) of the abdomen revealed a hepatic abscess with a linear calcified foreign body and gas. Percutaneous abscess drainage was performed under ultrasonographic guidance. After drainage, the patient became afebrile, and AUS and CT findings demonstrated that the abscess cavity had decreased in size, but still contained the foreign body. Under ultrasonographic guidance and fluoroscopy, we inserted endoscopic forceps into the sinus tract and succeeded in removing the foreign body from the liver. It was found to be a fish bone that was 2.8 cm long and 0.3 cm wide.
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3/62. Intracranial stent placement to trap an extruded coil during endovascular aneurysm treatment: technical note.

    OBJECTIVE: The development of low profile, navigable stents has expanded the range of intracranial neuroendovascular procedures. We report a unique case of endovascular stent placement to trap a partially extruded Guglielmi detachable coil (GDC) during treatment of an internal carotid artery (ICA) cavernous segment aneurysm. methods: A 49-year-old woman presented for endovascular coiling of a left superior hypophyseal artery aneurysm. Previously, a contralateral mirror lesion had been treated by stent-assisted coiling. heparin was administered to maintain an activated coagulation time of greater than 250 seconds, and a guide catheter was placed in the cervical ICA. A microcatheter was advanced into the aneurysm over a microguidewire. A GDC-10, 3-dimension, 6 x 20-mm coil was placed within the aneurysm, forming a stable basket. Three additional GDCs were placed with near-complete obliteration of the aneurysm. Attempted placement of a fifth coil caused partial prolapse of a previously placed coil into the cavernous ICA. We decided to place a stent rather than to snare the extruded coil because the extruded coil was integral to the aneurysm coil mass. A 3.5x8-mm balloon-expandable stent was placed across the aneurysm orifice, trapping the extruded coil between the stent and ICA. RESULTS: Digital subtraction angiography documented patency of the ICA lumen. The patient remains neurologically intact and awaits 3-month follow-up cerebral angiography. CONCLUSION: Trapping of an extruded intraaneurysmal coil via stent placement obviated the need for coil removal and avoided the risk of coil mass manipulation. The use of a stent to displace extruded coils and reconstitute a "normal" lumen is an excellent addition to our endovascular armamentarium.
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4/62. Broken anesthetic injection needles: report of 5 cases.

    A broken anesthetic needle is a rare complication in clinical practice. This article reports on 5 patients referred for removal of broken needles. The needles were located in the pterygomandibular space or near the maxillary tuberosity. These complications were the result of an unexpected movement by the patient or an incorrect anesthetic technique. The article also describes the case of a patient in whom an image observed in a routine panoramic radiograph could have been caused by a broken needle.
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5/62. Unusual fatal mechanisms in nonasphyxial autoerotic death.

    The diagnosis of autoerotic death is most often made when there has been accidental asphyxia from ropes or ligatures used by the deceased as a part of his or her autoerotic ritual. Three cases of probable autoerotic death are reported in which the mechanisms of death involved hyperthermia, sepsis, and hemorrhage, respectively. Case 1: A 46-year-old man was found dead in bushland clothed in a dress, female undergarments, and seven pairs of stockings/pantyhose. The underwear had been cut to enable exposure of the genitals. The recorded daily maximum temperature was 39 degrees C, and the deceased had been taking the drug benztropine. death was attributed to hyperthermia due to a combination of excessive clothing, high ambient temperature, and prescription drug side effect. Case 2: A 40-year-old man was found dead in his boarding house. At autopsy, a pencil was found within his abdominal cavity with perforation of the bladder and peritonitis. death was attributed to peritonitis/sepsis following intraurethral introduction of a pencil. Case 3: A 56-year-old man was found dead lying on his bed following massive rectal hemorrhage. A blood stained shoe horn was found nearby. death was attributed to hemorrhage following laceration of the anal canal with a shoe horn. The diagnosis of autoerotic death may be difficult when typical features are absent, however, any unusual injury associated with genitourinary manipulation must raise this possibility.
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6/62. Aortoesophageal fistula caused by foreign body.

    Aortoesophageal fistula is rare. A woman who developed aortoesophageal fistula after swallowing a fish bone developed hematemesis. 7 days later, we resected a false aneurysm near the left subclavian artery and repaired this section twice. Despite these measures, the woman died on hospital day 21. The clinical diagnosis was massive hematemesis from an infected aortic wall. The method of diagnosis, control of infection, and operative repair of aortoesophageal fistula are discussed.
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7/62. Sonographic appearance of a retained surgical sponge in the neck.

    We report the sonographic appearance and clinical course of a retained surgical sponge in the neck beginning 6 months after a partial thyroidectomy. Sonograms showed a subcutaneous curvilinear hyperechoic interface with marked acoustic shadowing obscuring the left side of the neck. Three months later, a fistulous tract could be seen. Surgical exploration revealed a florid foreign tissue reaction due to a retained surgical sponge. early diagnosis of retained sponges is important to enable expeditious removal before complications develop.
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8/62. Intracranial placement of a nasogastric tube after severe craniofacial trauma.

    Complications of intracranial placement of a nasogastric tube in patients with complex facial and skull base fractures are infrequent, though the associated morbidity and mortality are high. In such situations some authors advocate craniotomy to allow removal of the tube in several linear segments under direct visualization. Others advise tube removal nasally under antibiotic coverage. We present a case of complex craniofacial fracture in which a nasogastric tube was positioned intracranially 48 hours after admission. The tube was quickly removed through the nose, and the patient was discharged without neurologic problems.
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9/62. Two remarkable events in the field of intraocular foreign body: (1) The reversal of siderosis bulbi. (2) The spontaneous extrusion of an intraocular copper foreign body.

    Two unusual events concerning intraocular foreign bodies are presented. The first patient had an occult or unsuspected intraocular foreign body. He showed iridoplegia with mydriasis, siderosis iridis, and an intraocular piece of iron lying posteriorly near the retina. The foreign body was removed and the patient regained normal iris color and pupillary activity. His vision remains 20/15 six years postoperatively dispite ensuing retinal detachment one year after removal of the foreign body. The second patient was a young boy injured by a blasting cap explosion. He lost one eye from the injury and had a piece of intraocular brass in his left eye. In spite of the development of chalcosis and a mature cataract the lens gradually shrank in the pupillary space permitting a clear aphakic area and 20/25 vision. The brass fragment migrated forward and inferiorly and was finally extruded under the conjunctiva five years later, where it was removed and chemically analyzed by x-ray diffraction.
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10/62. Device for the removal of button batteries.

    OBJECTIVE: There is an increasing number of accidents by erroneous ingestion of button batteries in recent years; the batteries arouse the interest of infants because of their attractive shape and luster. The batteries remaining in the gastrointestinal tract and discharging electric current over a long period of time may induce ulceration or perforation, thus must be carefully considered the selection of appropriate treatment. methods: We remove erroneously ingested button batteries with two tubes with ferrite magnets nearly the same size as the button batteries themselves. patients: Four cases of erroneous ingestion of button batteries. RESULTS: We easily removed button batteries from the stomach within 5 minutes in all cases with two magnet-attached tubes. CONCLUSION: We present this battery removal device together with a literature review, because it seems convenient and useful.
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