Cases reported "Foreign Bodies"

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1/231. Hepatic abscess due to gastric perforation by ingested fish bone demonstrated by computed tomography.

    Perforation of the gastrointestinal tract by ingested foreign bodies is rare. Preoperative diagnosis of complications due to foreign bodies in the gastrointestinal tract can rarely be achieved because the conventional radiographic appearance is nonspecific. This report describes a 69-year-old woman who presented with vague clinical manifestations, intermittent abdominal pain, and low-grade fever. Hepatic abscess, secondary to a foreign body penetrating the gastric wall, was diagnosed preoperatively using computed tomography findings. On exploration, the foreign body turned out to be a fish bone. The abscess was confirmed and drained during surgery and a partial gastrectomy was performed. This case illustrates the value of CT in the evaluation of this condition.
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2/231. Aspirated foreign bodies in the tracheobronchial tree: report of 250 cases.

    During the last 14 years, 250 patients with aspirated foreign bodies in the tracheobronchial tree were admitted to kuwait Chest Diseases Hospital. Ninety-six per cent of the cases were under 10 years of age and 38% gave a clear history of foreign body inhalation. The rest were diagnosed either clinically, from the chest radiograph findings or because of unexplained pulmonary symptoms. In 247 cases, bronchoscopy under general anaesthesia was successful in removing the foreign bodies. In only three cases was bronchotomy needed. Seventy per cent of the foreign bodies were melon seeds. asphyxia and cardiac arrest occurred in four cases during bronchoscopy but the patients were successfully resuscitated. In 10 cases a tracheostomy was done before bronchoscopy and the removal of the foreign body, while in five it was needed after bronchoscopy. Fifteen patients developed late complications such as recurrent pneumonia or atelectasis of the lung. Early diagnosis and adequate treatment are essential to prevent pulmonary and cardiac complications and to avoid radical lung surgery.
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3/231. Extraction of a rubber bullet from a bronchus after 1 year: complete resolution of chronic pulmonary damage.

    inhalation of a foreign body (FB) into the bronchial tree rarely occurs asymptomatically and, if leading to recurrent pneumonia, can be very difficult to diagnose. The present report deals with the case of a 10-year-old boy who had three episodes of pneumonia in the left lower lobe caused by the asymptomatic inhalation of a FB 12 months before. Standard thoracic CT, done during the third episode, revealed a slight reduction in the volume of the left lung with air bronchograms, multiple areas of bronchiectasis, and parenchymal consolidation of a segment of the lower lobe. Flexible fiberoptic bronchoscopy revealed a FB at the distal end of the left lower lobar bronchus, surrounded by granulation tissue and fully obstructing the anterior basal segmental bronchus. High-resolution CT (HRCT) images showed an inverted C-shaped image obstructing a bronchus. Removal of the FB was successful only with rigid bronchoscopy under total anesthesia. The FB was an air-pistol rubber bullet that the boy remembered playing with 12 months before. Two months after removal of the FB (ie, 14 months from its asymptomatic inhalation) and treatment with oral steroids, antibiotics, and respiratory physiotherapy, the patient recovered completely, and HRCT showed complete normalization of the lung. We conclude that, when the radiographic density of the FB is greater than the surrounding pulmonary parenchyma, HRCT can reveal the FB, and diagnostic flexible fiberoptic bronchoscopy can be avoided.
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4/231. Transorbital penetrating injury of the paranasal sinuses.

    Penetrating injuries of the paranasal sinuses due to foreign bodies are rare, especially as a result of a traffic accident. Here we report a patient with a ballpoint pen lodged in his left eye following a traffic accident. The pen extended from the medial aspect of the left orbit, through the left ethmoid sinus and the nasal septum, to the right sphenoid sinus. We removed the pen uneventfully using endoscopic sinus surgery. There are no similar reports in the English literature and we therefore present this case because of its rarity.
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5/231. 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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6/231. Adjustable silicone gastric banding and band erosion: personal experience and hypotheses.

    BACKGROUND: Adjustable silicone gastric banding (ASGB) has been advocated as a minimally invasive procedure that is completely reversible for the surgical treatment of morbid obesity. Band erosion (BE) is one of the possible complications of ASGB. The authors report their experience with BE and discuss its possible causes. methods: Between February 1993 and February 1998, the authors performed 122 ASGB: 51 open and 71 laparoscopic procedures. RESULTS: Two cases of BE occurred (1.6%). CONCLUSION: Band erosion is a possible complication of ASGB that is often not diagnosed immediately. Prevention is essential and consists primarily in correct placement of the band. There appears to be only one solution to BE: removal of the band. Placement of a new band after removal is possible; the minimum interval is not known.
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7/231. Clinical diagnosis of an unusual cause of a cutaneous neck mass.

    A case of migrating ingested fish bone presenting as an unresolving inflamed neck mass is reported. The clinical features of this rare but easily misdiagnosed entity are discussed. The diagnosis must be suspected in a patient with an unresolving inflamed cutaneous lesion (especially one with a punctum), tenderness of the lesion elicited on swallowing and the presence of a palpable subcutaneous fistula tract. In such a patient, a history of recent foreign body ingestion must be actively sought. An accurate early diagnosis of this easily treatable condition is desirable as it could avert unnecessary delays, inconveniences, anxiety, costs, investigations and surgery.
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8/231. An unusual cause of nasal septum perforation.

    We present a case where the use of magnetically held earring clips in the nose led to an unfortunate series of events resulting in perforation of the nasal septum.
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keywords = nasal, nose
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9/231. Nasal wash technique for nasal foreign body removal.

    Nasal foreign bodies are seen commonly both in the office and pediatric emergency department setting. There have been a number of strategies described for their removal. We describe the "nasal wash" as a technique for nasal foreign body removal in the following three case reports. The "nasal wash" has been used in many pediatric vaccine studies as a method to collect mucus and relies on simple equipment readily available in the office setting.
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keywords = nasal
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10/231. A wandering nasal prong-a thing of risks and problems.

    We describe an unusual complication of nasal continuous positive airway pressure (nCPAP) ventilation in a preterm low birth weight neonate being weaned from respiratory support. The tube used to administer nasal CPAP became dislodged from its metal connector whilst in the nasopharynx and slipped into the stomach. After waiting eight days the tube showed no signs of passing spontaneously through the gastrointestinal tract and retrieval was then successfully achieved by means of a 3.5 mm paediatric fibreoptic bronchoscope without complication.
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keywords = nasal
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