Cases reported "Foreign Bodies"

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1/5. vocal cord paralysis and oesophago-broncho-aortic fistula complicating foreign body-induced oesophageal perforation.

    A 61 year old man died after presenting with a 24 h history of haematemesis and haemoptysis, and one year history of hoarseness of voice. Post-mortem examination showed a dental plate eroding through the mid-oesophagus into a bronchus and into the descending arch of the aorta, with scarring suggestive of old perforation. An organized haematoma also involved the left recurrent laryngeal nerve. Vocal cord paralysis may be a manifestation of foreign body-induced oesophageal perforation, which can lead to death from an oesophago-broncho-aortic fistula. Both complications of oesophageal perforation from a foreign body have not to our knowledge been previously reported.
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2/5. delayed diagnosis of tracheoesophageal prosthesis aspiration.

    In 1980, Singer and Blom published the results of their study on use of the tracheoesophageal puncture prosthesis for restoration of voice after total laryngectomy. Since then, the placement of tracheoesophageal puncture prostheses has been an integral part of rehabilitation after laryngectomy. Complications of this procedure have been recognized and are usually minimal. Inadvertent aspiration of the prosthesis is rare. Usually, patients seek help immediately after the incident. We report a case of unnoticed aspiration of a Blom-Singer prosthesis in a patient with a laryngectomy.
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3/5. A Christmas tree in the larynx.

    A 2 year-old boy presented with acute upper airway obstruction following a 15-month history of noisy breathing and hoarseness. An urgent laryngotracheal bronchoscopy was performed following inhalational induction of anesthesia. Using a fiberoptic bronchoscope, visualization of the larynx through a laryngeal mask airway revealed a flat plastic Christmas tree embedded within granulomatous cords causing almost complete obstruction and requiring tracheostomy prior to extraction. Twelve days later, the tracheostomy was successfully decannulated with the child's voice beginning to normalize. The family remembered the decoration from Christmas celebrations 2 years prior and recalled a coughing episode that predated the onset of hoarseness.
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4/5. Ingestion of a voice-master prosthesis followed by a potentially fatal aspiration.

    Various complications are associated with the use of indwelling voice prostheses. We present problems faced by a patient with his voice-Master prosthesis, the ingestion of the prosthesis followed by a potentially fatal aspiration. The voice-Master is unique in that in can be re-inserted. The safety strap is removed after primary insertion once the prosthesis is secure. However, during re-insertions this safety mechanism is no longer present. Therefore we recommend the placement of a temporary stitch or tie to minimize the risks of ingestion or aspiration of the prosthesis during re-insertions.
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5/5. Brillo pad crack screen aspiration and ingestion.

    crack cocaine is commonly smoked in a pipe with a metallic filter made from a steel wool scouring pad. We report an unusual complication of smoking crack cocaine: the aspiration and ingestion of a Brillo pad filter. A 34-year-old female presented 7 h after drinking beer and smoking crack. She was concerned that she might have inhaled the "screen" from her crack pipe, a piece of Brillo pad the size of her fingertip. She complained of "burning" in her throat, a foreign body sensation, and change in her voice, but no dyspnea, dysphagia, or abdominal pain. On physical examination, she was afebrile with a pulse of 105 beats/min and respiratory rate of 24 breaths/min. She was tearful and spoke in a whisper. There were no visible oropharyngeal burns and the lungs were clear to auscultation, but she had intermittent inspiratory stridor. The O2 saturation was 96%, and the ethanol concentration was 100 mg/dl. No foreign body or burn was seen on indirect laryngoscopy. A lateral neck x-ray study showed a normal epiglottis and no foreign body. Chest x-ray studies were unremarkable. Fiberoptic laryngoscopy showed left posterior arytenoid edema and swelling. An abdominal x-ray study revealed a foreign body in the right lower quadrant consistent with the Brillo pad filter. The next morning, the patient was asymptomatic and was discharged, recovering without sequellae. While crack pipe screen aspiration is a rarely reported event, physicians should be aware of the potential for foreign body aspiration and ingestion by this mechanism.
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