Cases reported "Foreign-Body Migration"

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1/232. Severe migratory granulomatous reactions to silicone gel in 3 patients.

    In humans implanted with silicone gel breast prostheses, a mild foreign body response results in the formation of a collagenous capsule around the prosthesis. Although many such patients may show evidence of a microscopic granulomatous foreign body reaction upon examination of capsular material at explantation of a prosthesis, it is unusual to have large, palpable granulomas, even in the presence of rupture or leakage. Rare patients have had severe local inflammation and complications resulting from silicone migration to the axilla, arm, or abdominal wall. We describe 3 patients who had deforming granulomas after implant rupture, along with other consequences of silicone gel migrating down the upper extremity. Silicone gel, once it leaves the implant, is not biologically inert and in some persons can elicit profound pathologic responses.
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2/232. Relapsing pneumonia due to a migrating intrathoracic foreign body in a World war II veteran shot 53 years ago.

    In the great majority of cases of long-standing intrathoracic foreign bodies, patients are asymptomatic. However, symptoms may occur years later from the migration of the foreign body. We report on a 70-year-old patient who developed relapsing pneumonia due to obstruction of a bronchial branch of the left apical group by a migrating infantry bullet impacting 53 years ago. This was not diagnosed until the second attack of pneumonia in 1998. The bullet remains were removed bronchoscopically and the pneumonia resolved completely without further complications.
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3/232. An unusual presentation of a foreign body in the urinary bladder: A migrant intrauterine device.

    A 35-year-old woman, who had had an intrauterine device inserted 7 years earlier, presented with dysuria, pollakiuria, suprapubic pain and urethral irritation. The intrauterine device was found in the bladder with stone formation and was removed by endoscopy.
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4/232. Esophagoaortic perforation by foreign body (coin) causing sudden death in a 3-year-old child.

    We report an extremely unusual consequence to foreign body ingestion in a case of a 3-year-old boy who died suddenly and at autopsy was found to have an esophagoaortic fistula. This fistula was caused by a coin which lodged posteriorly and eroded through the esophagus into the aorta. Serious complications following foreign body ingestion are rare and include stricture formation, intramural abscess, and the formation of fistula tracts. This case illustrates the potentially unpredictable behavior of impacted foreign bodies. The child's parents were initially suspected of child abuse based on the terminal hemoptysis.
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5/232. 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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6/232. Intrapulmonary artery and intrabronchial migration and extraction of a fragment of J-shaped atrial pacing catheter.

    A fragment of a fractured Telectronics Atrial Accufix 330-801 lead asymptomatically perforated the adjacent bronchus and was detected on routine chest X-ray. The metallic fragment was located by chest CT scan and bronchial fluoroscopy to lie between the right lobar bronchus and the pulmonary artery, confirming bronchial perforation. The foreign body was removed without complication by direct visualisation with rigid bronchoscopy.
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7/232. Intrapericardial tumbling bullet.

    foreign bodies of the pericardium are rare and they are associated most commonly with significant trauma. The diagnosis of a pericardial foreign body can be difficult. One must distinguish between foreign matter in the cardiac chamber or free-floating in the mediastinum. Serial chest x-rays and fluoroscopy were most helpful to us. Neither CT scan nor an echocardiogram were particularly helpful. To prevent pericarditis, either sterile or non-sterile, with potential for other significant complications, removal of a pericardial foreign body is always indicated.
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8/232. Intrasphenoidal migration of a premaxillary Kirschner wire.

    OBJECTIVE: The use of Kirschner wire for the fixation of premaxilla is a well-known method in bilateral cleft lip surgery. We report a case in which the Kirschner wire of the premaxillary fixation had migrated intrasphenoidally. RESULTS AND CONCLUSIONS: The foreign body was accidentally discovered during a cephalometric analysis and was taken out surgically through an upper lip sulcus incision. Although the wire remained asymptomatic for 10 years, it constituted a potential danger for intracranial migration.
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9/232. hyphema caused by a metallic intraocular foreign body during magnetic resonance imaging.

    PURPOSE: To report a 63-year-old man with a retained intraocular foreign body who developed a hyphema during magnetic resonance imaging (MRI) of the brain. methods: Case report and review of the current literature on ocular injury caused by intraocular foreign bodies when subjected to an electromagnetic field. RESULTS: Our patient underwent a brain MRI, and the intraocular foreign body caused a hyphema and increased intraocular pressure. The presence and location of the intraocular foreign body were determined by computed tomography (CT). CONCLUSION: magnetic resonance imaging can cause serious ocular injury in patients with ferromagnetic intraocular foreign bodies. This case demonstrates the importance of obtaining an occupational history, and, when indicated, a skull x-ray or CT to rule out intraocular foreign body before an MRI study.
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10/232. Transepidermal migration of external cardiac pacing wire presenting as a cutaneous nodule.

    Temporary epicardial pacing wires are used to control postoperative arrhythmias in patients who have undergone open heart surgery. We present an interesting case of a foreign body granuloma resulting from a retained epicardial pacing wire.
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