Cases reported "Foreign-Body Migration"

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1/33. 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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keywords = esophagus
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2/33. Missing anterior cervical plate and screws: a case report.

    STUDY DESIGN: A case report of an anterior cervical plate and screws that disappeared completely. OBJECTIVES: To present a case of a missing anterior cervical plate and screws, this being quite a rare complication of a cervical implant. SUMMARY OF BACKGROUND DATA: No mention of this complication was found in the literature. methods: methods in the literature and clinical presentation are reviewed. RESULTS: Dislodgment of an anterior cervical plate occurred in association with an methicillin-resistant staphylococcus aureus infection. Three months later the implants had disappeared, presumably passing without notice through the gastrointestinal tract. Whole body fluoroscopy could not identify any residual plate or screws. No esophageal fistula could be detected by barium meal swallow study. CONCLUSIONS: The plate and screws became dislodged, eroded through the posterior wall of the esophagus, then traversed the limit of the gastrointestinal tract, passing with feces without significant morbidity. Whether the methicillin-resistant staphylococcus aureus infection contributed to this unique circumstance or is coincidentally related to it remained a matter of speculation.
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keywords = esophagus
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3/33. The problem of the open safety pin.

    The open safety pin lodged in the stomach or esophagus presents a challenge to surgical judgment and technical skill. Most foreign bodies causing trouble lodge in the esophagus. Once in the stomach, uneventful passage can be expected in 80 to 90% of cases. Active intervention is reserved for those where intestinal performation is likely or where there is failure to progress. We have used the fiberesophagoscope to remove three open safety pins from the stomachs of two patients whose symptoms and threat of perforation required intervention. The microbiopsy forceps was used successfully to retrieve the open pins, but a newly developed grasping forceps for use with the fiberesophagoscope now provides a more secure hold on such foreign bodies. Rigid instruments retain their value for selected cases, but the flexible equipment now provides an important advance in the management of the open safety pin in the stomach.
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ranking = 2
keywords = esophagus
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4/33. Migrating oesophageal foreign body--an unusual case.

    Ingested foreign bodies which migrate extraluminally are rare occurrences. If untreated, they may result in life threatening complications. Exploration of the neck via an external approach to remove the foreign body is the recommended treatment. The CT Scan utilising fine cuts is invaluable in localising the foreign body for exploration. The case of a patient with a metallic foreign body in the oesophagus which migrated extraluminally is presented. Hemithyroidectomy was required to gain access for removal of the foreign body. A discussion on the management of such a case follows.
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ranking = 1
keywords = esophagus
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5/33. Endoscopic retrieval of a broken and migrated esophageal metal stent.

    In patients with inoperable malignant tumors of the esophagus or cardia, self-expanding metal stents are increasingly used to improve dysphagia. Usually, they are not difficult to place and, as compared to conventional plastic stents, complications such as stent migration or perforation, seem to occur less frequently. This is a report on a young patient with metastatic adenocarcinoma of the cardia, who was treated with a self expanding metal stent after endoscopic dilatation of a tumor stenosis in the distal esophagus. Immediately after the procedure, he was able to eat and gained weight. Within 6 weeks and while on continuous infusion of 5-fluorouracil, the patient complained about recurrent severe dysphagia. Plain x-ray demonstrated a broken and migrated stent, the 2 parts of which were seen in the stomach and the duodenum. The stent could be extracted endoscopically without any complication, but the procedure was difficult and lasted 4 h, as the stent broke 2 more times during retrieval.
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ranking = 2
keywords = esophagus
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6/33. Extraluminal migration of a coin in the oesophagus of a child misdiagnosed as asthma.

    Ingestion of a foreign body, the commonest being a coin, is a common problem in children. In most cases the coin will pass uneventfully through the gastrointestinal tract. However, on rare occasions it may become lodged in the oesophagus with subsequent extraluminal migration with the potential for serious complications such as vascular fistula or chronic suppurative infection. A case is presented of extraluminal migration of a coin in the oesophageal associated with abscess formation in a 15 month old boy. This case is particularly important because the presenting symptom of wheezing led to the erroneous diagnosis of asthma, which resulted in a three month delay in investigation and treatment. In addition, it raises the issue of whether to perform chest radiography on newly diagnosed asthmatic patients to rule out the presence of a foreign body and thereby prevent serious complications.
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ranking = 5
keywords = esophagus
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7/33. Stenting for cervical tracheo-esophageal malignant fistula: a case report.

    Esophago-respiratory neoplastic fistulas present serious problems of management, mostly because of the severe status of the patient. The authors present the case of a 49-year-old patient with a malignant eso-tracheal fistula manifesting as mild dysphagia and dyspnoea. An endoscopic palliative treatment of the fistula was performed introducing a metallic coated stent into the esophagus. The multiple stent displacement required a definitive, very high positioning of the stent in the lower pharynx, with significant discomfort. Severe respiratory conditions regressed and the patient survived 6 months after the initial placement. The authors suggest endoscopic palliation with esophageal prosthesis as the therapeutic choice in those cases not amenable to surgery.
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ranking = 1
keywords = esophagus
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8/33. Ingested nail penetrating the neck in an infant.

    Ingested sharp foreign bodies usually lodge themselves in the pharynx unlike their more common smooth counterparts, which are found in the upper esophagus. These are very rare in infants and pose problems like delayed presentation and occasionally extraluminal migration. A very rare case of through and through penetration of neck by an ingested nail in an infant, which presented 8 months after its ingestion, is reported.
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keywords = esophagus
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9/33. Management of the cervical esophagus and hypofarinx perforations complicating anterior cervical spine surgery.

    STUDY DESIGN: Five cases of esophageal or pharyngeal perforation diagnosed during or after anterior cervical spine surgery are presented. OBJECTIVE: To outline a protocol for the early diagnosis and treatment of iatrogenic pharyngoesophageal perforations. SUMMARY OF BACKGROUND DATA: Pharyngoesophageal perforations after anterior cervical spine surgery are uncommon or rarely reported complications. They may have serious functional consequences, including death, if they are not diagnosed promptly and treated effectively. These potentially fatal conditions require a surgical and medical therapy. methods: Clinical course, diagnostic tools and guidelines for the management of five patients presenting esophagopharingeal perforations are illustrated. RESULTS: These five cases resulted in definitive healing of the laceration without functional consequences. CONCLUSION: We believe that awareness of these complications and their causes, prompt recognition of the symptoms and immediate and multimodality therapies are essential tools to achieve successful results.
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ranking = 4
keywords = esophagus
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10/33. Intercostal drain migration post esophagectomy.

    A 38-year-old man underwent an Ivor-Lewis esophagectomy for a squamous carcinoma at the lower third of his esophagus. On the fifth postoperative day one liter of turbid fluid appeared from the intercostal drain and there was a right-sided pleural effusion on the chest radiograph. A contrast swallow demonstrated a leak at the distal part of the gastric staple line. This leak was managed conservatively and subsequent contrast swallows failed to show any leakage despite the persistent drainage from the drain. At gastroscopy, the intercostal drain was seen to have eroded through the stomach wall. The drain was repositioned and the patient was discharged from hospital 5 days later. We believe this to be the first report of an intercostal drain migration into the stomach after an elective esophagectomy.
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ranking = 1
keywords = esophagus
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