Cases reported "Foreign-Body Reaction"

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11/38. Surgical staple metalloptysis after apical bullectomy: a reaction to bovine pericardium?

    Palliation of symptomatic emphysema may include bullous resection to improve function of the remaining lung. Buttressing staple lines with bovine pericardium partially alleviates postoperative air leak, but can promote inflammation and infection. We report a patient expectorating staples and pericardium 5 years after bilateral apical bullectomy. Previous reporting of this complication in lung volume reduction operation also involved both pericardium and staples, and we propose that an ongoing local inflammatory reaction to these materials may facilitate delayed erosion into airways.
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ranking = 1
keywords = metal
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12/38. Ferruginous foreign body: a clinical simulant of melanoma with distinctive histologic features.

    A 53-year-old man reported a pigmented lesion on his forearm that he had first become aware of approximately 30 years previously. More recently, the lesion had become symptomatic and was excised because of concern of melanoma; however, during tissue processing, an embedded metallic object was found. Histologic examination of the tissue surrounding the site of the metallic object confirmed an inner zone of iron deposition with a distinctive histologic appearance indistinguishable from rust, associated with a foreign body reaction. Surrounding this was an outer zone of siderophages with the more usual histologic appearance. Chemical analysis of the foreign body confirmed its ferruginous nature. On subsequent questioning, the patient informed us that he had worked with heavy equipment in a mine at the time that he had first noticed the lesion.
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ranking = 0.5
keywords = metal
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13/38. The histology of "reactive lines" in well-fixed components.

    The histologic findings from 2 total knee arthroplasties (TKAs) in 1 patient who died 5 years after surgery are reported. Cement was placed under the tibial and femoral metal backs but not around the stems. All components were securely fixed. "Reactive lines," present around the tips of the stems on radiography, were seen to contain thin, soft connective tissue without debris or macrophages. The histologic features of a reactive line are described.
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ranking = 0.25
keywords = metal
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14/38. Metal-backed patellar component failure in total knee arthroplasty presenting as a giant calf mass.

    Failure of total knee arthroplasty (TKA) caused by wear of the polyethylene-bearing surface of a metal-backed tibial platform or a metal-backed patellar component is a recognized complication. We present a case of a 78-year-old woman with a cystic mass in the left calf caused by metal wear debris from the failure of a Miller-Galante I TKA. The patient received a left TKA to treat advanced osteoarthritis in July 1990 and was lost to follow-up immediately after the operation. In December 1998, she presented at our clinic 2 days before admission, when an originally silent mass over the calf turned intolerably painful. A series of examinations revealed a calf mass caused by wear debris of total knee prosthesis and subsequent inflammation of the knee joint. curettage of the cyst and simultaneous revision TKA were successful in relieving her symptoms.
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ranking = 0.75
keywords = metal
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15/38. Endoscopic basket extraction of a urethral foreign body.

    The presence of a foreign body in the genitourinary tract represents a urologic challenge that often requires prompt intervention. We describe an endoscopic approach that was used for removal of a foreign body located in the prostatic urethra of a schizophrenic man. A nitinol stone basket was used as an effective means for extraction of a large metal screw from the urethra of this patient.
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ranking = 0.25
keywords = metal
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16/38. lithiasis in the ileal conduit and the continent urinary pouch: two cases and a review.

    We present 2 patients who developed stones (6 and 57 g) in the ileal conduit; the first stone was passed and the second required surgical removal; its nidus was a surgical staple. After a review of the literature which includes 25 other cases of stones in ileal conduits, as well as over 20 cases of stones in continent urinary pouches, it is concluded that the use of metallic staples in the construction of the ileal conduit or the continent urinary pouch should be abandoned.
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ranking = 0.25
keywords = metal
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17/38. Long-term penile incarceration by a metal ring resulting in urethral erosion and chronic lymphedema.

    A patient presented with a metal ring around the base of his penis. The ring had been placed 3 years prior to presentation. Intra-operative findings revealed a ventral erosion with complete transection of the urethra and massive fixed lymphedema of the penile skin distal to the ring. Treatment consisted of removal of the ring with metal shears and bolt cutters. Small reduction of the edema was seen 3 months following removal, and the patient refused further treatment. The most interesting part of the outcome was the preservation of penile urethral voiding although intromission was not possible.
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ranking = 1.5
keywords = metal
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18/38. Material reaction to suture anchor.

    The authors present a case of material reaction to suture anchor, which is rarely reported. Leukocyte rate, leukocyte differential, multiple cultures, and gram stain test could not prove infection. A second surgery for exploration of the shoulder joint was performed to reconstruct the rotator cuff without using anchors, and the rotator cuff tear healed after the second surgery. During the second surgery, the bone surrounding the anchors was found to be eroded and substituted with necrotic tissue. The anchors protruded outside the bone. The pathological examination of the necrotic tissue showed multinucleated giant cells of foreign body type, some of which had engulfed minute splinters of particulate foreign material. Either metal- or suture-induced bioreaction is suspected in this case.
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ranking = 0.25
keywords = metal
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19/38. Massive wear of an incompatible metal-on-metal articulation in total hip arthroplasty.

    We report on a case of massive wear because of an incompatible metal-on-metal combination. In a 62-year-old man, a cobalt-chromium (CoCr) inlay and a stainless steel head were paired by accident. Because of persistent pain, revision surgery was performed 7 months later. Histologic analysis of the surrounding tissue revealed massive metallosis. The wear volume was increased by a factor of 18 for the head and 2 for the cup compared with normal metal-on-metal articulation. The serum concentrations of chromium and cobalt were increased by a factor of 20 and 4 over levels of a healthy population, respectively. Incompatible metal-on-metal combinations should be revised immediately. In case of delayed diagnosis, no metal-on-metal articulation should be implanted because of the high volume of metal in the human body.
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ranking = 4.5
keywords = metal
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20/38. Delayed reaction to shrapnel retained in soft tissue.

    BACKGROUND: Treatment of penetrating injuries to soft tissues does not require surgical excision of shrapnel. metals usually remain inert and do not cause damage and are therefore left in soft tissue. OBJECTIVE: Characterization of delayed reaction to shrapnel retained for many years in soft tissue. patients: Four patients sustained penetrating injuries to the limbs with embedded shrapnel. Many years later, they experienced delayed reaction to the metals that required surgery, with very unusual findings. CONCLUSIONS: Although nonsurgical treatment of shrapnel in soft tissues is the treatment of choice in most cases, we need to be aware of the possibility of late complications requiring surgical treatment.
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ranking = 0.25
keywords = metal
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