Experiencia en el tratamiento de la perforación de esófago cervical por cuerpo extraño en población adulta en el Hospital de San José, Bogotá durante un período de 5 años / Experience in the treatment of cervical esophageal perforation due to foreign body in the adult population at the Hospital de San José, Bogotá over a 5-year period

Introducción. La perforación esofágica cervical por cuerpos extraños es una entidad clínica poco frecuente, pero con un potencial alto de complicaciones, incluyendo la muerte como desenlace. Su tratamiento sigue siendo discutible, sin evidencia suficiente para definir el mejor abordaje entre el quirúrgico y el conservador. Métodos. Mediante un estudio de tipo observacional, retrospectivo, con componente analítico, se evaluaron los pacientes adultos con diagnóstico de perforación de esófago cervical por cuerpo extraño, tratados en el hospital de San José, Bogotá, D.C., Colombia, entre enero de 2018 y junio de 2023. Resultados. La población consistió en 22 pacientes, donde predominaron las mujeres (59 %), con una media de edad de 61,32 ± 9,04 años. Siete pacientes (31,8 %) recibieron manejo quirúrgico y 15 (68,2 %) manejo conservador. Para los desenlaces, el 90,9 % de los pacientes fueron dados de alta (domicilio) y el 9,1 % pasaron de manejo conservador a manejo quirúrgico; no se reportó ninguna muerte derivada de la perforación. Según el análisis multivariado, no hubo diferencias en los desenlaces asociadas con la edad (p=0,189), el tipo de tratamiento (p=0,095), los hallazgos tomográficos (p=0,371) o los hallazgos intraoperatorios (p= 0,515). Conclusiones. En este estudio se identificaron similares desenlaces clínicos con el tratamiento quirúrgico y conservador. El manejo conservador va tomando relevancia al no tener desventajas frente al tratamiento quirúrgico, sobre todo por ser menos invasivo.

Introduction. Cervical esophageal perforation due to foreign bodies is a rare clinical entity, but with a high potential for complications, including death as an outcome. Its treatment remains debatable, without sufficient evidence to define the best surgical or conservative approach. Methods. Through an observational, retrospective study, with an analytical component, adult patients with a diagnosis of cervical esophageal perforation due to a foreign body, treated at the Hospital San José, Bogotá, D.C., Colombia, between January 2018 and June 2023, were evaluated. Results. The population consisted of 22 patients, where women predominated (59%), with a mean age of 61.32 ± 9.04 years. Seven patients (31.8%) received surgical management and 15 (68.2%) conservative management. For the outcomes, 90.9% of the patients were discharged home and 9.1% went from conservative to surgical management. No deaths resulting from perforation were reported. According to the multivariate analysis, there were no differences in outcomes associated with age (p=0.189), type of treatment (p=0.095), tomographic findings (p=0.371), or intraoperative findings (p=0.515). Conclusions. Similar clinical outcomes with surgical and conservative treatment were identified in this study. Conservative management is becoming more relevant as it has no disadvantages compared to surgical treatment, especially because it is less invasive.

Cuerpo extraño rectal en emergencias: dos casos clínicos / Rectal foreign body in emergencies: two clinical cases

INTRODUCTION: Rectal foreign body (RFB) poses a challenge for emergency surgeons in diagnosis. Clinical suspicion is essential, along with imaging support, which will allow the most effective removal treatment to be carried out depending on the case. OBJECTIVE: To describe the procedures for an anorectal pathology commonly present in emergency services. CLINICAL CASES: Two cases are reported of men who were admitted to the emergency room with a self-inserted RFB (carrot and screwdriver). Upon admission, they gave a confusing anamnesis, and images were taken to confirm their diagnosis. They required a laparotomy to assist in its transanal removal in the first case and a protective loop colostomy in the second. DISCUSSION: RFB consultation frequently occurs in male patients who have inserted objects for sexual self-stimulation. Because of the shame and desire to conceal these cases, these patients become "special" patients. Literature reviews and case studies on the subject in particular are scarce.

INTRODUCCIÓN: El cuerpo extraño rectal (CER) plantea al cirujano de urgencias un desafío en el diagnóstico, su sospecha clínica es fundamental junto con el apoyo de imágenes, lo que permitirá realizar el tratamiento de extracción más efectivo según sea el caso. OBJETIVO: Describir los procedimientos para una patología ano rectal presente comúnmente en los servicios de urgencia. CASOS CLÍNICOS: Se reportan dos casos de hombres que ingresaron a emergencias con un CER auto insertado (zanahoria y destornillador), entregando a su ingreso una confusa anamnesis, tomándose imágenes que certificaron su diagnóstico y que requirieron una laparotomía para ayudar en su extracción transanal en el primer caso y una colostomía de protección en asa en el segundo. DISCUSIÓN: La consulta por CER se presenta frecuentemente en pacientes hombres que han introducido objetos por autoestimulación sexual. Por la vergüenza y deseo de ocultamiento en estos casos, convierte a estos pacientes, en pacientes "especiales". Las revisiones bibliográficas y la casuística sobre el tema en particular son escasas.

Complicações relacionadas ao uso de polimetilmetacrilato na face: Análise de 209 casos / Complications related to the use of polymethyl methacrylate on the face: Analysis of 209 cases

Introdução: O polimetilmetacrilato é um produto de preenchimento permanente. A injeção deste material na face pode levar a complicações. O objetivo deste estudo é determinar em uma série de casos o tempo mediano de ocorrência de complicações, as áreas mais comprometidas, os tipos de complicações e tratamentos mais realizados. Método: Foram estudados 209 casos de pacientes portadores de complicações relacionadas ao uso de polimetilmetacrilato na face que buscaram tratamento entre o período de janeiro de 2000 a junho de 2021. Os dados analisados foram sexo, idade, número de injeções, momento da aplicação, intervalo de tempo até surgir a complicação, tipo de complicação, região comprometida e tratamento realizado. Resultados: A idade média dos pacientes foi de 45 anos (23 a 79 anos). Destes, 172 eram mulheres e 37 homens. O número de aplicações variou de 1 a 5. O tempo mediano de surgimento de complicações foi de 71 meses. As regiões mais comprometidas foram a malar, em 102 pacientes; mandibular, em 100; e zigomática, em 91. Granuloma foi observado em 135 pacientes; edema, em 120; e inflamação, em 78. O tratamento mais realizado foi a injeção de corticoide, em 111 pacientes, seguido de remoção cirúrgica, em 40. Conclusão: Os resultados podem servir como base de conhecimento para uma melhor compreensão das complicações com o uso de polimetilmetacrilato na face.

Introduction: Polymethylmethacrylate is a permanent filler product. Injecting this material into the face can lead to complications. The objective of this study is to determine in a series of cases the median time for complications to occur, the most affected areas, the types of complications, and the treatments most performed. Method: 209 cases of patients with complications related to the use of polymethyl methacrylate on the face who sought treatment between the period of January 2000 and June 2021 were studied. The data analyzed were gender, age, number of injections, moment of application, interval time until the complication arises, type of complication, affected region, and treatment performed. Results: The average age of patients was 45 years (23 to 79 years). Of these, 172 were women and 37 men. The number of applications ranged from 1 to 5. The median time for complications to appear was 71 months. The most affected regions were the malar, in 102 patients; mandibular, in 100; and zygomatic, in 91. Granuloma was observed in 135 patients; edema, in 120; and inflammation, in 78. The most common treatment was corticosteroid injection, in 111 patients, followed by surgical removal, in 40. Conclusion: The results can serve as a knowledge base for a better understanding of complications with the use of polymethylmethacrylate in the face.

Complicaciones perianales causadas por agentes modeladores inyectados en glúteos / Perianal complications caused by gluteal injection of modeling agents

En este reporte presentamos tres pacientes en quienes ocurrieron condiciones inflamatorias perianales tardías, luego de la administración de sustancias modeladoras no identificadas en los glúteos. El diagnóstico inicial y supuesto no fue correcto, ya que no se investigó durante la evaluación preliminar el antecedente de la administración de elementos modeladores. Recomendamos que los pacientes con patologías inflamatorias del ano, sobre todo aquellos cuyo curso es extraño, se les pregunte acerca de la administración de agentes modeladores en los glúteos. Esta práctica puede contribuir a la eficacia del diagnóstico de manifestaciones perianales caracterizadas por flogosis, que se presentan de forma inusual. (AU)

In this report we present three patients in which late perianal inflammatory conditions occurred after administration of unidentified modeling agents to the buttocks. The initial diagnosis was not correct because of the administration of modeling agents was not investigated during the initial eval-uation. We recommend inquiring patients with inflammatory pathologies of the anus, especially those whose course is unusual, about the adminis-tration of modeling agents to the buttocks. This approach can contribute to the efficiency of the diagnosis of perianal complaints characterized by inflammation, but rare in its appearance. (AU)

Clinical application of Visual throat forceps in the removal of hypopharyngeal foreign body / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.

Prognostic value of a classification and regression tree model in patients with open-globe injuries

Objective@#To evaluate the accuracy of the Classification and Regression Tree (CART) model in prognosticating visual outcomes of patients with open-globe injuries@*Methods@#This was a retrospective, single-center, cohort study of patients with open-globe injuries seen over a two-year period. Purposive sampling of hospital medical records was done to collect data from both in- and out-patient cases. The CART algorithm was utilized to determine the predicted visual outcome for each case, and the accuracy of prognostication was measured by computing for sensitivity, specificity, positive predictive value, and negative predictive value. The area under the receiver operating characteristic curve was used to check its discriminatory capability.@*Results@#A total of 65 eyes (65 patients) with the following diagnoses based on the Birmingham Eye Trauma Terminology (BETT) classification were included: penetrating eye injury (n=58), globe rupture (n=2), and intraocular foreign body (n=5). Majority were male patients (81.5%) in the 17-39 year age group (40%). The sensitivity and specificity of CART were 100% (95% CI 93.6 to 100%) and 77.8% (95% CI 40 to 97.2%), respectively, with an overall accuracy of 96.9% (95% CI 89.3 to 99.6%). Area under the curve (AUC) was statistically significant at 0.89 (95% CI 0.79 to 0.95), indicating that the CART model can discriminate vision survival versus no vision.@*Conclusion@#The CART model demonstrated high accuracy in prognosticating visual outcomes after an openglobe injury in the local setting. It may be used as a helpful tool to guide treatment decisions in open-globe injuries.

Aspectos gerais do retículo peritonite traumática em bovinos / General aspects of traumatic reticulum peritonitis in cattle / Aspectos generales de la peritonitis del retículo traumático en ganado

A Retículo Peritonite Traumática está diretamente ligada à ingestão de objetos metálicos perfuro cortantes, como pregos e pedaços de arame, que podem penetrar ou perfurar a parede do retículo. Embora a ocorrência de corpos estranhos de alumínio seja rara, outros elementos, como fios de pneus usados para fixar lonas em silagens e até cerdas de arame de escovas utilizadas em pequenos aeroportos, têm sido registrados como causas dessa afecção. A ingestão desses objetos pode resultar em lesões no retículo, desencadeando episódios de retículo peritonite traumática e suas sequelas, como pericardite traumática, inflamação do fígado, abscessos no baço e muito mais. Os sinais clínicos podem variar, mas incluem comportamento anormal, motilidade reduzida do rúmen, fezes mal digeridas, febre e sinais de dor. O diagnóstico baseia-se na avaliação dos sinais clínicos do animal, juntamente com exames complementares, como hemograma, bioquímico, ultrassom e radiografia. É importante considerar as alterações hematológicas, como leucocitose e hiperfibrinogenemia, como indicadores-chave desta afecção. O diagnóstico também envolve testes de dor ao corpo estranho. O tratamento pode ser conservativo ou cirúrgico. A abordagem conservativa envolve a administração de antibióticos, anti-inflamatórios e soluções intravenosas, além do tratamento de deficiências nutricionais subjacentes. A opção cirúrgica exige a remoção do corpo estranho do retículo, seguida de cuidados pós-operatórios.

Traumatic Reticulum Peritonitis this directly linked to the ingestion of sharp metallic objects, such as nails and pieces of wire, which can penetrate or pierce the wall of the reticulum. Although the occurrence of aluminum foreign bodies is rare, other elements, such as tire wires used to attach tarpaulins to silage and even wire bristles from brushes used in small airports, have been recorded as causes of this condition. Ingestion of these objects can result in damage to the reticulum, triggering episodes of traumatic reticulum peritonitis and its sequelae, such as traumatic pericarditis, liver inflammation, spleen abscesses and more. Clinical signs may vary but include abnormal behavior, reduced rumen motility, poorly digested feces, fever and signs of pain. The diagnosis is based on the evaluation of the animal's clinical signs, together with complementary tests, such as blood count, biochemistry, ultrasound and radiography. It is important to consider hematological changes, such as leukocytosis and hyperfibrinogenemia, as key indicators of this condition. Diagnosis also involves foreign body pain testing. Treatment can be conservative or surgical. The conservative approach involves administering antibiotics, anti-inflammatories and intravenous solutions, in addition to treating underlying nutritional deficiencies. The surgical option requires removal of the foreign body from the reticulum, followed by post-operative care.

La peritonitis traumática del retículo esto directamente ligada a la ingestión de objetos metálicos punzantes, como clavos y trozos de alambre, que pueden penetrar o perforar la pared del retículo. Aunque la aparición de cuerpos extraños de aluminio es rara, se han registrado como causas de esta afección otros elementos, como los alambres de neumáticos utilizados para fijar las lonas al ensilaje e incluso las cerdas de alambre de los cepillos utilizados en los aeropuertos pequeños. La ingestión de estos objetos puede provocar daños en el retículo, desencadenando episodios de peritonitis traumática del retículo y sus secuelas, como pericarditis traumática, inflamación del hígado, abscesos del bazo y más. Los signos clínicos pueden variar, pero incluyen comportamiento anormal, motilidad ruminal reducida, heces mal digeridas, fiebre y signos de dolor. El diagnóstico se basa en la evaluación de los signos clínicos del animal, junto con pruebas complementarias, como hemograma, bioquímica, ecografía y radiografía. Es importante considerar los cambios hematológicos, como la leucocitosis y la hiperfibrinogenemia, como indicadores clave de esta afección. El diagnóstico también implica la prueba del dolor por cuerpo extraño. El tratamiento puede ser conservador o quirúrgico. El enfoque conservador implica la administración de antibióticos, antiinflamatorios y soluciones intravenosas, además de tratar las deficiencias nutricionales subyacentes. La opción quirúrgica requiere la extracción del cuerpo extraño del retículo, seguida de cuidados postoperatorios.

Odontogenic maxillary sinusitis associated with foreign body displacement after tooth extraction: report of an unusual case / Sinusite maxilar odontogênica por corpo estranho após extração dentária: relato de um caso incomum

Background: Odontogenic maxillary sinusitis caused by a foreign body presents diagnostic and therapeutic challenges due to its infrequent occurrence and unique characteristics compared to sinusitis originating from other sources. CaseReport:Illustrating such fact, this report presents the clinical case of a 37-year-old woman referred complaining of pain in the same region where she had extracted her upper right first molar five days before. The intraoral examination revealed the presence of an orifice in the region, suggesting oroantral communication. Imaging exams revealed opacification of the right maxillary sinus and the unexpected presence of a highly radiodense object. With the diagnosis of maxillary sinusitis due to a foreign body established, the surgical approach initially consisted of administering preoperative medication, preceded by access to the maxillary antrum using the Caldwell-Luc technique. The object was found and removed, consisting of a surgical drill. At follow-up there was complete absence of symptoms and complete closure of communication. Conclusion: Cases of odontogenic maxillary sinusitis caused by drill detachment after tooth extraction are fairly uncommon. A thorough clinical evaluation proved to be essential and the Caldwell-Luc access was effective, safe and with good postoperative results, even with the absence of standardized diagnostic and management methods(AU)

Contexto: A sinusite maxilar odontogênica causada por corpo estranho apresenta desafios diagnósticos e terapêuticos devido à sua ocorrência infrequente e características únicas em comparação com sinusites originadas de outras fontes. Relato do Caso: Ilustrando tal fato, este relato apresenta o caso clínico de uma mulher de 37 anos de idade encaminhada com queixa de dor em mesma região que havia extraído o primeiro molar superior direito cinco dias antes. Ao exame intraoral verificou-se a presença de um orifício na região, sugerindo comunicação oroantral. Os exames de imagem revelaram opacificação do SM direito e a inesperada presença de um objeto altamente radiodenso. Com o diagnóstico de sinusite maxilar por corpo estranho estabelecido, a abordagem cirúrgica consistiu inicialmente na administração de medicação pré-operatória, precedida pelo acesso ao antro maxilar através da técnica de Caldwell-Luc. O objeto foi encontrado e removido, consistindo em uma broca cirúrgica. Ao acompanhamento houve ausência completa dos sintomas e total fechamento da comunicação. Conclusão: Casos de sinusite maxilar odontogênica causada por descolamento da broca após extração dentária são bastante incomuns. Uma avaliação clínica minuciosa mostrou-se primordial e o acesso de Caldwell-Luc eficaz, seguro e com bons resultados pós-operatórios, mesmo com as ausências de métodos de diagnóstico e manejo padronizados.(AU)

Cuerpo extraño en espacio paraglótico / Foreign body in the paraglottic space

Los cuerpos extraños en la vía aérea son una urgencia muy común en la práctica de la otorrinolaringología. La mayoría suelen encontrarse en población pediátrica donde la gravedad es mayor. En adultos estos episodios suelen ser accidentales, siendo la exploración física fundamental para su diagnóstico. Exponemos aquí el caso de un varón qué presentó una espina de pescado en el área interaritenoidea.

Foreign bodies in the airway are a very common emergency in the practice of otorhinolaryngology, the majority of which are usually found in the pediatric population. In adults, these episodes are usually accidental, and physical examination is fundamental for its diagnosis. We report a case of fish bone impaction in the interarytenoid area.

Radiolucent metallic foreign body: a case report

A 13-year-old boy who accidentally ingested an aluminum beverage can pull tab. Neck and chest radiographs did not reveal any ingested foreign body. This case report illustrates poor negative predictive value of conventional radiographs for a suspected aluminum foreign body and demonstrates superiority of CT for this purpose. In such presentations, it is imperative to have a low threshold for performing further diagnostic evaluation with CT due to the relatively high radiolucency of aluminum.

An Incidental Finding Of Button Battery In The Nose Without Any Complication- A Case Report Of A Rare Presentation

Aim And Background-A foreign body in nose presents with unilateral purulent nasal discharge, nasal obstruction and nasal bleed.We present a case in which a button battery remained uncomplicated in the nasal cavity for a year. However, if it is found, it should be removed as early as possible. A 6-year-old female child presented with aCase Description – one-year history of foul-smelling, left-sided nasal discharge. During anterior rhinoscopy, a black, rigid mass was observed. A circular foreign object was found in the floor of the left nasal cavity during a CT (computed tomography) scan of the Nose and PNS (paranasal sinuses). General anesthesia was used during the diagnostic nasal endoscopy on the child. A foreign body was visualized and removed using a curved curette. The nasal mucosa was normal on follow-up, and there was no septal perforation. A detailed history, assessment and radiological examination plays aConclusion- key role in management of foreign bodies.We report that a button battery was left in the nose for a long time without causing any problems. There were no complications from an unnoticed button battery in theClinical Significance: nose for a year. However, if it is found, it should be removed.

Creatively tiding over the crisis

Background: A patient with a retained intraocular metallic foreign body post?trauma was taken up for vitrectomy and intraocular foreign body removal. Unfortunately, the intraocular magnet was not available at the moment on the table! How a little bit of creativity and innovative thought helped us tide over this crisis is the content of this video. Purpose: To demonstrate magnetization of a metallic surgical instrument for temporary use in the event of unavailability of the intraocular magnet for intraocular foreign body removal. Synopsis: A ferromagnetic substance can be magnetized temporarily using an existing magnet. We obtained a general?purpose magnet and wrapped it in sterile plastic, using which we magnetized normal intraocular forceps and a Micro Vitreo Retinal (MVR) blade by giving about 20–30 strokes over the magnet in a single direction. This aligned the magnetic domains in the metal in a parallel fashion. These Do It Yourself (DIY)? magnetic instruments were then effectively utilized to remove the metallic intraocular foreign body. Highlights: The video showcases effectively harnessing the available resources and tiding over the dearth of a necessary instrument, with the right use of an innovative idea and some creativity!.

Light emitting diode bulb aspiration in children: a rare entity

Foreign body aspiration is a life threatening emergency in children. Different types of foreign bodies are aspirated and reported in literature but light emitting diode (LED) bulb is an unusual cause of foreign body aspiration. Rigid bronchoscopy is gold standard for treatment of foreign body aspiration. We wish to present a case of 9 years old male child with LED bulb aspiration which was retrieved with rigid bronchoscopy.

An unusual case of nasal foreign body presenting as recurrent otitis media

Otitis media (OM) is a common problem involving children. In the majority, the cause is related to dysfunction of the Eustachian tube due to bacterial or viral rhinitis and less commonly due to nasopharyngeal tumors. We present a case of recurrent OM which was evaluated and incidentally found a nasal foreign body for which the patient was asymptomatic. This nasal body was the cause of recurrent OM which is very unusual.

Rare Incidental Foreign Body in the Maxillary Sinus on Routine Radiographic Examination

Accidental entry of any foreign body into the paranasal sinus could be due to known causes or unknown causes with the patient being either symptomatic or sometimes asymptomatic. Such asymptomatic conditions make it difficult to detect the foreign body for an indefinite period which on a longer duration may lead to various complications later. Routine radiographic examination during dental checkup reports to serve a good purpose in these kinds of cases by accidental detection of such foreign bodies in the maxillofacial region leading to early diagnosis and timely management. The present paper highlights the importance of routine radiographs in detecting a rare type of foreign body (nasal stud) in the maxillary sinus in the asymptomatic patient.

Impacted-button-battery-masquerading-as-recurrent-epistaxis-in-an-child

Epistaxis in children is one of the most common referral dealt by an ENT outpatient department . Here we report a case of a 2-year-old girl who presented with complaints of recurrent episodes of epistaxis and discharge from the right nasal cavity since 1 month duration. Endoscopic examination of the right side of nose revealed a button battery impacted between the inferior turbinate and the cartilaginous portion of nasal septum

Hoja de cuchillo retenida en el hueco axilar

Introducción: El hallazgo de un cuerpo extraño retenido, específicamente una hoja de cuchillo es infrecuente. En ocasiones, estos cuerpos extraños pasan inadvertidos y se diagnostican de forma diferida o retrasada. Objetivo: Describir el diagnóstico y tratamiento de un paciente con una hoja de cuchillo retenida en el hueco de la axila. Caso clínico: Varón de 25 años, agredido con un cuchillo, que sufrió una herida en la región posterior del hombro y fue suturado sin realizar ningún examen complementario. Dos semanas después acudió por molestias en el hombro lesionado, se indicó radiografía en la cual apareció una imagen radiopaca que correspondió con una hoja de cuchillo en proyección subescapular. Refería molestias del hombro e impotencia funcional. Se opera con anestesia general, se realiza incisión axilar, se identifica el objeto, en íntimo contacto con la vena axilar; la punta hacia el vértice axilar, cruzando bajo la vena axilar en su entrada al tórax. Se extrajo el cuerpo extraño bajo visión directa, sin complicaciones. El paciente evolucionó favorablemente. Conclusiones: Los cuerpos extraños retenidos, que pasan inadvertidos son raros, sin embargo, existen regiones como la axila en que por las características anatómicas del espacio se dificulta su diagnóstico. En este caso coincidió una combinación poco usual de fenómenos, la actitud defensiva del lesionado y la dirección de la herida, que propiciaron quedara la hoja en el hueco axilar.

Introduction: The finding of a retained foreign body, specifically a knife blade, is a rare event. Sometimes these foreign bodies go unnoticed and are diagnosed deferred or delayed. Objective: To describe the diagnosis and treatment of a patient with a knife blade retained on axillary hole. Clinical case: 25-year-old male, attacked with a knife, who suffered a wound in the posterior region of the shoulder and was sutured without performing any complementary examination. Two weeks later, he came due to discomfort from the injured shoulder. An X-ray of the shoulder was indicated, where a radiopaque image appeared that corresponds to the knife blade, in subscapular projection. He refers shoulder discomfort and functional impotence. It is operated under general anesthesia, axillary incision, the object is identified in intimate contact with the axillary vein, the tip towards the axillary vertex, crossing under the axillary vein at its entrance to the thorax, the foreign body is removed under direct vision and without complications. Evolved favorably. Conclusions: Retained foreign bodies that go unnoticed are rare. However, there are regions such as the armpit where, due to the anatomical characteristics of the space, their diagnosis is difficult. In this case, an unusual combination of phenomena coincided, the defensive attitude of the injured person and the direction of the lunge, which led to the blade remaining in the axillary hole.

Penile strangulation by a metal ring

Penile strangulation due to the metallic ring is an uncommon clinical entity that requires urgent attention to prevent irreversible nerve damage, and if neglected gangrene of the penis. Various methods have been described in the literature for removing constricting foreign bodies, but there is no consensus regarding an acceptable technique. We report the case of a 51-year-old man with a history of a metal ring used for sexual pleasure lodged over the shaft of his penis with an inability to remove the same.

FLEXIBLE VERSUS RIGID ESOPHAGOSCOPY IN THE MANAGEMENT OF ESOPHAGEAL FOREIGN BODY IMPACTION

Background: Foreign body(FB) impaction accounts for 4% of emergency endoscopies in clinical practice. Flexible endoscopy(FE) is a recommended therapeutic option because it can be performed under local anesthesia, it is cost effective and is well tolerated. Rigid endoscopy (RG) under general anesthesia is another option and is advantageous in some circumstances. The aim of the study is to compare ef?cacy and safety of ?exible and rigid esophagoscopy in esophageal foreign body removal. It is a prospective study done in E.N.T department in KIMS Methods: MEDICAL COLLEGE, Amalapuram, which includes 50 patients with impacted foreign body esophagus. Parameters like type of foreign body, location of impacted foreign body are included. The study analyzies the type of procedure the patient have undergone, the intra operative and post operative complications. This prospective cohort study includes 50 patients Results: who have undergone surgical procedure for removal of impacted foreign body. Flexible esophagoscopy is performed in 30 patients and rigid esophagoscopy is performed in 20 patients . The most frequent complications are mucosal erosion, mucosal edema, and ulceration. Flexible esophagoscopy and rigid esophagoscopy are equally safe and effective for Conclusion: removal of impacted esophageal foreign body

Oral ingestion of foreign body in neonates and infants: a clinical review

Foreign body (FB) ingestion in adult and children population is not uncommon but accidental. Same is rare in neonates and infants. Many of the FBs ingestion go unnoticed or unexpressed if baby is preverbal.Most of the foreign bodies pass spontaneously per anal. Only the larger size or sharp FBs get stuck in places of gastro intestinal tract and presents the patient in emergency department. Similarly corrosive and toxic FBs also invite immediate attention. Literature on the clinical aspects of the foreign body ingestion among neonates and infants was searched electronically through PubMed and individual study. Relevant articles were reviewed thoroughly and summarized. Instances of foreign body ingestion (FBI) in neonate and adult are in ascending trend over last several years. Imaging and identification of radiolucent FBs become challenging for surgeons. Conservative treatment for spontaneous evacuation, endoscopic retrieval and surgical removal are the modalities for FBI management.