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2.
J Investig Med High Impact Case Rep ; 12: 23247096241238527, 2024.
Article En | MEDLINE | ID: mdl-38646799

Biliary endoprostheses are widely used in the treatment of biliary lithiasis, malignant and benign strictures, and occasionally in long-lasting biliary fistulas. They can be placed endoscopically during endoscopic retrograde cholangiopancreatography and radiologically (percutaneous) when the endoscopic route is not feasible. Complications associated with the endoscopic placement of biliary endoprostheses are well described in the literature, with migration being the most common. Intestinal obstruction is a rare complication associated with the migration of these devices. There are no reports in the literature of this complication occurring after percutaneous placement. We present a case of a patient who arrived at the emergency department with ileal obstruction secondary to the migration and concurrent embedding of a covered stent placed radiologically to treat a biliary leak after surgery. The patient underwent diagnostic laparoscopic and ileal resection, revealing a lithiasic concretion at the tip of the stent, causing the small bowel obstruction.


Foreign-Body Migration , Intestinal Obstruction , Stents , Aged , Humans , Male , Cholangiopancreatography, Endoscopic Retrograde , Foreign-Body Migration/surgery , Foreign-Body Migration/diagnostic imaging , Foreign-Body Migration/complications , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestine, Small , Laparoscopy , Stents/adverse effects
3.
Trop Doct ; 54(3): 284-286, 2024 Jul.
Article En | MEDLINE | ID: mdl-38562095

A 72-year woman with a history of multiple cerebrovascular accidents presented with severe epigastric pain. An oesophageal perforation by the tip of a Ryles tube, which had migrated into the mediastinum, was diagnosed by radiography. An attempt at pushing the nasogastric tube into the stomach resulted in increasing the rupture to about 6 cm in size. Replacement by a triple-lumen nasojejunal feeding tube and subsequent feeding with c.1,400 calories per day enabled the perforation to close without further intervention.


Esophageal Perforation , Foreign-Body Migration , Intubation, Gastrointestinal , Humans , Esophageal Perforation/etiology , Esophageal Perforation/diagnostic imaging , Female , Foreign-Body Migration/complications , Aged , Intubation, Gastrointestinal/adverse effects , Enteral Nutrition/instrumentation , Enteral Nutrition/adverse effects , Radiography
4.
Am Surg ; 89(8): 3614-3615, 2023 Aug.
Article En | MEDLINE | ID: mdl-36960753

Gunshot wounds account for significant morbidity and mortality in the United States. A rare and potentially fatal complication of a gunshot wound is bullet embolus. Potential complications include distal limb ischemia, coronary infarct, renal infarction, stroke, pulmonary embolization, cardiac valvular injury, thrombophlebitis, and dysrhythmias. Overall, surgical embolectomy and endovascular retrieval are the preferred treatments for bullet emboli. We report one case of venous bullet embolus and one case of arterial bullet embolus, both of which were successfully treated with endovascular retrieval. A thorough physical exam and appropriate imaging are vital to prompt identification and treatment of bullet emboli, as the repercussions of missed injuries can be devastating.


Embolism , Foreign-Body Migration , Heart Injuries , Wounds, Gunshot , Humans , Wounds, Gunshot/complications , Wounds, Gunshot/diagnostic imaging , Wounds, Gunshot/surgery , Embolism/diagnostic imaging , Embolism/etiology , Embolism/surgery , Veins , Embolectomy , Heart Injuries/surgery , Foreign-Body Migration/complications
5.
Nihon Hinyokika Gakkai Zasshi ; 114(2): 70-74, 2023.
Article Ja | MEDLINE | ID: mdl-38644190

A 76-year-old woman was referred to our department because of high fever and bladder irritative symptoms. Computed tomography revealed the presence of a heterogeneous mass with indistinct borders on the left anterior wall of the bladder. The lesion contained a linear hyperdense shadow. We initially suspected malignancy, such as urachal carcinoma or soft-tissue sarcoma. However, upon review of previous computed tomography scans, it was confirmed that the linear hyperdense shadow had migrated from the intestinal tract to the bladder. Considering the possibility of abscess formation caused by a foreign body, we decided to perform a transurethral biopsy. The results of the pathological analysis showed abscess formation. The patient was diagnosed with perivesical abscess caused by accidental ingestion of a fish bone. Following the administration of antibiotics, the lesion markedly shrank. Although it is difficult to distinguish perivesical abscess from malignant disease, invasive treatment can be avoided by appropriate diagnosis based on imaging studies.


Abscess , Foreign-Body Migration , Aged , Female , Humans , Abscess/etiology , Bone and Bones/pathology , Foreign Bodies/complications , Foreign Bodies/diagnostic imaging , Foreign-Body Migration/complications , Foreign-Body Migration/diagnostic imaging , Tomography, X-Ray Computed , Urinary Bladder/pathology , Urinary Bladder/diagnostic imaging , Urinary Bladder Diseases/etiology , Urinary Bladder Diseases/pathology
7.
J Med Case Rep ; 16(1): 198, 2022 May 22.
Article En | MEDLINE | ID: mdl-35598001

BACKGROUND: Bullet embolus is a rare condition following gunshot injuries and represents a clinical challenge regarding both diagnosis and management. CASE PRESENTATION: We report the case of a 35-year-old Iranian (Middle-Eastern) male patient with a shotgun injury to both buttocks, which traveled to the heart and the popliteal area through the femoral vein and superficial femoral artery, respectively. Surgical intervention was applied for the popliteal pellet, and the patient was discharged without further complications. CONCLUSION: Although bullet emboli can be a clinical challenge, with the advent of modern procedures, removal has become safer. X-ray, computed tomography, and transthoracic and/or transesophageal echocardiography may be used as adjuncts to help establish the diagnosis.


Embolism , Foreign-Body Migration , Wounds, Gunshot , Adult , Embolism/diagnostic imaging , Embolism/etiology , Embolism/surgery , Femoral Artery/diagnostic imaging , Femoral Artery/surgery , Foreign-Body Migration/complications , Humans , Iran , Male , Radiography , Wounds, Gunshot/complications , Wounds, Gunshot/diagnostic imaging , Wounds, Gunshot/surgery
8.
BMC Surg ; 22(1): 92, 2022 Mar 09.
Article En | MEDLINE | ID: mdl-35272656

BACKGROUND: Accidental ingestion of fish bone is a common cause of otolaryngological emergency. Migration of the ingested bone into the thyroid gland, however, occurs very rarely. The associated clinical presentation, symptoms and duration of discomfort are also highly variable between patients and can be diagnostically challenging. CASE PRESENTATION: Here, we report the case of a 71-year-old female patient presenting with an ingested fish bone that migrated into the right thyroid lobe as a rare cause of suppurative thyroiditis with the clinical features of sepsis. We outline the diagnostic approach, peri- and intraoperative management as well as complications. It is proposed that besides endoscopy, imaging methods such as ultrasound or computed tomography may be necessary to verify the diagnosis and location of an ingested fish bone. Prompt surgical removal of the foreign body and resection of the infectious focus is recommended to minimize the risk of local inflammation, recurrent nerve lesions and septic complications arising from the spread of infection. CONCLUSION: Fish bone migration into the thyroid gland is an extremely rare event, the successful detection and surgical management of which can be achieved through a careful interdisciplinary approach.


Foreign Bodies , Foreign-Body Migration , Thyroiditis, Suppurative , Animals , Female , Foreign Bodies/complications , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Foreign-Body Migration/complications , Foreign-Body Migration/diagnosis , Foreign-Body Migration/surgery , Humans , Neck/pathology , Thyroiditis, Suppurative/diagnosis , Thyroiditis, Suppurative/etiology , Thyroiditis, Suppurative/surgery
10.
BMC Surg ; 22(1): 6, 2022 Jan 08.
Article En | MEDLINE | ID: mdl-34996410

BACKGROUND: Ingestion of fish bones leading to gastric perforation and inducing abscess formation in the caudate lobe of the liver is very rare. CASE PRESENTATION: A 67-year-old man presented to our hospital with a 2-day history of subxiphoid pain. There were no specific symptoms other than pain. Laboratory tests showed only an increase in the number and percentage of neutrophils. Contrast-enhanced Computerized tomography (CT) of the abdomen showed two linear dense opacities in the gastric cardia, one of which penetrated the stomach and was adjacent to the caudate lobe of the liver, with inflammatory changes in the caudate lobe. We finally diagnosed his condition as a caudate lobe abscess secondary to intestinal perforation caused by a fishbone based on the history and imaging findings. The patient underwent 3D laparoscopic partial caudate lobectomy, incision and drainage of the liver abscess, and fishbone removal. The procedure was successful and we removed the fishbone from the liver. The patient was discharged on the 9th postoperative day without other complications. CONCLUSIONS: Liver abscess caused by foreign bodies requires multidisciplinary treatment. Especially when located in the caudate lobe, we must detect and remove the cause of the abscess as early as possible. Foreign bodies that perforate the gastrointestinal tract can penetrate to the liver and cause abscess formation, as in this case. When exploring the etiology of liver abscesses, we should investigate the general condition, including the whole gastrointestinal tract.


Foreign Bodies , Foreign-Body Migration , Laparoscopy , Liver Abscess , Aged , Animals , Foreign Bodies/complications , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Foreign-Body Migration/complications , Foreign-Body Migration/diagnostic imaging , Foreign-Body Migration/surgery , Humans , Liver Abscess/diagnostic imaging , Liver Abscess/etiology , Liver Abscess/surgery , Male
11.
Interact Cardiovasc Thorac Surg ; 34(6): 1186-1187, 2022 06 01.
Article En | MEDLINE | ID: mdl-35088832

Embolization of a bullet or shrapnel from the heart (left ventricle) to the peripheral arterial circulation is practically unknown. We present a 38-year-old man with no comorbidities who was referred to our centre with a bullet injury to the left side of his chest. The patient complained of mild pain and numbness in his right lower limb. A trauma series was advised. A contrast angiogram of the peripheral lower limbs showed a bullet in the right popliteal artery with no flow in the tibial arteries. A bullet was removed from the distal popliteal artery at its bifurcation with a long thrombus proximal to it. Removal of the foreign body is the widely accepted management, especially when it leads to symptoms like ischaemia or signs of infection, as was the situation in our case.


Embolism , Foreign-Body Migration , Wounds, Gunshot , Adult , Embolism/diagnostic imaging , Embolism/etiology , Embolism/surgery , Foreign-Body Migration/complications , Foreign-Body Migration/diagnostic imaging , Humans , Ischemia/diagnostic imaging , Ischemia/etiology , Ischemia/surgery , Male , Popliteal Artery , Wounds, Gunshot/complications , Wounds, Gunshot/diagnostic imaging , Wounds, Gunshot/surgery
14.
Heart Surg Forum ; 24(3): E587-E588, 2021 Jun 25.
Article En | MEDLINE | ID: mdl-34173740

Inferior vena cava (IVC) filters have been widely used to prevent pulmonary emboli in patients with venous thromboembolism. Here we report a rare case of complete pericardial tamponade with severe mitral and tricuspid valve regurgitation due to a fractured IVC filter. A 38-year-old male came to our emergency department with a 19-day history of progressive chest tightness. Chest x-ray revealed a tethering catheter fractured at the level of the junction of the superior vena cava and the right atrium. We performed open surgery and discovered that a steel wire had punctured the atrioventricular septum, the mitral valve, and finally the posterior wall of the left ventricle. The patient recovered quite well and was discharged after 1 week.


Cardiac Surgical Procedures/methods , Device Removal/methods , Foreign-Body Migration/complications , Heart Injuries/etiology , Heart Ventricles , Vena Cava Filters/adverse effects , Venous Thromboembolism/prevention & control , Adult , Echocardiography , Foreign-Body Migration/diagnosis , Foreign-Body Migration/surgery , Heart Injuries/diagnosis , Heart Injuries/surgery , Humans , Male , Reoperation
16.
BMC Gastroenterol ; 21(1): 82, 2021 Feb 23.
Article En | MEDLINE | ID: mdl-33622248

BACKGROUND: Migration of fish bones into abdominal para-aortic tissue after penetrating the junction of 3rd and 4th part of duodenum is incredibly rare. CASE PRESENTATION: A 68-year-old man was admitted to our hospital with persistent colic in the lower abdomen after eating fish two weeks ago. Abdominal computed tomography (CT) scan showed High density streaks along the anterior and lower edges of the 3rd part of duodenum with peripheral exudation and localized peritonitis. Esophagogastroduodenoscopy didn't find foreign bodies and perforations in the digestive tract. Laparoscopic surgery and intraoperative endoscopy were made to detect foreign bodies and perforation site was found. After transition to open surgery, the fish bone was found in abdominal para-aortic tissue and removed without complications. Postoperative recovery is smooth, and the patient resumed normal diet and was discharged. CONCLUSIONS: It is difficult to choose a treatment plan for foreign bodies at the 3rd part of the duodenum, because it is difficult to judge the damage caused by the foreign body to the intestine and the positional relationship with the surrounding important organs. Conservative treatment or surgical treatment both have huge risks. The handling of this situation will extremely test the psychology, physical strength and professional experience of the surgeon.


Foreign Bodies , Foreign-Body Migration , Intestinal Perforation , Abdomen , Aged , Animals , Bone and Bones , Duodenum/diagnostic imaging , Foreign Bodies/complications , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Foreign-Body Migration/complications , Foreign-Body Migration/diagnostic imaging , Foreign-Body Migration/surgery , Humans , Intestinal Perforation/diagnostic imaging , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Male
17.
Dig Dis Sci ; 66(4): 983-987, 2021 04.
Article En | MEDLINE | ID: mdl-33428037

Removal of foreign bodies from the upper gastrointestinal tract, though a common occurrence, can be technically challenging and risky. We report the case of a young man that, after eating a pizza cooked in a wood-burning oven, reported a sense of foreign body. Though the first evaluation by fiberoptic laryngoscopy found no foreign body, after a few weeks, the patient was readmitted from the ER for worsening symptoms and fever. A CT scan showed a metallic mediastinal foreign body inside a large fluid collection. After multidisciplinary evaluation, an endoscopic removal was attempted by accessing the mediastinal collection through EUS-guided positioning of a Hot Axios™ stent. The cavity was drained by naso-esophageal suction. The foreign body was a fragment of the brush used to clean the oven. The patient is now doing well after 7 months.


Endoscopy , Endosonography/methods , Esophagus , Foreign Bodies , Foreign-Body Migration , Mediastinum , Drainage/methods , Endoscopy/instrumentation , Endoscopy/methods , Esophagus/diagnostic imaging , Esophagus/pathology , Foreign Bodies/diagnostic imaging , Foreign Bodies/etiology , Foreign-Body Migration/complications , Foreign-Body Migration/diagnosis , Foreign-Body Migration/physiopathology , Foreign-Body Migration/surgery , Humans , Male , Mediastinum/diagnostic imaging , Mediastinum/pathology , Stents , Surgery, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Treatment Outcome , Young Adult
18.
BMJ Case Rep ; 14(1)2021 Jan 11.
Article En | MEDLINE | ID: mdl-33431448

Embolised needles causing injury to the right heart and cardiac tamponade has been reported before in intravenous drug users, but to our knowledge, this is the first reported case of a needle migrating via the pulmonary arterial system to cause perforation of the left ventricle. Appropriate utilisation of imaging modalities such as plain X-ray and point-of-care focused cardiac ultrasound can be vital and life-saving in the emergency setting, and the value of gated multidetector CT as a powerful tool for imaging moving structures is highlighted.


Foreign-Body Migration/diagnosis , Heart Injuries/diagnosis , Heart Ventricles/injuries , Needles/adverse effects , Substance Abuse, Intravenous/complications , Adult , Cardiopulmonary Bypass , Echocardiography , Foreign-Body Migration/complications , Foreign-Body Migration/surgery , Heart Injuries/etiology , Heart Injuries/surgery , Heart Ventricles/diagnostic imaging , Heart Ventricles/surgery , Humans , Lung/blood supply , Lung/diagnostic imaging , Lung/surgery , Male , Pericardiocentesis , Pulmonary Artery/diagnostic imaging , Thoracic Surgery, Video-Assisted , Treatment Outcome
19.
BMJ Case Rep ; 14(1)2021 Jan 04.
Article En | MEDLINE | ID: mdl-33397649

Rectal erosions after ventral rectopexy (VR) is an uncommon but challenging adverse event and can be associated with partial migration of the mesh into the intestinal cavity. Re-do surgery is difficult and often provides colostomy and/or anterior rectal resections. However, no alternative solutions are described in the available literature. An 82-year-old woman presented to our hospital for rectal erosion and intraluminal migration of the mesh placed at a 1-year laparoscopic VR. We performed an innovative totally endoscopic approach, using thulium laser and two endoscopes, that led to a successful removal of the mesh. The described mini-invasive technique can be an effective alternative to surgery in tertiary referral centres.


Endoscopy , Foreign-Body Migration/surgery , Laser Therapy , Rectal Prolapse/surgery , Rectum/injuries , Surgical Mesh/adverse effects , Aged, 80 and over , Female , Foreign-Body Migration/complications , Humans , Thulium
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