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1.
Medicine (Baltimore) ; 98(44): e17780, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689845

RESUMO

RATIONALE: Foreign bodies related ureteral obstruction and hydronephrosis is rare and usually cause numerous problems for clinical physicians. PATIENT CONCERNS: We report a 36-year-old female who was referred to our hospital due to a 4-year history of dull pain on the left back. DIAGNOSIS: X-ray and abdominal CT revealed a foreign body around the upper part of the left ureter with ureteral obstruction and hydronephrosis. INTERVENTIONS: Laparoscopy was performed and a 3-cm sewing needle was removed successfully. OUTCOMES: After 6 months' follow-up, the patient's ureteral obstruction and hydronephrosis were significantly reduced, and the double-J ureteral stent was removed. LESSONS: This case indicated that ureteral obstruction and hydronephrosis caused by foreign bodies needed to be early diagnosed and located. Invasive therapies rather than conservative treatments are preferred to remove the FBs and relieve obstruction.


Assuntos
Corpos Estranhos/complicações , Hidronefrose/etiologia , Laparoscopia/métodos , Ureter/lesões , Obstrução Ureteral/etiologia , Adulto , Feminino , Corpos Estranhos/cirurgia , Humanos , Hidronefrose/cirurgia , Laparoscopia/instrumentação , Stents , Ureter/cirurgia , Obstrução Ureteral/cirurgia
2.
Medicine (Baltimore) ; 98(40): e17424, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577758

RESUMO

RATIONALE: There are many difficult cases in the clinic because of the diversity of foreign bodies. The removal of a syringe cap is not so easy because there is always no hole at the closed end. PATIENT CONCERNS: A 54-year-old man suddenly developed dyspnea during his treatment in the hospital. DIAGNOSES: Foreign body in the left main bronchus. INTERVENTIONS: The foreign body was removed using fiberoptic bronchoscope together with gastroscope biopsy forceps. OUTCOMES: A repeat CT showed well inflation of left lung. LESSONS: The combined use of gastroscope biopsy forceps in trachea is more conducive to remove a foreign body similar to a syringe cap.


Assuntos
Brônquios , Broncoscopia , Corpos Estranhos/cirurgia , Gastroscopia/instrumentação , Biópsia/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade
3.
Orv Hetil ; 160(42): 1677-1681, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31608692

RESUMO

Migration of swallowed foreign bodies from the gastrointestinal tract is a rare phenomenon compared with the total number of ingestions. In the reported two cases, the serious septic condition indicated urgent surgical intervention. We found a piece of wire swallowed a few months earlier in the right lobe of the liver and the retroperitoneum in case one, and a piece of wire in the pericardium, which migrated from the stomach through the left lobe of the liver, in case two. Abscesses and phlegmonae were found in the retroperitoneum and then in the femoral region requiring a reoperation in case one, and in the liver and pericardium in case two. After the evacuation of abscesses, both patients made full recovery. Diagnostic difficulties and therapeutic challenges served the reasons to present these cases. Orv Hetil. 2019; 160(42): 1677-1681.


Assuntos
Abscesso/complicações , Corpos Estranhos/diagnóstico por imagem , Migração de Corpo Estranho/diagnóstico por imagem , Fígado/diagnóstico por imagem , Pericárdio/diagnóstico por imagem , Trato Gastrointestinal Superior/diagnóstico por imagem , Abscesso/cirurgia , Adulto , Feminino , Corpos Estranhos/cirurgia , Migração de Corpo Estranho/cirurgia , Trato Gastrointestinal , Humanos , Pessoa de Meia-Idade , Radiografia , Estômago , Resultado do Tratamento , Trato Gastrointestinal Superior/cirurgia
5.
J Craniofac Surg ; 30(7): 2257-2260, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31490446

RESUMO

One of the indications of the surgical approach of the temporomandibular joint is the presence of foreign body in its interior. However, joint handling offers risks, especially bleeding. In these cases, angiography and embolization of the arteries involved with the projectile play an important role in the prevention of complications. In this report, the authors describe a case of a 23-year-old male victim of firearm attack with comminuted fracture of the right mandibular condyle. The patient underwent angiography and prophylactic embolization of the arteries adjacent to the foreign body. A surgical procedure was performed to remove the projectile and bone fragments with the aid of the X-ray image intensifier, which resulted in the restoration of mandibular function, absence of joint pain, and satisfactory dental occlusion. This case shows the importance of auxiliary imaging methods for performing a safe surgical procedure for removal of ballistic and bony fragments from the interior of the temporomandibular joint.


Assuntos
Articulação Temporomandibular/cirurgia , Ferimentos por Arma de Fogo/cirurgia , Oclusão Dentária , Armas de Fogo , Corpos Estranhos/cirurgia , Fraturas Cominutivas/cirurgia , Humanos , Masculino , Côndilo Mandibular/cirurgia , Adulto Jovem
6.
Ann Otol Rhinol Laryngol ; 128(12): 1141-1146, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31364383

RESUMO

OBJECTIVES: Insertion of mold material into the middle ear is a complication of molding procedure for ear impression. These cases are referred to an ENT specialist. There is no standardized approach to this problem. Literature shows different clinical strategies. The aim of this study is to share our experience and to analyze the adverse outcome of different clinical approaches. METHODS: A case series of six patients with molding material inside the middle ear after complicated molding procedure for swimming earplugs are described. Additionally, available literature was reviewed to analyze results of the clinical approach after iatrogenic molding procedures. Forty-nine ears were included. RESULTS: In-office removal of the material is associated with a significant risk of adverse outcome if the eardrum cannot be examined. This also accounts for ossicular involvement. CONCLUSIONS: Temporal bone CT is advised in patients after complicated ear mold fitting if the tympanic membrane cannot be examined completely or the middle ear is involved. Blind removal should be avoided. Retroauricular transcanal tympanotomy or transmastoidal tympanotomy with facial recess approach is best practice in case the mold material has entered the middle ear. A clinical treatment algorithm is presented.


Assuntos
Orelha Média , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Auxiliares de Audição/efeitos adversos , Ajuste de Prótese/efeitos adversos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Corpos Estranhos/etiologia , Humanos , Masculino , Ventilação da Orelha Média , Perfuração da Membrana Timpânica/complicações , Perfuração da Membrana Timpânica/cirurgia
7.
BMC Surg ; 19(1): 102, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387640

RESUMO

BACKGROUND: Acupuncture is a famous traditional medicine in China, but the complications caused by broken acupuncture needles have been rarely reported. It seems easy to remove the foreign matters usually, but things become difficulty in special issues. Here, we reported a recently encountered case to provide an important teaching point of treating a chronically retained broken needle in retroperitoneum. CASE PRESENTATION: A 42-year-old man presented with a chronically retained broken needle in his body after acupuncture therapy two years ago. However, due to the discomfort at the left back recently and ordinary inconvenience such as security check, he came to our hospital for minimally invasive surgery. He was introduced to our department because the broken needle had migrated from subcutaneous to adipose tissue in retroperitoneum during the two years. Considering the position of the broken needle, the patient was performed by laparoscopy in general anesthesia. The operation time was about 31 min and there were only three 7 mm incisions in the left lateral abdominal wall. The X-ray exam was performed to confirm that the broken needle was removed integrally. The patients begun normal activity at 6 h after surgery and was discharged on the second day after surgery. CONCLUSIONS: Acupuncture is widely used for pain treatment in China, but how to handle the complication of acupuncture needle broken in body are rarely reported. Laparoscopy will be the reasonable choice for treating needles broken in retroperitoneum.


Assuntos
Terapia por Acupuntura/instrumentação , Falha de Equipamento , Corpos Estranhos/cirurgia , Laparoscopia/métodos , Agulhas , Espaço Retroperitoneal/cirurgia , Adulto , China , Corpos Estranhos/etiologia , Humanos , Masculino
9.
Medicine (Baltimore) ; 98(29): e16486, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335713

RESUMO

RATIONALE: Esophageal foreign body is a commonly seen in China. However, pseudoaneurysm of the aortic arch caused by ingestion of fish bones is a rare, life-threatening condition. PATIENT CONCERNS: A 71-year-old male was admitted to the Ear, Nose, and Throat department with a 4-day history of chest pain after eating fish. DIAGNOSES: After taking out the fish bone by rigid endoscopy, magnetic resonance imaging and computerized tomography angiography (CTA) scans revealed the presence of an aortic arch pseudoaneurysm, which was likely caused by the fish bone. INTERVENTIONS: A successful endovascular graft exclusion surgery was performed to block the aorta ulcer. OUTCOMES: The patient recovered and was discharged 20 days after hospitalization. The patient was healthy and had no fever or chest pain 4 months after discharge from the hospital. LESSONS: Esophageal foreign bodies may lead to life-threatening impairment of the aorta or other big arteries. When esophageal foreign bodies puncture the esophageal wall, especially in the second stenosis of the esophagus, an enhanced-contrast computed tomography scan or a CTA scan may be necessary to exclude any potential impairment of the arteries.


Assuntos
Falso Aneurisma/etiologia , Aorta Torácica , Doenças da Aorta/etiologia , Esôfago/lesões , Corpos Estranhos/complicações , Alimentos Marinhos/efeitos adversos , Idoso , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Animais , Aorta Torácica/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Osso e Ossos , Esofagoscopia , Esôfago/diagnóstico por imagem , Esôfago/cirurgia , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios X
10.
Medicine (Baltimore) ; 98(30): e16489, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348257

RESUMO

RATIONALE: Foreign body ingestion is often encountered in clinical practice; however, intestinal perforation owing to foreign body ingestion is rare. PATIENT CONCERNS: Here, we present the cases of 2 patients who accidentally swallowed foreign bodies and later presented with pain in the right lower abdominal quadrant. DIAGNOSES: Both patients were initially diagnosed with acute appendicitis and underwent immediate emergency laparotomy. INTERVENTIONS: During the operation, the appendix was found to be only mildly inflamed. On transection of the appendix, the mucosa was found to be inflamed, and yellow-white exudate was noted. We, therefore, decided to explore the entire bowel. The bowel examination revealed small bowel perforations, and palpation of the adjacent bowel revealed a hard, sharp object. The object was removed through the perforation site, the perforation was repaired, and the abdomen was closed in layers. OUTCOME: The postoperative recovery, in both cases, was uneventful. LESSONS: Patients who swallow sharp or large foreign bodies should undergo endoscopy as soon as possible to avoid intestinal perforation. Clinicians should inquire about a history of foreign body ingestion. The preoperative diagnosis of intestinal perforation secondary to foreign body ingestion requires a high degree of clinical suspicion and awareness.


Assuntos
Corpos Estranhos/cirurgia , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/etiologia , Doença Aguda , Idoso , Apendicite/diagnóstico , Diagnóstico Diferencial , Humanos , Laparotomia , Masculino , Pessoa de Meia-Idade
11.
Medicine (Baltimore) ; 98(26): e16146, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261541

RESUMO

Foreign bodies impaction in the esophagus is a common clinical emergency. The aim of this study was to investigate the clinical features of foreign body ingestion, and to analyze the risk factors of complications during the endoscopic procedure.From 18 general hospitals in Zhejiang Province in China, 595 patients who underwent gastroscopic removal of ingested foreign bodies were prospectively recruited. Patient characteristics, clinical features, foreign body features, clinical outcomes, and complications were documented.The most common types of foreign body in the esophagus were sharp objects (75.9%), including fish bones (34.0%), chicken bones (22.1%), and fruit nuclei (17.1%). The remaining types were non-sharp objects (24.1%), including food bolus (14.6%). Most objects were lodged in the proximal esophagus (75.9%). Foreign body-related complications occurred in 63 patients (10.5%), including hemorrhage (5.0%), perforation and infection (5.5%). The complication rate was increased by 4.04- and 8.48- fold when endoscopic retrieval was performed after impacted for over 24 and 48 hours, respectively, after impaction, as compared with within 12 hours. Logistic regression analysis revealed that the patients with sharp objects developed more complications than those with non-sharp ones (odds ratio, 2.85; 95% confidence interval, 1.08-7.50; P = .034). However, complications were unrelated with the location in the esophagus or length of foreign bodies (P > .05).Sharp objects were the most frequently ingested foreign bodies in the esophagus in China. The prevalence of complications was increased in the patients with long foreign body retention time (>24 hours) and sharp objects. Sharp foreign bodies in the esophagus are recommended to be removed within 24 hours.


Assuntos
Esofagoscopia , Esôfago/cirurgia , Corpos Estranhos/cirurgia , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , China , Esôfago/diagnóstico por imagem , Esôfago/lesões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Tempo para o Tratamento , Adulto Jovem
16.
JNMA J Nepal Med Assoc ; 57(215): 56-58, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080248

RESUMO

Accidental foreign body ingestion is a common problem encountered in Emergency. Deliberate foreign body ingestion may result due to an act of insanity or an act of daring. A shaman locally known as Dhami was brought to Emergency with the history of ingestion of bell clappers. He denied the history of psychiatric illness or substance abuse. On physical examination, there were signs of peritonitis. Laparotomy was done to remove the foreign bodies. Post-operative period was uneventful. Apart from the surgical intervention, psychological counselling was given to him. This is a rare interesting case due to the fact that the 15 cm long foreign bodies passing all the way through without significant injury and finally causing obstruction in ileocecal junction and perforation in the distal ileum. Keywords: foreign bodies; Nepal; shaman.


Assuntos
Corpos Estranhos/complicações , Obstrução Intestinal/etiologia , Perfuração Intestinal/etiologia , Peritonite/etiologia , Corpos Estranhos/cirurgia , Humanos , Íleo/lesões , Íleo/cirurgia , Obstrução Intestinal/cirurgia , Perfuração Intestinal/cirurgia , Laparotomia , Masculino , Pessoa de Meia-Idade , Nepal
17.
Medicine (Baltimore) ; 98(18): e15435, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045808

RESUMO

RATIONALE: Gastrointestinal foreign body (FB) is an emergency commonly encountered by the pediatric gastroenterology department. Management of their extraction requires knowledge and careful consideration of removal techniques. PATIENT CONCERNS: Two little girls swallowed multiple magnets that stuck together for >3 days, which was an indication for surgery. DIAGNOSIS: X-ray revealed dense shadows in the left abdomen. However, the abdominal examination revealed a soft abdomen without tenderness, rebound tenderness, or muscle rigidity. INTERVENTION: The multiple magnets were removed by endoscopy instead of surgery. OUTCOME: We conducted sufficient preoperative assessment and preparation. Eventually, we successfully removed the multiple magnets by endoscopy, and no perforation or fistula formation was observed. Surgery was avoided. LESSONS: Swallowing multiple magnets isn't a rare emergency in children. Physicians must be aware that surgery is not the only option even if multiple magnets are swallowed for >12 hours. Endoscopic removal can be considered if there is no obstruction, perforation, or fistula formation upon careful patient assessment. If endoscopic removal fails, surgical treatment should be performed as soon as possible to avoid serious complications.


Assuntos
Corpos Estranhos/cirurgia , Trato Gastrointestinal/cirurgia , Gastroscopia/métodos , Imãs , Pré-Escolar , Feminino , Corpos Estranhos/diagnóstico por imagem , Trato Gastrointestinal/diagnóstico por imagem , Humanos
18.
Medicine (Baltimore) ; 98(22): e15750, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31145290

RESUMO

RATIONALE: Penetrating neck traumas are dangerous and have a high mortality rate, particularly in patients with common carotid artery injuries. Advances in diagnostic imaging technology have shifted management of penetrating neck injuries from mandatory exploration to selective management. The question is now regarding optimal selection of auxiliary examinations to assess "stability" rapidly and guide clinics in managing such patients. PATIENT CONCERNS: A 56-year-old man suffered neck trauma with the right common carotid artery caused by a percussive drill. The carotid artery could not be clearly displayed in computed tomography (CT) angiography imaging. DIAGNOSES: Penetrating neck trauma due to percussive drill bit with common carotid artery injury. INTERVENTIONS: X-ray and bedside duplex ultrasound with color Doppler flow imaging were used to assess the state of trauma and the foreign body was removed under general anesthesia. OUTCOMES: The patient was discharged at postoperative day 10 with no complication. The patient had no sequelae from this injury at 6-month follow up. LESSONS: X-ray provides a comprehensive assessment of damage, and can efficiently detect foreign bodies in the skull and cervical vertebrae. Duplex ultrasound to be a viable method to exclude macrovascular injury in unstable patients who are not eligible for computed tomography angiography (CTA) or catheter angiography imaging. Widely available duplex ultrasound and x-ray should be considered in emergency situations.


Assuntos
Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Primitiva/cirurgia , Corpos Estranhos/cirurgia , Lesões do Pescoço/cirurgia , Ferimentos Penetrantes/cirurgia , Lesões das Artérias Carótidas/etiologia , Indústria da Construção/instrumentação , Corpos Estranhos/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Lesões do Pescoço/etiologia , Ferimentos Penetrantes/etiologia
19.
J Craniofac Surg ; 30(7): e598-e600, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31135661

RESUMO

Trauma is one of the leading causes of death worldwide. Due to its anatomy and position in the facial skeleton, the orbit becomes a region susceptible to trauma which may also involve the penetration of foreign bodies (FBs). These events can have serious repercussions depending on their extent due to the proximity of the orbit with other noble structures of the face and skull. Because of this, a system of prehospital management of traumas must be established, in order to promote a better prognosis for patients. The present study aims to report the case of a patient suffering from a motorcycle accident with multiple fragments of FBs in the region of orbit-zygomatic-maxillary complex. The emergency surgical removal of the fragments was performed by a multidisciplinary team, involving Ophthalmology and Oral and Maxillofacial Surgery and Traumatology (OMST). Wound cleansing and debridement were performed with subsequent removal of the foreign bodies by the OMST team, in addition to the reduction and fixation of related fractures. As for Ophthalmology, the evisceration of the affected eye was performed due to its anatomical and functional impairment. The patient is 12 months postoperatively, with no aesthetic or functional complaints regarding OMST. The anatomical knowledge of the traumatized region, besides the establishment of the conduct regarding the removal of possible associated foreign bodies are required so that the success of the treatment can be obtained, aiming to minimize the damages to the patient.


Assuntos
Acidentes de Trânsito , Corpos Estranhos/cirurgia , Maxila/cirurgia , Órbita/cirurgia , Zigoma/cirurgia , Desbridamento , Feminino , Humanos , Maxila/lesões , Pessoa de Meia-Idade , Órbita/lesões , Procedimentos Cirúrgicos Reconstrutivos , Zigoma/lesões
20.
BMJ Case Rep ; 12(4)2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040138

RESUMO

We present two children treated with endovascular techniques to gain proximal arterial control of the internal carotid and vertebral artery prior to removal of penetrating objects from the skull base. Both siblings (8-month-old and 22-month-old boys) were injured by different sharp objects (knife and scissor) by a guardian. They were transported to the emergency room where vascular control, including coil embolisation and internal carotid balloon occlusion, was performed in the neuroendovascular suite for safe removal of penetrating objects. Both minors recovered and were discharged home without any focal neurological deficits. In two children with scissor and knife stab with intracranial penetration, endovascular technique allowed safe removal of objects and ensured proximal arterial control was maintained to control for possible extravasation of blood on removal from the skull base.


Assuntos
Oclusão com Balão , Artéria Carótida Interna/diagnóstico por imagem , Corpos Estranhos/cirurgia , Artéria Vertebral/diagnóstico por imagem , Ferimentos Perfurantes/cirurgia , Oclusão com Balão/métodos , Artéria Carótida Interna/cirurgia , Angiografia Cerebral , Vítimas de Crime , Embolização Terapêutica , Procedimentos Endovasculares , Corpos Estranhos/diagnóstico por imagem , Humanos , Lactente , Masculino , Procedimentos Neurocirúrgicos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares , Artéria Vertebral/cirurgia , Ferimentos Perfurantes/complicações , Ferimentos Perfurantes/diagnóstico por imagem , Ferimentos Perfurantes/fisiopatologia
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