OBJECTIVE: To evaluate the utility and advantages of the coaxial snare technique in the retrieval of tubular foreign bodies. MATERIALS AND METHODS: Using the coaxial snare technique, we attempted to retrieve tubular foreign bodies present in seven patients. The bodies were either stents which were malpositioned or had migrated from their correct position in the vascular system (n=2), a fragmented venous introducer sheath (n=1), fragmented drainage catheters in the biliary tree (n=2), or fractured external drainage catheters in the urinary tract (n=2). After passing a guidewire and/or a dilator through the lumina of these foreign bodies, we introduced a loop snare over the guidewire or dilator, thus capturing and retrieving them. RESULTS: In all cases, it was possible to retrieve or reposition the various items, using a minimum-sized introducer sheath or a tract. No folding was involved. In no case were surgical procedures required, and no complications were encountered. CONCLUSION: The coaxial snare technique, an application of the loop snare technique, is a useful and safe method for the retrieval of tubular foreign bodies, and one which involves minimal injury to the patient.
Adult ; Case Report ; Catheters, Indwelling ; Drainage/instrumentation ; Foreign Bodies/*radiography/*therapy ; Foreign-Body Migration ; Human ; Male ; Middle Age ; *Stents

There are many medical causes of abdominal pain; abdominal epilepsy is one of the rarer causes. It is a form of temporal lobe epilepsy presenting with abdominal aura. Temporal lobe epilepsy is often idiopathic, however it may be associated with mesial temporal lobe sclerosis, dysembryoplastic neuroepithelial tumors and other benign tumors, arterio-venous malformations, gliomas, neuronal migration defects or gliotic damage as a result of encephalitis. When associated with anatomical abnormality, abdominal epilepsy is difficult to control with medication alone. In such cases, appropriate neurosurgery can provide a cure or, at least, make this condition easier to treat with medication. Once all known intra-abdominal causes have been ruled out, many cases of abdominal pain are dubbed as functional. If clinicians are not aware of abdominal epilepsy, this diagnosis is easily missed, resulting in inappropriate treatment. We present a case report of a middle aged woman presenting with abdominal pain and episodes of unconsciousness. On evaluation she was found to have an intra-abdominal foreign body (needle). Nevertheless, the presence of this entity was insufficient to explain her episodes of unconsciousness. On detailed analysis of her medical history and after appropriate investigations, she was diagnosed with temporal lobe epilepsy which was treated with appropriate medications, and which resulted in her pain being relieved.
Radiography, Abdominal ; Humans ; Foreign Bodies/pathology/*radiography ; Female ; Epilepsy, Temporal Lobe/*diagnosis/drug therapy ; Electroencephalography ; Anticonvulsants/therapeutic use ; Adult ; Abdominal Pain/drug therapy/*etiology/*radiography ; *Abdomen

OBJECTIVE: To investigate the clinical pathological features of tracheobronchial foreign bodies and to improve the diagnosis and treatment. METHOD: A retrospective study was conducted on 1050 cases with suspected tracheobronchial foreign bodies. Each patient was analyzed for age, sex, history, complication and location of the foreign body. Nine hundred and forty-nine out of 1050 cases were diagnosed as tracheobronchial foreign body, in which 13 patients coughed out the foreign bodies before operation and the rest 936 cases were given operation by bronchoscope under general anesthesia. RESULT: Among the 949 cases, 936 cases were given operation, with successful removal of foreign bodies in 932 cases (99.6%). One patient suffered from complication (0.1%). CONCLUSION For the diagnosis of tracheobronchial foreign bodies, it is very important to collect the detailed history of foreign body inhalation, physical examination and chest roentgenoscopy. Spiral CT with 3-D reconstruction of trachea and bronchus is performed in patients with suspected foreign bodies. Complete surface anesthesia of respiratory tract mucosa is the key procedure in the removal of foreign bodies from respiratory tract by bronchoscope.
Adolescent ; Adult ; Aged ; Bronchi ; Child ; Child, Preschool ; Female ; Foreign Bodies ; diagnostic imaging ; therapy ; Humans ; Infant ; Male ; Radiography ; Retrospective Studies

Female ; Foreign Bodies ; diagnostic imaging ; therapy ; Headache ; therapy ; Humans ; Medicine, Traditional ; Metals ; Middle Aged ; Radiography ; Skull ; diagnostic imaging ; injuries ; Witchcraft ; Wounds, Penetrating ; diagnostic imaging ; therapy

OBJECTIVE: To investigate the clinical pathological features of children tracheobronchial foreign bodies and to improve diagnosis and treatment. METHOD: A retrospective study 368 children cases with tracheobronchial foreign bodies in our hospital. Each patient was analyzed for age, sex, nature,complication and location of the foreign body, results of bronchoscopic removal and presence of foreign bodies in the airways. Among this cases, three of them coughed out the foreign body before operation; two of them failed to be operated for serious complication, others were conducted by rigid bronchoscopy and bronchoscopic removal with general anaesthesia. RESULT: Three children of 368 coughed out the foreign body before operation; 4 children of them were dead for the long heartbeat respiratory arrest and deep coma; 2 children of them suffered form hypoxic ischemic encephalopathy and epilepsy; others were successfully taken out by operation. CONCLUSION For the diagnosis of children cases with tracheobronchial foreign bodies, it is very important to collect the detailed history of foreign body inhalation, physical examination and careful analysis on the findings from chest radiographs or CT scan.
Anesthesia, General ; Bronchi ; Bronchoscopy ; Child, Preschool ; Female ; Foreign Bodies ; diagnostic imaging ; therapy ; Humans ; Infant ; Infant, Newborn ; Male ; Radiography, Thoracic ; Retrospective Studies ; Trachea

Coronary stent dislodgement is a rare complication of percutaneous coronary intervention. We report a case of stent dislodgement in the ascending thoracic aorta. The stent was mechanically distorted in the left circumflex artery (LCX) while being delivered to the proximal LCX lesion. The balloon catheter was withdrawn, but the stent with the guide wire was remained in the ascending thoracic aorta. The stent was unable to be retrieved into the guide catheter, as it was distorted. A goose neck snare was used successfully to catch the stent in the ascending thoracic aorta and retrieved the stent externally via the arterial sheath.
Angioplasty, Balloon, Coronary/*adverse effects/*instrumentation ; *Aorta, Thoracic/radiography ; Cardiac Catheterization/*adverse effects/*instrumentation ; Coronary Angiography ; Device Removal/*instrumentation ; Foreign Bodies/etiology/radiography/*therapy ; Humans ; Male ; Middle Aged ; Radiography, Interventional ; *Stents ; Treatment Outcome

OBJECTIVETo investigate the clinical characteristics and treatment of negative pressure pulmonary edema (NPPE) with upper airway obstruction (UAO) in children.

METHODData of 3 cases with NPPE and UAO in pediatric intensive care unit (PICU) from Mar, 2007 to May, 2013 were analyzed.

RESULT(1) Two cases were male and 1 was female with age respectively 6, 16 and 30 months.One had airway foreign body , 1 laryngitis , and 1 retropharyngeal abscess. The onset of NPPE varied from 5 to 40 minutes following relief of obstruction. (2) NPPE presented with acute respiratory distress with signs of tachypnea, tachycardia, 2 of the 3 with pink frothy pulmonary secretions, progressively decreased oxygen saturation, rales on chest auscultation and wheezing. (3) NPPE chest radiograph showed diffuse interstitial and alveolar infiltrates, images confirmed pulmonary edema. (4) All these patients received these therapeutic measures including mechanical ventilation, retaining high PEEP, diuretics, limiting the fluid input volume to 80-90 ml/ (kg×d) on the basis of circulation stability. The rales on chest auscultation disappeared after 10, 6, 12 hours. The ventilators of 2 patients were removed within 24 hours, in another case it was removed 50 hours later because of secondary infection. All patients were cured and discharged without complication.

CONCLUSIONNPPE progresses very fast, characterized by rapid onset of symptoms of respiratory distress after UAO, with pulmonary edema on chest radiograph. The symptoms resolve rapidly if early support of breath and diuretics are applied properly.

Acute Disease ; Airway Obstruction ; complications ; Child, Preschool ; Diuretics ; therapeutic use ; Female ; Foreign Bodies ; complications ; Humans ; Infant ; Laryngismus ; complications ; Male ; Positive-Pressure Respiration ; Postoperative Complications ; etiology ; physiopathology ; therapy ; Pulmonary Edema ; diagnosis ; etiology ; physiopathology ; therapy ; Radiography, Thoracic ; Retrospective Studies

OBJECTIVETo analyze the clinical characteristics of negative pressure pulmonary edema (NPPE).

METHODA retrospective investigation of the clinical manifestation, imageology, clinical course and outcome of 4 children with NPPE seen between June 2012 and July 2013 in a children's hospital. The causation of the airway obstruction was also explored.

RESULTAll the 4 cases were boys, the range of age was 40 days to 9 years. They had no history of respiratory and circulatory system disease. In 3 cases the disease had a sudden onset after the obstruction of airway, and in one the onset occurred 1.5 hours after removing the airway foreign body. All these cases presented with tachypnea, dyspnea, and cyanosis, none had fever. Three cases had coarse rales. Chest radiography was performed in 3 cases and CT scan was performed in 1 case, in all of them both lungs displayed diffuse ground-glass-like change and patchy consolidative infiltrates. Three cases were admitted to the ICU, duration of mechanical ventilation was less than 24 hours in 2 cases and 39 hours in one. Oxygen was given by mask to the remaining one in emergency department, whose symptoms were obviously improved in 10 hours. None was treated with diuretics, glucocorticoids or inotropic agents. Chest radiographs were taken within 24 hours of treatment in 2 cases and 24-48 hours in the other 2; almost all the pulmonary infiltrates were resolved. All the 4 cases were cured. The causes of airway obstruction were airway foreign bodies in two cases, laryngospasm in one and laryngomalacia in the other.

CONCLUSIONNPPE is a life-threatening emergency, which is manifested by rapid onset of respiratory distress rapidly (usually in several minutes, but might be hours later) after relief of the airway obstruction, with findings of pulmonary edema in chest radiograph. The symptoms resolve rapidly by oxygen therapy timely with or without mechanical ventilation. In children with airway obstruction, NPPE should be considered.

Acute Disease ; Airway Obstruction ; complications ; Child ; Child, Preschool ; Foreign Bodies ; complications ; Humans ; Infant ; Intensive Care Units ; Intubation, Intratracheal ; methods ; Laryngismus ; complications ; Larynx ; Lung ; diagnostic imaging ; pathology ; Male ; Oxygen Inhalation Therapy ; Positive-Pressure Respiration ; methods ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed