BACKGROUND AND OBJECTIVE

Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

METHODS

This retrospective cohort study included 145 patients aged

RESULTS

Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age 48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (CONCLUSION

Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.

Human ; Adolescent: 13-18 Yrs Old ; Child: 6-12 Yrs Old ; Foreign Bodies ; Endoscopy ; Child ; Retrospective Studies ; Aged ; Cohort Studies ; Eating ; Methods ; Numismatics ; Patients ; Philippines ; Physical Examination ; Time

BACKGROUND AND OBJECTIVES

The global pandemic caused by Coronavirus Disease 2019 (COVID-19) has affected millions, with growing evidence of the potential role of ocular tissues in viral transmission. At the time of writing, local data regarding the phenomenon was limited. This study investigated external ocular manifestations in patients with COVID-19 at a referral center in the Philippines, examined correlations between demographics, systemic manifestations, and laboratory results with ocular manifestations, and determined their timing relative to systemic symptoms.

METHODS

This single-center, descriptive cross-sectional study was carried out from December 8 to 18, 2020 at the adult COVID-19 wards of the Philippine General Hospital involving 72 participants. Data collection involved relevant clinical history taking and performing gross eye examination. The prevalence of ocular manifestations was described with 95% confidence intervals. Correlations between ocular manifestations and quantitative variables were analyzed with point-biserial correlation, and associations with qualitative variables were tested using chi-square or Fisher’s exact tests.

RESULTS

Among participants, 31.9% presented with ocular manifestations with foreign body sensation as the most prevalent ocular symptom (11.1%) and conjunctival hyperemia as the most prevalent ocular finding (19.4%). The median age of patients with ocular manifestations was 41 years old with a higher prevalence in the male population (73.9%, CI=95%, p=0.001). No significant correlation was observed between presence of external ocular manifestations and the different systemic and ocular co-morbidities as well as with COVID-19 clinical classification. Among those who experienced symptoms, majority (29.2%) of the patients experienced systemic symptoms prior to the onset of ocular symptoms. Ocular complaints may present as the sole manifestation (13.9%). Several laboratory parameters were measured and only temperature and AST levels showed a low positive correlation with the presence of ocular manifestations. 

CONCLUSION

Ocular manifestations occur in roughly one third of patients with COVID-19 based on this study population. With some individuals presenting with ocular signs or symptoms as the initial and sole manifestation, healthcare practitioners must exercise caution and remain vigilant in managing patients who present as such. At the time of writing, this is the first local study investigating the different external ocular manifestations in patients with COVID-19. There is a need to pursue more robust studies and conduct more local investigations which will guide both ophthalmologists and other practitioners in strengthening existing guidelines regarding precautionary practices, clinical diagnosis, and management of COVID-19 patients.

Human ; Sars-cov-2 ; Covid-19 ; Philippines ; Adult ; Association ; Classification ; Collection ; Confidence Intervals ; Coronavirus ; Cross-sectional Studies ; Data Collection ; Demography ; Diagnosis ; Disease ; Exercise ; Eye ; Foreign Bodies ; History ; Hospitals ; Hospitals, General ; Hyperemia ; Laboratories ; Male ; Morbidity ; Ophthalmologists ; Pandemics ; Patients ; Population ; Prevalence ; Referral And Consultation ; Role ; Sensation ; Temperature ; Time ; Tissues ; Volition ; World Health Organization ; Writing

BACKGROUND AND OBJECTIVE

Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

METHODS

This retrospective cohort study included 145 patients agedRESULTS

Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age 48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (CONCLUSION

Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.

Human ; Adolescent: 13-18 Yrs Old ; Child: 6-12 Yrs Old ; Foreign Bodies ; Endoscopy ; Child ; Retrospective Studies

Foreign bodies in the tongue are rare in clinical practice. Accurate localization and appropriate surgical path selection are essential to reduce surgical risk and postoperative complications. This paper reports a case in which the fishbone foreign body at the base of tongue was removed using a translingual ventral approach aided with imaging localization.
Humans ; Foreign Bodies/diagnostic imaging* ; Tongue/surgery*

Injuries deeper than the platysma are considered as penetrating neck injuries, constituting approximately 5% - 10% of all trauma. Many vital organs are at risk from a penetrating neck injury. These injuries in zone 1 have the highest mortality, because the injuries are close to the vital organs and difficult to access surgically. A 41-year-old male, a car mechanic by profession, presented to the emergency department with a penetrating neck injury on the right side. CT scan demonstrated a metallic foreign body in zone 1 between the right internal jugular vein and the common carotid artery. The patient was asymptomatic, and the foreign body was removed surgically. This case shows a rare presentation of a penetrating neck injury with a foreign body located in zone 1, where no vital internal structure was injured. As of now, no previous case report has been identified on such presentation. Thus, it will provide a valuable addition to the pre-existing literature.
Humans ; Male ; Adult ; Neck Injuries/diagnostic imaging* ; Wounds, Penetrating/diagnostic imaging* ; Foreign Bodies/diagnostic imaging* ; Jugular Veins ; Tomography, X-Ray Computed ; Carotid Artery Injuries/surgery* ; Carotid Artery, Common

The presentation of a foreign body in the lower urinary tract is a challenging urological emergency with highly variable management approaches. A retrospective cohort study was undertaken to identify the patients who presented with self-inserted genitourethral foreign body to adult tertiary centers within our local health network (Southern Adelaide Local Health Network, Adelaide, Australia) from October 2002 to October 2022. Patient demographics, type of foreign body, psychiatric comorbidities, retrieval techniques, complications, and readmission data were extracted. Twenty-seven cases were identified with a median age of 44 years. Twenty-three (85.2%) were male and 4 (14.8%) were female. Ten patients (37.0%) had a concurrent psychiatric illness. The most commonly inserted foreign bodies were plastic tubes/wires (29.6%). Twenty cases (74.1%) were retrieved endoscopically. Three patients (11.1%) required open cystotomy and one underwent a transperineal urethrotomy. Four patients (14.8%) represented after discharge. Two patients had repeat presentations for genitourinary foreign body insertion. A significant monotonic positive trend of foreign body presentations was identified (Mann-Kendall tau = 0.95, P = 0.043). Presentations of genitourethral foreign body insertions have trended upward over the past two decades. However, most cases were successfully managed endoscopically.
Humans ; Male ; Foreign Bodies/epidemiology* ; Female ; Adult ; Retrospective Studies ; Middle Aged ; Urethra/surgery* ; Aged ; Young Adult ; Treatment Outcome

Objective:This article explores the diagnosis and treatment of a special type of laryngeal foreign body with granuloma in children, providing a clinical reference for standardized diagnosis and treatment. Methods:This article retrospectively analyzes one case admitted to our department and five other cases reported in relevant literature involving a special type of laryngeal foreign body with granuloma in children. It summarizes the clinical characteristics of this disease and explores its diagnosis and treatment. Results:①A total of 6 cases were misdiagnosed and had a long course of illness. Five cases had no clear history of foreign body at the first visit. One case had foreign body history but no foreign body was found. ②The clinical symptoms were diverse, which could be hoarseness, cough, wheezing, dyspnea, or no symptoms. ③A total of 3 cases were diagnosed by laryngoscopy, and 3 cases were diagnosed by laryngoscopy and imaging examination. ④Foreign bodies that were not wrapped in granulomas, were removed first and then the granulomas were treated; foreign bodies wrapped in granulomas were removed after the removal of granulomas. Conclusion:A special type of laryngeal foreign body with granuloma may lack of accurate foreign body history, resulting in long-term retention of foreign bodies, leading to granuloma formation and misdiagnosis. Electronic laryngoscopy combined with CT examination contribute to early diagnosis. Low temperature plasma under endoscope and anesthetic laryngoscope is conducive to the exposure and precise removal of foreign bodies and avoids tracheotomy to a certain extent.
Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Foreign Bodies/surgery* ; Granuloma, Foreign-Body/therapy* ; Larynx/pathology* ; Retrospective Studies

OBJECTIVE

To describe a case of a craniomaxillofacial penetrating injury focusing on the importance of a multidisciplinary approach with insights into the surgical planning for successful removal of the foreign body during the pandemic.

METHODS

Design: Case Report

Setting: Tertiary Government Training Hospital

Patient: One

RESULTS

A 15-year-old boy presented with a work-related puncture wound in the right nasomaxillary area with accompanying soft-tissue swelling. Physical examination of his face showed no external foreign body. Craniofacial computed tomography scans revealed a rod-shaped opaque foreign body about 12 cm in length and 9 mm in diameter lodged in the right maxillary sinus extending to the right temporal lobe. The otolaryngology-head and neck surgeon and neurosurgeon planned the crucial extraction of the foreign body, but the requirement for a negative RT-PCR, blood products, and additional imaging delayed this emergent operation. The foreign body was eventually removed via combined trans-antral approach and right frontotemporal craniotomy, zygotomy, and craniectomy around the foreign body in the temporal floor with duraplasty and cranioplasty.

CONCLUSION

Successful treatment of penetrating craniomaxillofacial injuries involves diligent clinical assessment, radiologic diagnosis and a well-planned multidisciplinary surgical approach. Delays in treatment may be beneficial if they allow precise location of the foreign body and thorough evaluation of involved structures. Safeguarding the healthcare workers during the pandemic was as important as ensuring a successful and safe surgery for the patient.

Human ; Male ; Adolescent: 13-18 Yrs Old ; Foreign Bodies ; Temporal Lobe ; Maxillary Sinus ; Middle Cerebral Artery ; Infratemporal Fossa

Objective: To report a case of a migrating foreign body in the esophagus of a 65-year-old woman: its clinical presentation, diagnosis and management Methods: Design: Case Report Setting:Tertiary Government Training Hospital Patient: One Results: A 65-year-old woman consulted with a history of foreign body ingestion (chicken bone). Initial imaging confirmed the presence of the ingested object. Rigid esophagoscopy did not find the foreign body. Subsequent neck computed tomography (CT) scan revealed a hyperdense, spindle-shaped object situated lateral to the left esophagus. The foreign object was successfully retrieved via a lateral pharyngotomy approach without complication. Conclusion Migrating foreign bodies may initially present with minimal or nonspecific symptoms such as foreign body sensation or dysphagia but can progress to more overt signs. In such cases, CT offers superior localization compared to radiographs and is essential in guiding definitive surgical management to facilitate safe and effective foreign body retrieval. Rigid esophagoscopy remains a valuable tool for confirming migration and evaluating for mucosal injury or perforation. When endoscopic retrieval is unsuccessful, timely surgical intervention is critical to prevent serious complications.
Human ; Female ; Aged: 65-79 Yrs Old ; Esophagus ; Foreign Bodies ; Women

OBJECTIVE

The study aims to compare the demographic profile, management, and outcomes of patients with foreign body ingestion before and during the COVID-19 pandemic.

METHODS

Design: Retrospective Review of Records

Setting: Tertiary Government Training Hospital

Participants: Records of 156 patients, 81 from the pre-pandemic period (2018-2020) and 75 during pandemic period (2020-2022), diagnosed with aerodigestive foreign bodies

RESULTS

One hundred fifty-six (156) patients, 81 from the pre-pandemic period (2018-2020) and 75 during pandemic period (2020-2022) were included in this study. Median age pre pandemic is 9 years old (Standard deviation = 22.19) and 16 years old (Standard deviation = 19.63) during pandemic. The male-to-female ratio for pre-pandemic and during pandemic is 54:27 and 52:23, respectively. The majority of the patients ingested coins (53% pre-pandemic and 44% during pandemic) followed by dentures (22% pre-pandemic and 35% during pandemic). T-test results show that Time from Ingestion to Consult shows a borderline statistically significant difference between the pre-pandemic and during-pandemic periods for the time from ingestion to consult (t-value = -1.967; p-value of 0.051), implying a slight difference in the time patients took to seek medical help after ingesting a foreign body between the two periods. Time from Consultation to the Operating Room indicates that there is significant difference between the pre-pandemic and during pandemic time from consultation to the operating room (t-value= -2.037; p-value= 0.043, suggesting significant change in the time taken to move patients from consultation to the operating room between the two periods, possibly indicating changes in hospital protocols or patient flow during the pandemic.

CONCLUSION

Results showed that there was a noticeable shift in the age distribution of patients, with older patients encountered during the pandemic period, suggesting changes in healthcare-seeking behavior and accessibility. Data also showed that more patients in both periods were male, consistent with existing literature on foreign body ingestion demographics. The median time (in hours) from ingestion to consultation increased significantly during the pandemic, indicating delays in seeking medical care. This was likely due to travel restrictions, fear of COVID-19 in public, and changes in public health protocols. Despite these consultation delays, the median time from consultation to the operating room remained consistent, reflecting the efficiency of healthcare providers in the tertiary hospital. Operating time and the level of foreign bodies in the esophagus did not differ significantly between the two periods, implying a stable surgical procedure. The significant difference in the overall time across patients from consultation to the operating room during the pandemic suggests changes in hospital protocols and patient flow management.

Human ; Foreign Bodies ; Eating ; Ingestion ; Esophagoscopy ; Covid-19