3.Clinical diagnosis and treatment of intraorbital wooden foreign bodies.
Jia LI ; Li-Ping ZHOU ; Jing JIN ; Hong-Feng YUAN
Chinese Journal of Traumatology 2016;19(6):322-325
PURPOSEThe intraorbital wooden foreign body is often misdiagnosed or missed on computed tomog- raphy (CT) scan, due to the invisible or unclear images. The residual foreign bodies often occur during surgical removal. The clinical manifestations, imaging features and treatment of intraorbital wooden foreign bodies were discussed in this study.
METHODWe retrospectively analyzed 14 cases of intraorbital wooden foreign bodies managed at our hospital between January 2007 and May 2015. All patients underwent orbital CT examination before surgery, and surgery was performed under general anesthesia with orbital wound debridement and suture, as well as exploration and removal of wooden foreign bodies.
RESULTSAt first, 11 cases underwent removal of foreign bodies, including 1 case with incomplete removal and then receiving a secondary surgery. Foreign bodies were not found in three cases with preoperative misdiagnosis and orbital MRI found residual foreign bodies in the orbit. Operations were performed via primary wound approach in eight cases, conjunctival approach in two cases, and anterior orbitotomy in four cases. Postoperatively, one case was complicated with eye injuries, three cases with ocular muscle injuries, eight cases with visual loss, and eight cases with orbital abscess. The length of foreign bodies ranged from 1.8 cm to 11.0 cm. The maximum of four foreign bodies were removed at the same time.
CONCLUSIONBecause the imaging of orbital wooden foreign bodies is complex and varied, MRI should be combined when they are invisible on CT scan. At the same time injuries trajectory and clinical mani- festations of patients should be taken into account. Surgical exploration should be extensive and thor- ough, and foreign bodies and orbital abscess must be cleared.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Eye Foreign Bodies ; diagnostic imaging ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Wood
4.Clinical Outcome in Patients with Negative Rigid Oesophagoscopy for Suspected Foreign Body Ingestion.
Donovan Kc EU ; Audrey Yn LIM ; Yipeng WU ; Yew Kwang ONG ; Chwee Ming LIM
Annals of the Academy of Medicine, Singapore 2016;45(7):326-329
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Eating
;
Esophagoscopy
;
Esophagus
;
diagnostic imaging
;
surgery
;
False Positive Reactions
;
Foreign Bodies
;
diagnosis
;
diagnostic imaging
;
Foreign-Body Migration
;
diagnosis
;
diagnostic imaging
;
Humans
;
Middle Aged
;
Pharynx
;
diagnostic imaging
;
surgery
;
Radiography
;
Remission, Spontaneous
;
Retrospective Studies
;
Tomography, X-Ray Computed
;
Young Adult
5.Clinical analysis of 4 children with negative pressure pulmonary edema.
Jiehua CHEN ; Shu WANG ; Hongling MA ; Wenjian WANG ; Dan FU ; Wenxian HUANG ; Jikui DENG ; Huiying TANG ; Yanxia HE ; Yuejie ZHENG
Chinese Journal of Pediatrics 2014;52(2):122-127
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
6.A Case of a Cholesterol Granuloma Occluding the External Auditory Canal in a 12-Year-Old Girl.
Ji Sun KONG ; Mee Seon KIM ; Kyu Yup LEE
Korean Journal of Audiology 2014;18(2):89-92
Cholesterol granulomas are benign granulomatous lesions caused by tissue reaction to a foreign body such as cholesterol crystals. These crystals have been are associated with pathological conditions of pneumatized spaces, including those causing inadequate aeration, obstruction of drainage, and hemorrhage in pneumatized spaces, and where materials trapping materials, such as hemosiderin or cholesterol become trapped, and then forming a cholesterol granuloma. Cholesterol granulomas are frequently found in the temporal bones, with the middle ear, mastoid caverna, and petrous apex being the most commonly affected sites. As there have been few reported cases of cholesterol granulomas presenting as a mass in the external acoustic canal (EAC), a cholesterol granuloma occluding the entire EAC in a pediatric patient is considered quite rare. We encountered a large cholesterol granuloma occupying the entire EAC, resulting in total EAC occlusion in a 12-year-old girl. The granuloma was diagnosed via medical imaging and surgically excised.
Child*
;
Cholesterol*
;
Diagnostic Imaging
;
Drainage
;
Ear Canal*
;
Ear, Middle
;
Female
;
Foreign Bodies
;
Granuloma*
;
Hemorrhage
;
Hemosiderin
;
Humans
;
Mastoid
;
Temporal Bone
7.Multiple metallic foreign bodies accidentally detected in different body cavities: a case report.
Husai MA ; Yixin CAI ; Ni ZHANG ; Junlin GAO ; Dong ZHAO ; Gang LIU ; Xiangning FU
Chinese Journal of Traumatology 2014;17(3):173-174
We accidentally found an unusual case of a middle aged Tibetan woman who had eight metallic foreign bodies (eight needles) in her head, chest and abdomen. These needles were not related to any surgical intervention or trauma. The diagnosis "metallic foreign bodies" cannot usually be made in an acute setting. Some patients may present chronic symptoms, such as infection or pain. However, in some cases, the patients do not have any symptoms.
Abdominal Cavity
;
Adult
;
Female
;
Foreign Bodies
;
diagnostic imaging
;
Humans
;
Incidental Findings
;
Metals
;
Radiography
;
Skull
;
Thoracic Cavity
8.Multislice spiral CT diagnosis error analysis of children's airway foreign bodies.
Junmei ZHANG ; Bei SHEN ; Zhiyong GUO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(15):1158-1159
OBJECTIVE:
Analysis of multislice CT (MSCT) on the misdiagnosis reasons of children bronchial foreign body, avoid missed diagnosis, to achieve reasonable application.
METHOD:
Fourteen cases of misdiagnosed cases of data were retrospectively analyzed in our department of suspicious in children with bronchial foreign body, and discuss the misdiagnosis reasons.
RESULT:
Fourteen cases of misdiagnosis of children with 9 cases by MSCT examination showed no obvious foreign matter. Through bronchoscopy intraoperative found foreign body, 5 cases by multislice CT (MSCT) to found foreign body, 4 cases of phlegm scabs, 1 case is inflammatory granulation, all recovered after treatment. Reasons of misdiagnosis were threshold selection error, scanning level from the inception glottis, imaging error, etc.
CONCLUSION
MSCT is a very valuable diagnostic on airway foreign body check method, but there are certain limitations, we should improve the understanding of misdiagnosis and reduce the occurrence of this phenomenon.
Bronchi
;
Child, Preschool
;
Diagnostic Errors
;
Female
;
Foreign Bodies
;
diagnostic imaging
;
Humans
;
Infant
;
Male
;
Retrospective Studies
;
Tomography, Spiral Computed
;
methods
9.Neglected foreign body in contralateral limb in a traumatic transfemoral amputee---radiographs can be misleading.
Atin JAISWAL ; Masood HABIB ; Yashwant-Singh TANWAR
Chinese Journal of Traumatology 2013;16(1):61-64
Missed or neglected foreign bodies are not infrequent in surgical practice. This case report highlights the fact that thorough clinical examination and detailed evaluation of trauma patients are very necessary so that any associated injuries or foreign bodies will not be missed and any unforeseen clinical or medico-legal complications can be prevented. We present a case of a 35-year- old male patient who had traumatic transfemoral amputation of the right lower limb with a clean laceration (size 2 cm multiply 1 cm) over the medial aspect of the left thigh. Radiographs suggested a single radioopaque foreign body which proved misleading, as during surgical removal multiple radiolucent and radiopaque foreign bodies were discovered. Postoperative ultrasound was performed and showed no retained foreign bodies. A secondary closure of the right thigh amputation was done and patient was discharged. At the last follow-up, 9 months after injury, the patient had no complaints, and both the amputation stump and the wound over the left thigh were healthy. Thus in the cases of retained foreign bodies, in addition to thorough clinical examination and radiography, ultrasonograpy should be supplemented. And if required, use of CT scan as well as MRI should be also considered.
Accidents, Traffic
;
Adult
;
Amputation
;
Diagnostic Errors
;
Foreign Bodies
;
diagnostic imaging
;
Humans
;
Leg Injuries
;
complications
;
Male
;
Radiography
;
Thigh
;
surgery
;
Ultrasonography
10.Medical foreign bodies in urinary bladder: a case report.
Hai WANG ; Zhi-gang JI ; He XIAO ; Ji-rui NIU
Chinese Medical Sciences Journal 2013;28(3):192-193
Foreign Bodies
;
diagnostic imaging
;
surgery
;
urine
;
Humans
;
Iatrogenic Disease
;
Male
;
Middle Aged
;
Radiography
;
Urinary Bladder
;
diagnostic imaging
;
surgery
;
Urinary Retention
;
diagnostic imaging
;
etiology
;
surgery
;
urine

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