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

INTRODUCTION: Aural foreign bodies (FBs) are a common presenting complaint in emergency departments (EDs) worldwide. This study aims to describe trends and outcomes of aural FBs in the paediatric population, presenting to a tertiary hospital in Singapore. METHODS: A retrospective review of medical records was conducted of all children 0-16 years old with aural FBs who presented to KK Women's and Children's Hospital ED from 2013 to 2017. Clinical data that were collected include patient demographics, type of FB, ear compartment and laterality of FB, symptoms, duration of impaction, mode of removal, outcome in ED, and final disposition. RESULTS: There were a total of 1,003 cases. The largest age group consisted of 53.7% preschool children of 0-6 years. Males (61.7%) were more common than females (38.3%). FBs were predominantly organic materials (25.6%), followed by beads and stones (15.2%). Most FBs were found in the right ear (56.6%). The majority of patients were asymptomatic (62%). Symptoms observed included ear pain (20.1%), itch (4.8%) and bleeding (3.2%). FBs were removed by instruments (36.6%), suctioning (15.4%), syringing (8.2%), or a combination of methods (13.7%). In the ED, 73.9% of patients had an attempt at removal, among which 78.4% of FBs were successfully removed, 5.9% required specialist review, and 15.7% were unsuccessful. CONCLUSION The majority of paediatric aural FBs can be successfully removed in the ED. Emergency physicians should be trained and equipped with the relevant skills to remove aural FBs.
Adolescent ; Child ; Child, Preschool ; Emergency Service, Hospital ; Female ; Foreign Bodies/therapy* ; Humans ; Infant ; Infant, Newborn ; Male ; Retrospective Studies ; Singapore/epidemiology*

PURPOSE: This study aimed to analyze the clinical characteristic of different foreign body injuries in children and offer the preventions. METHODS: A retrospective study and the demographic information, injury causes, foreign body injury types and other clinical factors were recorded and analyzed. RESULTS: Of the 2999 patients, 1877 (62.6%) were boys and 1122 (37.4%) were girls. The majority (72.8%, n = 2184) of the injuries were found in 1-3 years old children. The most common anatomical site was the respiratory tract (73.4%, n = 2201) followed by the digestive tract (18.6%, n = 558), the genitourinary tract (1.93%, n = 58) and other sites (6.07%, n = 182). There were 60.4% of the in-patients from rural areas and 53.2% of the patients without medical insurance, the rate of cost by medical insurance increased with age. The medians of length of hospital stay and hospitalization cost were four days and 4767.3 CNY respectively. Most of the patients had surgical treatment (90.6%, n = 2717) and 64.9% of them had the complications (n = 1946). The cure rates of the all foreign body injuries types were above 90%, especially in genitourinary tract (98.3%). CONCLUSION Different types of the foreign body injuries had dissimilar clinical characteristics. The effective prevention and control measures should be taken according to the variety of high-risk population, incidence season and foreign body injury types.
Age Factors ; Child ; Child, Preschool ; China ; epidemiology ; Digestive System ; Female ; Foreign Bodies ; classification ; epidemiology ; etiology ; prevention & control ; Genitalia ; Humans ; Infant ; Male ; Respiratory System ; Risk ; Rural Population ; statistics & numerical data ; Time Factors ; Urinary Tract

INTRODUCTIONIngestion of fish bones is a common clinical complaint among adult patients. The aim of this study was to evaluate the epidemiological and behavioural risk factors for fish bone ingestion.

METHODSBetween 2009 and 2010, a physician-administered questionnaire was administered to 112 consecutive patients who presented to the emergency department of an adult tertiary hospital with the complaint of fish bone ingestion.

RESULTSThe wearing of dentures, the use of utensils to eat fish and the practice of deboning fish in one's mouth were found to be associated with an increased risk of fish bone ingestion.

CONCLUSIONTo prevent the occurrence of fish bone ingestion and its possible complications, at-risk populations should be advised on the precautions to take when eating boned fish.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Bone and Bones ; Child ; Cooking and Eating Utensils ; Dentures ; Eating ; Emergency Service, Hospital ; Feeding Behavior ; Female ; Fishes ; Foreign Bodies ; epidemiology ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Singapore ; Surveys and Questionnaires ; Young Adult

BACKGROUNDIn China, tracheobronchial foreign body (TFB) aspiration, a major cause of emergency episode and accident death in children, remains a challenge for anesthetic management. Here, we share our experience and discuss the anesthetic consideration and management of patients with TFB aspiration.

METHODSThis was a single-institution retrospective study in children with an inhaled foreign body between 1991 and 2010 that focused on the complications following rigid bronchoscopy (RB). Data including the clinical characteristics of patients and TFB, anesthetic method, and postoperative severe complications were analyzed by different periods.

RESULTSDuring the 20-year study period, the charts of 3149 patients who underwent RB for suspected inhaled TFB were reviewed. There were 2079 male and 1070 female patients (1.94:1). A nut (84%) was the most commonly inhaled object. The study revealed a 9% (n = 284) overall rate of severe postoperative complications related to severe hypoxemia, laryngeal edema, complete laryngospasm, pneumothorax, total segmental atelectasis, and death with incidences of 3.2%, 0.9%, 1.3%, 0.3%, 0.3%, and 0.1%, respectively. The rates of preoperative airway impairment, negative findings of TFB, and adverse postoperative events have been on the rise in the past 5 years.

CONCLUSIONSThe survey results confirmed that hypoxemia remains the most common postoperative complication in different periods. Both controlled ventilation and spontaneous ventilation were effective during the RB extraction of the foreign body at our hospital in the modern technique period. An active respiratory symptom was commonly seen in the groups with negative findings.

Airway Obstruction ; complications ; diagnosis ; epidemiology ; surgery ; Bronchoscopy ; adverse effects ; Child ; Child, Preschool ; Female ; Foreign Bodies ; Humans ; Hypoxia ; diagnosis ; epidemiology ; etiology ; Male ; Retrospective Studies

BACKGROUND/AIMS: Esophageal perforation is a rare but often a life-threatening condition. However, the incidence and clinical features of esophageal perforation caused by ingested foreign body are unknown. This study investigated the incidence of esophageal perforation caused by ingested foreign body and evaluated the clinical features and outcome of patients with esophageal perforation. METHODS: Among a total of 196 adult patients with confirmed esophageal foreign body and complained of at least one of the related symptoms at the emergency department between January 2000 and July 2008, 18 patients with esophageal perforation due to esophageal foreign body ingestion were included in the study. Data were collected by retrospectively reviewing the electric medical records. RESULTS: The incidence of esophageal foreign body and esophageal perforation in adults was 19.4% (196/1,009) and 1.8% (18/1,009), respectively. Chest pain was the most common symptom and fishbone was the most common foreign body causing esophageal perforation. Mediastinitis or mediastinal abscess occurred in 13 patients (13/18, 72.2%). About half (8/18) of the patients were admitted to the intensive care unit but there was no in-hospital mortality. CONCLUSIONS: The incidence of esophageal perforation in patients with foreign body ingestion was low but it increased up to 9.2% in patients with esophageal foreign body. However, prognosis was favorable with timely proper treatment. Chest pain can be an ominous sign indicating the presence of esophageal perforation in patients with esophageal foreign body.
Aged ; Chest Pain/etiology ; Emergency Medical Services ; Esophageal Perforation/*diagnosis/epidemiology/etiology ; Female ; Foreign Bodies/*complications ; Humans ; Incidence ; Intensive Care Units ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo investigate the clinical features of tracheobronchial foreign bodies in children and to provide a basis for feasible preventive measures.

METHODSA retrospective analysis was performed on the clinical data of 114 children with tracheobronchial foreign bodies confirmed by fiberoptic bronchoscopy between February 2012 and February 2013.

RESULTSThe majority (71.9%) of children with tracheobronchial foreign bodies were younger than three years old, and the male-to-female ratio was 2:l. The proportion of cases in winter was higher than that in summer. The incidence of tracheobronchial foreign bodies was significantly higher among rural children than among urban children. The positive rate of CT varied significantly for tracheobronchial foreign bodies at different sites, and the patients with tracheal foreign bodies had a significantly lower positive rate of chest CT than patients with foreign bodies in the left and right main bronchi (P<0.01). The misdiagnosis rate in children with a history of aspiration of foreign bodies was significantly lower than in children without one (P<0.01).

CONCLUSIONSHealth education related to the prevention of tracheobronchial foreign bodies in children should be conducted primarily in rural areas. Tracheobronchial foreign bodies are common in children younger than three years old. Bronchoscopy should be performed early for suspected cases of tracheobronchial foreign bodies.

Bronchi ; Child ; Child, Preschool ; Female ; Foreign Bodies ; diagnosis ; epidemiology ; prevention & control ; Humans ; Infant ; Male ; Retrospective Studies ; Seasons ; Tomography, X-Ray Computed ; Trachea

OBJECTIVETo investigate the risk factors of surgical interventions in patients with esophageal foreign bodies(EFBs).

METHODSForty-three cases with EFBs underwent surgical interventions from January 1962 to January 2011 in Department of Thoracic Surgery at the Tangdu Hospital were enrolled in the study group. Forty three cases with EFBs who received non-surgical treatment in the same hospital and during the same period matched by gender and age(the age difference between the paired patients was 5 years or less) were selected as the control group. Clinical data including type of EFBs, duration of impaction, location of EFBs, complications associated with EFBs were collected. Univariate and multivariate conditional logistic analysis were used for risk factors analysis.

RESULTSUnivariate conditional logistic analysis showed that type of EFBs, duration of impaction, location of EFBs, and complications associated with EFBs were risk factors of surgical interventions in patients with EFBs(P<0.05). Further multivariate conditional logistic analysis showed that type of EFBs(sharp EFBs) was the independent factor of surgical interventions in patients with EFBs(P=0.043; OR=29.228, 95% CI:1.114-766.686).

CONCLUSIONSPhysician should pay more attention to patients with sharp EFBs. Whether the patients need surgical interventions or not should base on factors including duration of impaction, location of EFBs, and complications associated with EFBs.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Esophagus ; Female ; Foreign Bodies ; epidemiology ; surgery ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Young Adult