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*

OBJECTIVETo study the clinical features and prognosis of gastrointestinal injury caused by foreign bodies in the upper gastrointestinal tract in children.

METHODSA retrospective analysis was performed for the clinical data of 217 children who were diagnosed with foreign bodies in the upper gastrointestinal tract complicated by gastrointestinal injury by gastroscopy from January 2011 to December 2016, including clinical features, gastroscopic findings, complications, and prognosis.

RESULTSAmong the 217 children, 114 (52.5%) were aged 1-3 years. The most common foreign body was coin (99/217, 45.6%), followed by hard/sharp-edged food (45/217, 20.7%) and metal (35/217, 16.1%). The most common gastrointestinal mucosal injury was ulceration (43.8%), followed by erosion (33.2%). Compared with other foreign bodies, button cells were significantly more likely to cause esophageal perforation (P<0.01). The esophagus was the most commonly injured organ (207/217, 95.4%). Of all the 217 children, 24 (11.1%) experienced infection. The children with perforation caused by foreign bodies had a significantly higher incidence rate of infection than those with ulceration caused by foreign bodies (P=0.003). Of all the 217 children, 204 (94.0%) underwent successful endoscopic removal of foreign bodies. Among these children, 98 were hospitalized due to severe mucosal injury and were given anti-infective therapy, antacids, and supportive care including enteral nutrition through a nasogastric tube and/or parenteral nutrition. Of all the children, 10 left the hospital and were lost to follow-up, and all the other children were improved and discharged.

CONCLUSIONSMost cases of foreign bodies in the upper gastrointestinal tract occur at 1-3 years of age. Coin, hard/sharp-edged food, and metal are the most common foreign bodies. Button cells are more likely to cause esophageal perforation. The incidence rate of secondary infection increases with the increasing severity of gastrointestinal mucosal injury. Children undergoing endoscopic removal of foreign bodies and enteral nutrition through a nasogastric tube tend to have a good prognosis.

Female ; Food ; adverse effects ; Foreign Bodies ; diagnosis ; etiology ; therapy ; Humans ; Infant ; Male ; Metals ; adverse effects ; Prognosis ; Retrospective Studies ; Upper Gastrointestinal Tract ; injuries

Objective: To explore the treatment of penile incarceration with a metal ring. METHODS: Based on our experience in the successful management of a case of penile incarceration with a metal ring by coiling and bloodletting from the corpus cavernosum, we reviewed the relevant literature and analyzed the indications, advantages and disadvantages of different methods for the treatment of penile incarceration with a circular foreign body. RESULTS: The clamping and cutting methods were non-invasive, fast, effective, and with few complications, which could be applied to the treatment of penile strangulation at all levels. However, clamping was not desirable enough for a hard metal ring and the cutting method took a longer time and might increase the risk of unnecessary damage to the penile skin, urethra and cavernous body. Prepuce edema decompression and the thin tube-coiling method, with the advantages of minimal invasiveness, simple operation and no need of special tools, were suitable for penile strangulation injury under level 3, but might cause penile skin injury and potential postoperative erectile dysfunction. Surgical resection, as an invasive procedure, could be applied to severe penile strangulation at level 4 or 5. CONCLUSIONS The principle for the treatment of penile incarceration with a circular foreign body is to remove the foreign object as soon as possible and not to add secondary damage.
Bloodletting ; methods ; Constriction, Pathologic ; therapy ; Erectile Dysfunction ; prevention & control ; Foreign Bodies ; complications ; therapy ; Humans ; Jewelry ; adverse effects ; Male ; Penis ; blood supply ; injuries ; pathology ; Postoperative Complications ; prevention & control ; Urethra

The management of hemodynamically normal patients with retained intra-pericardial foreign body remains a matter of conjecture. The available literature supports non-operative management of such innocuous foreign bodies. We report our experience of a hemodynamically normal patient with a retained intra-pericardial pellet from a firearm injury. He initially received successful non-operative management but developed fatal hemopericardium 21 days after injury. In this paper, we discussed the pitfalls in the management of such injuries in light of the available literature and summarized the clinical experience.
Adult ; Fatal Outcome ; Foreign Bodies ; therapy ; Heart Injuries ; therapy ; Humans ; Male ; Wounds, Gunshot ; therapy

OBJECTIVETo investigate the etiology and clinical manifestation of hemoptysis in children.

METHODA retrospective analysis was performed for 106 cases of hemoptysis who were admitted to The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from January 2005 to December 2014.The clinical information including laboratory tests and image data were collected and analyzed.

RESULTA total of 106 patients (50 males and 56 females) were identified. The median age was 9.1 years (range 2 months to 18 years). Pneumonia (35, 31.1%) was the most common etiology of hemoptysis, which included bacterial pneumonia (27 cases), mycoplasmal pneumonia(4 cases), chlamydial pneumonia (3 cases), and influenza pneumonia(1 case). Other causes included bronchitis(15, 14.2%), pulmonary tuberculosis (11, 10.4%), bronchiectasis (11, 10.4%), diffuse alveolar hemorrhage (8, 7.5%), idiopathic pulmonary hemosiderosis(6, 5.7%), cardiovascular dysplasia(6, 5.7%), pulmonary contusion (4, 3.8%), foreign body in bronchus (2, 1.9%), allergic bronchopulmonary aspergillosis (2, 1.9%). Eighty-six patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and eleven patients, respectively. Pneumonia accounted for 33.7% of mild hemoptysis and 45.5% of massive hemoptysis were due to bronchiectasis; 80.2% were treated with antibiotics and 41.5% were given hemostatic agents; 8.5% received lobectomy. Ninety-six patients (90.6%) were cured and parents gave up treatment in 4 cases (3.8%). Six patients (5.7%) suffered from recurrent hemoptysis.

CONCLUSIONHemoptysis mainly occurred in children who were older than 6 years, the most common cause of hemoptysis was respiratory tract infection. In most cases, the amount of hemoptysis was small and the overall prognosis was good.

Adolescent ; Bronchiectasis ; complications ; Bronchitis ; complications ; Child ; Child, Preschool ; Female ; Foreign Bodies ; complications ; Hemoptysis ; diagnosis ; etiology ; therapy ; Hemosiderosis ; complications ; Humans ; Infant ; Influenza, Human ; complications ; Lung Diseases ; complications ; Lung Injury ; complications ; Male ; Pneumonia, Bacterial ; complications ; Prognosis ; Retrospective Studies ; Tuberculosis, Pulmonary ; complications

Gastric cancer is the most common cancer in Korean males and can easily spread to distant organs such as the liver, lungs, brain, or bones. However, skin metastasis, particularly of the eye, is rare. Metastatic eyelid cancer is extremely rare; metastases from internal organs have not been reported so far. We recently experienced a patient with metastatic eyelid cancer from adenocarcinoma of the stomach. A 62-year-old female was admitted with a right upper eyelid mass and foreign body sensation. She had a history of stomach cancer of 3 years. She was treated by chemotherapy and radiotherapy for pathologic fracture. After receiving supportive care for 2 years, the mass appeared on her right pupil. Punch-biopsy of the mass was performed and histological examination revealed adenocarcinoma, the same as the initial histological result. We report this case with a review of related literature.
Adenocarcinoma* ; Brain ; Drug Therapy ; Eyelid Neoplasms ; Eyelids* ; Female ; Foreign Bodies ; Fractures, Spontaneous ; Humans ; Liver ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Pupil ; Radiotherapy ; Sensation ; Skin ; Stomach ; Stomach Neoplasms

Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling. It is often associated with persistent clearing of the throat, chronic cough, hoarseness, and catarrh. Its etiology remains unclear ; however, laryngopharyngeal reflux may play a role in a subset of patients. Psychogenic problems have often been thought to cause or trigger the globus sensation. Personality studies have found higher levels of alexithymia, neuroticism, and psychological distress (including anxiety, low mood, and somatic concerns) and lower levels of extraversion in patients presenting with globus. Globus patients with laryngopharyngeal reflux exhibited weaker psychological symptoms than non- laryngopharyngeal reflux globus patients, and globus patients who did not respond to proton pump inhibitor had significantly higher anxiety scores. In cases with negative clinical investigations and consistent globus symptom, other treatment strategies, including speech therapy, antidepressants, and cognitive-behavioral therapy, should be considered.
Affective Symptoms ; Airway Obstruction ; Antidepressive Agents ; Anxiety ; Common Cold ; Cough ; Extraversion (Psychology) ; Foreign Bodies ; Hoarseness ; Humans ; Laryngopharyngeal Reflux ; Pharynx ; Proton Pumps ; Sensation ; Speech Therapy

OBJECTIVE: Insertion of a foreign body in the nasal cavity is a very common incident in children. It is easily diagnosed, but the type of foreign body varies and the extraction can sometimes be difficult with risk of complications. The present study reported nasal foreign bodies diagnosed in emergency in our ENT department, with an update on the state of knowledge. METHOD: A prospective study between Feb 2013 to Sept 2015 included patients admitted to the ENT emergency unit for nasal foreign body. Data comprised age, gender, circumstances of discovery, symptoms, type of foreign body, extraction method and complications. Many patients required anterior rhinoscope for the diagnosis and removal (179/249, 71. 9%), and 170 cases were directly removed and 9 cases were into alimentary canal; Most irregularly shaped objects were removed by a endoscope under general anesthesia (70/249, 28.1%), including button batteries (n= 65), nasal calculi (n = 2) and chopsticks (n = 3). RESULT The main types of foreign body were vegetal forms (61.8%). The incident was discovered following nasal symptoms in 24.9% (n = 62). Extraction was easy by using forceps, micro-hooks or suction in 71.9% of qn:Nasal sinuses foreign body on prevention, detailed history and make the necessary inspection, can improve the correct diagnostic rate.
Anesthesia, General ; Child ; Electric Power Supplies ; Endoscopy ; Foreign Bodies ; diagnosis ; therapy ; Humans ; Microsurgery ; Nasal Cavity ; pathology ; Paranasal Sinuses ; pathology ; Prospective Studies ; Suction ; Surgical Instruments

OBJECTIVE: To discuss the application of endotracheal intubation in the rescue of children with severe trachea and bronchial foreign body. By observing the patient's clinical pathological characteristics, the diagnosis and treatment experience were summarized. METHOD: A retrospective analysis of 10 children with severe tracheal and bronchial foreign bodies were performed. They were given emergency intubation and cardiopulmonary resuscitation to relieve respiratory and circulatory failure after reaching hospital. After the restoration of spontaneous respiration, oxygen saturation increased by more than 90 percent and vital signs stable, the foreigh body was removed with bronchoscopy. The role of endotracheal intubation before and after the treatment of tracheal and bronchial foreign bodies in children was observed. RESULT: Ten cases of children were rescued successfully. No one died and the complications such as cerebral palsy, pneumothorax and pneumomediastinum didn't happened. CONCLUSION For the children with severe tracheal and bronchial foreign body, endotracheal intubation can establish effective ventilation in a shorter period of time. The earlier endotracheal intubation, the shorter time required and the higher success rate. Endotracheal intubation can increase the survival rate of children with cardiopulmonary resuscitation, and can reduce disability.
Bronchi ; physiopathology ; Bronchoscopy ; Child ; Foreign Bodies ; therapy ; Humans ; Intubation, Intratracheal ; Retrospective Studies ; Trachea ; physiopathology

Fish bones are the most common pharyngeal foreign bodies encountered in the ENT emergency. Many fish bones may be buried in the surrounding soft tissue of the pharynx and larynx. Any delayed treatment for these foreign bodies may cause catastrophic complications. We present a case of 51-year-old woman who had an ingested fish bone migrating to the retropharyngeal space. We used spiral Computed tomography scanning (CT, taken at intervals of 2mm) with dimensional reconstruction for the accurate location diagnosis and surgical planning. We treated successfully before any complication by transoral Laser CO2 microsurgery.
Animals ; Female ; Foreign Bodies ; surgery ; Humans ; Laser Therapy ; Microsurgery ; Middle Aged ; Pharynx ; surgery ; Seafood ; Tomography, Spiral Computed ; Tomography, X-Ray Computed