Nonsurgical removal of a rectal foreign body using a vacuum extractor

PURPOSE: Rectal foreign bodies can be extracted by non-surgical methods. However, glass objects require technical considerations to minimize morbidity and may necessitate surgical extraction. We describe a technique that allowed safe transanal extraction of a glass foreign body and avoided laparotomy. METHODS: A patient with a history of a previous rectal foreign body that required laparotomy presented with another incarcerated rectal foreign body. After attempts at manual extraction failed, spinal anesthesia was induced, and an obstetric vacuum extractor was used to transanally withdraw the glass foreign body. RESULTS: The glass foreign body was withdrawn uneventfully using the vacuum extractor. Laparotomy was avoided. The patient was hospitalized for observation and discharged 24 hours later. CONCLUSIONS: Use of the delivery vacuum extractor provided a safe, cost-effective method of glass foreign body removal by the transanal route. Literature review found no other reports of rectal foreign body removal by this method.     

An unusual esophageal foreign body perforation--a case report and review of the literature

Esophageal foreign body remains a common clinical problem. Esophageal perforation is an uncommon associated condition which almost affects invariably the esophagus. A rare case of cervical esophageal perforation secondary to an unexpected migration of a swallowed foreign body is presented. Methods of treatment are discussed and the literature is reviewed.     

An unusual foreign body in the recto-sigmoid region: report of a case

A large variety of rectal foreign bodies have been reported in the literature. Ingenious methods have been described for the retrieval of these foreign bodies. We present the case of an unusual foreign body in the recto-sigmoid region. A review of the literature is presented and a management strategy is suggested. Received: 4 January 2000 / Accepted: 29 April 2000     

Presentation and management of nasal foreign bodies in a Chinese metro area

Nasal foreign bodies in children are common complaints encountered by pediatric otolaryngologists. We investigated clinical features, diagnosis, and treatment of nasal foreign bodies in children in a Chinese metro area.Six hundred sixty eight children with nasal foreign bodies presented to Shenzhen Children''s Hospital, diagnosed and treated by the authors were enrolled from January 2016 to October 2019, causes for medical consultation, age, sex, duration, types, locations, removal, and complications were recorded and analyzed.Nasal foreign bodies were common in children between 1 and 5 years of ages (96.8%). The right nasal cavity (61.4%) was the most common site for foreign body insertion (61.4%). Most of the children (89.4%) presented for a complaint of nasal discomfort or foreign body insertion themselves, or for foreign body impaction discovered by the caregivers. Most of the foreign bodies (85.0%) were discovered within 1 day. The most nasal foreign bodies were the whole toys and toy parts (34.1%). The majority of nasal foreign bodies (99.1%) located in the antero-inferior portion of the nasal cavities and could be removed with simple instruments. The occurrence of complications in nasal foreign bodies (10.2%) was not common.The present study objectively exhibited clinical features, diagnosis, and treatment of nasal foreign bodies in a Chinese metro area.     

A rare cause of hemoptysis]

The existence of a bronchial foreign body is an unusual cause of haemoptysis. We observed a sixty two year-old women who presented several medium-abundance haemoptysis. They were associated with a systematic alveolar-interstitial radiological picture of the ventral upper right lobe. A right upper lobectomy showed that an old bronchial foreign body (piece of bone) was responsible for the systematic intra-alveolar bleeding. Though most of the breathed foreign bodies are expressed into immediate symptoms, some of them remained undiagnosed and may be responsible for haemoptysis, infectious complications, atelectasis and for bronchiectasis. Their extraction through endoscopy or most often surgery is necessary for a proper recovery. In spite of histopathological differences between foreign bodies, broncholithiasis and lung tumor the diagnosis may be difficult clinically and on radiology.     

Endobronchial foreign body demonstrated by xerotomography.

A case of pneumonia secondary to aspirated foreign body is presented. Xerotomography was useful in detecting abnormalities of the tracheobronchial tree and in demonstrating endobronchial foreign bodies.     

Foreign body aspiration diagnosed by microscopy

We report a rare case of foreign body aspiration diagnosed by microscopic analysis of a sample of the foreign body. A 50-year-old man presented with a 5-month history of 40 pound weight loss and a nonresolving right lower lobe pneumonia. Medical history, radiographic studies, direct visualization of the foreign body by flexible fiberoptic bronchoscopy, and gross examination of a sample of the foreign body retrieved by a forceps biopsy catheter failed to yield the diagnosis. Moderate bleeding associated with the bronchoscopic "biopsy" procedure contributed to a preliminary misdiagnosis of endobronchial tumor. Microscopic analysis of the "biopsy" specimen demonstrated vegetable matter. The patient underwent rigid bronchoscopy and a peanut was retrieved from the bronchus intermedius. He was maintained on antibiotics for an additional 8 weeks and had complete clinical and radiographic recovery. The epidemiology, presentation, and management strategies of foreign body aspiration in the adult are briefly reviewed.     

Emergency admissions due to swallowed foreign bodies in adults

AIM:To study a retrospective analysis of patients who presented to the emergency departments(ED)with complaints related to foreign body ingestions.METHODS:Patients older than 16 years of age who presented to the ED between January 1stand December 31stof 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient charts.RESULTS:A total of 100 patients presented with a complaint of foreign body ingestion during the study period.Overall,an X-ray was performed on 75 patients,and a fiberoptic evaluation was performed on45 patients.A foreign body was detected in 46(46%)patients.The diagnostic yield of the X-ray was 27(36%)out of 75 patients,while the diagnostic yield of the fiberoptic evaluations was 21(47%)out of 45 patients.The detected foreign bodies were mostly located in the esophagus(17 out of 46 foreign bodies detected).When the types of ingested foreign bodies were evaluated,52(52%)patients reported ingesting food,and19(19%)patients reported swallowing pins.An X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two cases.In 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation,the foreign material was detected and removed.CONCLUSION:Plain radiography is helpful in the localization of radiopaque swollen foreign bodies,while fiberoptic methods are useful as both diagnostic and therapeutic tools,regardless of radiopacity.     

Aspiration of dental implant -- reasons, management and prevention

Aspiration of foreign bodies is extremely rare in adults, but it may occur during the course of dental treatment and become a serious problem for the patient. A case of a 77-year old man with chronic cough after dental treatment and unrecognised aspiration of an implant is presented. The implant remained unidentified for three years as an endobronchial foreign body of the lower lobe bronchus. A bronchoscopic removal failed and surgery was indicated for lobectomy of the right lower lobe because of chronic pneumonia. A review of prevention, signs and symptoms, management and documentation of the complications is presented.     

Schistosomiasis--cancer: etiological considerations. A review.

Evidence for a causal connection between Schistosoma haematobium-infection and carcinoma of the urinary bladder is discussed. A group relationship of schistosomiasis cancer to cancers as+sociated with asbestosis, foreign body implants, and cicatrization is suggested on the basis of several criteria. Results of experimental foreign body tmuorigenesis in mice are presented and elaborated in relationship to schistosomiasis cancer. Carcinogenic development at the cellular level is discussed with emphasis on the essential role of tissue-environmental conditions, especially fibrotic changes and macrophage quiescence.     

Unusual foreign body aspiration

Tracheobronchial foreign body aspiration in adults is rare when compared to children. In this case report, 76 year old female patient who aspirated a screw of tracheostomy cannula which was taken out by fiberoptic bronchoscopy (FOB) was presented. This case showed us that education of patients about stoma care is important. The FOB can be used safely to get foreign body from distal airways.     

Colorectal foreign bodies

A nine-year experience with 55 colorectal foreign bodies extracted from 51 patients is presented. Adherence to a management protocol according to the classification of the level of the foreign bodies within the rectum is emphasized. The therapeutic principles of pre-extraction biplane abdominal roentgenograms, appropriate anesthesia for adequate sphincter relaxation, transanal extraction under direct vision whenever possible, proctosigmoidoscopy and inpatient observation following removal of the foreign body have resulted in no morbidity or mortality in this series.     

An alternative approach to management of Fogarty catheter disruption associated with endobronchial foreign body extraction

The Fogarty balloon catheter is a useful adjunct in removing aspirated foreign bodies, but its use is not without risks. A case is presented of Fogarty catheter disruption while attempting to remove a foreign body. The resulting debris in the distal airway was inaccessible to bronchoscopic retrieval. An effective treatment plan is outlined to deal with this problem.     

Management of Retained Colorectal Foreign Bodies: Predictors of Operative Intervention

PURPOSE This study was designed to review experience at our hospital with retained colorectal foreign bodies.METHODS We reviewed the consultation records at Los Angeles County + University of Southern California General Hospital from October 1993 through October 2002. Ninety-three cases of transanally introduced, retained foreign bodies were identified in 87 patients. Data collected included patient demographics, extraction method, location, size and type of foreign body, and postextraction course.RESULTS Of 93 cases reviewed, there were 87 individuals who presented with first-time episodes of having a retained colorectal foreign body. For these patients, bedside extraction was successful in 74 percent. Ultimately, 23 patients were taken to the operating room for removal of their foreign body. In total, 17 examinations under anesthesia and 8 laparotomies were performed (2 patients initially underwent an anesthetized examination before laparotomy). In the eight patients who underwent exploratory laparotomy, only one had successful delivery of the foreign object into the rectum for transanal extraction. The remainder required repair of perforated bowel or retrieval of the foreign body via a colotomy. In our review, a majority of cases had objects retained within the rectum; the rest were located in the sigmoid colon. Fifty-five percent of patients (6/11) presenting with a foreign body in the sigmoid colon required operative intervention vs. 24 percent of patients (17/70) with objects in their rectum (P = 0.04).CONCLUSIONS This is the largest single institution series of retained colorectal foreign bodies. Although foreign objects located in the sigmoid colon can be retrieved at the bedside, these cases are more likely to require operative intervention.Reprints are not available.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, New Orleans, Louisiana, June 21 to 26, 2003Poster presentation at the Digestive Diseases Week, Orlando, Florida, May 17 to 22, 2003.     

Case of Unusual Foreign Body in the Rectum

A 44-year-old male patient with a foreign body in rectum (beverage bottle), introduced as sexual perversion, is presented with literature review. The management emphasis is on transanal retrieval and ruling out of the rectal and colonic perforation and the requirement for postremoval psychiatric treatment.     

Asymptomatic esophageal perforation by a coin in a child

Ingestion of coins by children is a common event that rarely causes serious complications. We present a case of asymptomatic esophageal perforation by a penny in a child who presented with wheezing six months after the ingestion. When esophagography and triple endoscopy failed to show the perforation, thoracotomy resulted in successful removal of the foreign body, which was encased in granulation tissue between the trachea and esophagus. Complications of foreign body ingestion are discussed.     

Subcutaneous emphysema and pneumomediastinum due to foreign body aspiration in children with asthma

Pneumomediastinum (PM) and subcutaneous emphysema (SCE) are well recognized as complications of acute asthma exacerbation in children with asthma. We present herein a report of three cases of asthmatic children who presented with PM and SCE found to be secondary to foreign body aspiration. The cases highlight that clinicians must remain vigilant for co-morbidities in an asthma exacerbation, and less common etiologies of PM and SCE, such as foreign body aspiration, should also be carefully considered in asthmatic children.     

Management of foreign bodies of the upper gastrointestinal tract

In the United States, 1500 people die yearly of ingested foreign bodies of the upper gastrointestinal tract. The flexible esophagogastroduodenoscope has had a major impact on the treatment of these foreign bodies. The following discussion includes the management of coins, meat impaction, sharp and pointed objects, button batteries, and cocaine packets; and it reflects both a personal experience and a review of the literature. The uses of the rigid and the flexible endoscopes, the Foley catheter, glucagon, papain, and gas-forming agents are presented. The cost-effectiveness impact of the flexible endoscope is also detailed, and morbidity and mortality rates for foreign body management are included.     

成人纤维支气管镜在幼儿支气管异物治疗中的应用

目的探讨成人纤维支气管镜在幼儿(11/12～3)支气管异物治疗中的可行性及价值。方法在全麻插管下行气管切开,从切开处将纤维支气管镜缓慢插入气管,观察异物所在部位,并根据异物的性质采用不同的手法取出。结果本组共8例,治疗全部取得成功,无并发症出现。结论在全麻插管控制呼吸下应用成人纤维支气管镜钳取幼儿支气管异物的治疗方法是可行的,尤其适用于异物过深或有多个异物的患儿。