Authors: Dana Elena Mîndru, Gabriela Păduraru, Carmen Daniela Rusu...

Foreign body aspiration (FBA) is a frequent diagnosis in children. In the absence of other lung conditions, such as asthma or chronic pulmonary infections, this manifests as a sudden onset of cough, dyspnea, and wheezing. The differential diagnosis is based on a scoring system which takes into account the clinical picture as well as the radiologic aspects. The treatment that is considered the gold-standard for FBA in children remains to be rigid fibronchoscopy, however it comes with several potentially crucial local complications such as airway edema, bleeding, and bronchospasm, along inherent issues due to general anesthesia. : Our study is a retrospective study analyzing the medical files of the cases from our hospital over the span of 9 years. The study group consisted of 242 patients aged 0-16 years diagnosed with foreign body aspiration in the Emergency Clinical Hospital for Children "Sfânta Maria" Iași, between January 2010-January 2018. Clinical and imaging data were extracted from the patients' observation sheets. In our cohort, the distribution of children with foreign body aspiration was uneven, with the highest incidence being reported in children from rural areas (70% of cases), whereas the most affected age group was 1-3 years, amounting to 79% of all cases. The main symptoms which led to emergency admittance were coughing (33%) and dyspnea (22%). The most important factors that determined the unequal distribution were socio-economic status, which relates to a lack of adequate supervision by parents, as well as the consumption of food inappropriate for their age. Foreign body aspiration is a major medical emergency that may be associated with dramatic clinical manifestations. Several scoring algorithms designed to establish the need for bronchoscopy have been proposed, taking into account both the clinical and radiological results. The issue with asymptomatic or mild symptomatic cases, as well as difficulties managing cases with radiolucent foreign bodies, remains a challenge.

Topics: Child; Humans; Infant; Retrospective Studies; Bronchoscopy; Lung Diseases; Cough; Dyspnea; Foreign Bodies

PubMed: 37374317
DOI: 10.3390/medicina59061113

Authors: Ariadna Fabià Mayans, Josep Segarra Tomás, Helena Ascaso Til...

Topics: Foreign Bodies; Humans; Male; Middle Aged; Urinary Bladder

PubMed: 29521271
DOI: No ID Found

Authors: S Bhasin, J G Williams

INTRODUCTION

Insertion of foreign objects into the rectum is a well-described phenomenon and not an uncommon referral to the general surgeon on call. Although usually not life-threatening, there can be consequences following migration of the object or perforation of the large bowel. This study looks at the incidence of removal of foreign objects from the rectum over the last decade and the financial burden it presents to the NHS.

METHODS

Hospital Episode Statistics for 2010-2019 were used to calculate the number of rectal foreign bodies that required removal in hospital. Data for age groups and genders have been compared.

RESULTS

A total of 3,500 rectal foreign bodies were removed over the course of 9 years. Males accounted for 85.1% of rectal foreign bodies whilst 14.9% were females. This equates to 348 bed-days per annum. Admission peaks were observed in the second and fifth decades of life.

CONCLUSION

This study shows that the incidence of rectal foreign bodies is higher in men and has been increasing over the period studied. Most foreign bodies can be removed trans-anally with the use of anaesthesia, with only a small proportion of patients requiring hospital stay over 24 hours (mean length of stay = 24 hours). Nearly 400 rectal foreign body removals are performed each year with an annual cost of £338,819, illustrating the effect this has on NHS resources.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Foreign Bodies; Foreign-Body Migration; Health Care Costs; Humans; Infant; Length of Stay; Male; Middle Aged; Rectum; Sex Factors; State Medicine; United Kingdom; Young Adult

PubMed: 34719960
DOI: 10.1308/rcsann.2020.7129

Authors: Ram Samujh, Khizer Mansoor, Imran Khan...

We report a rare case of appendicitis due to screw in the appendix in a 4-year old boy. An appendicectomy was done. Foreign body appendicitis should be treated with early surgical intervention.

Topics: Appendectomy; Appendicitis; Child, Preschool; Foreign Bodies; Humans; Male

PubMed: 17827638
DOI: No ID Found

Authors: Ines Trabelsi, Soumaya Kbaier, Yasmine Daoued...

INTRODUCTION

The ingestion of foreign body (FB) is a common problem in paediatrics. Children are curious by nature and tend to explore environment by inserting objects into their mouths.

AIM

To update our epidemiological and clinical data and adapt clinical management in order to limit morbidity associated with this fairly frequent accidental pathology.

METHODS

Retrospective descriptive study including children aged less than 15 years, hospitalized in the Children's Medicine Department B of the Tunis Children's Hospital from 1 January 2016 to 31 December 2021 having ingested a FB.

RESULTS

Forty-four children were included and admitted for foreign body ingestion, with a sex ratio of 1.4. The mean age was 4 years 4 months. Most children were asymptomatic on admission. In the others, digestive forms predominated (n=19). The average consultation time was 10.8 hours. The FBs were mainly foams and corrosives (75%), represented by batteries in 52% of cases and coins in 22% of cases. Thoraco-abdominal X-rays carried out on all patients revealed a radio-opaque foreign body in 95% of cases. The most frequent location was the colon (n=17). Endoscopy was chosen in 14 patients and was extractive in five. The mean time from admission to endoscopic extraction was 10.6 hours. The mean time to expulsion by natural route was 49 hours. Complications were noted in two patients: ulceration of the oesophageal mucosa and dyspnoea following rigid endoscopy in one case.

CONCLUSION

This study has shown that the ingestion of foreign body in children is a frequent and potentially serious accident.

Topics: Humans; Foreign Bodies; Male; Retrospective Studies; Female; Child, Preschool; Child; Tunisia; Adolescent; Infant; Eating

PubMed: 39748691
DOI: 10.62438/tunismed.v102i12.4857

Authors: Fouad Hajji, Ahmed Ameur

Topics: Abdomen; Female; Flank Pain; Foreign Bodies; Humans; Middle Aged; Tomography, X-Ray Computed

PubMed: 26175822
DOI: 10.11604/pamj.2015.20.332.6609

Review

Authors: Jedda Rupert, James David Honeycutt, Michael Ryan Odom...

Foreign bodies may be introduced into the skin through lacerations and soft tissue wounds. Long-term complications of retained foreign bodies include chronic pain and neurovascular impairment. Wound exploration and initial imaging with radiography or ultrasonography should be considered before foreign body removal. Risks and benefits of removal should be discussed with the patient. Although some foreign bodies may be left in place, removal should be considered if the risk of complications is high. A cooperative patient and adequate wound visualization are important for successful foreign body removal. Adequate analgesia and judicious use of anxiolytics and sedation may be helpful. Wound irrigation with normal saline or tap water is recommended after foreign body removal. Antiseptic solutions for wound irrigation may impair healing and should be avoided. Although there is no consensus on the use of antibiotic prophylaxis, several indications exist. The patient's tetanus immunization history should be reviewed, and vaccine should be administered if indicated.

Topics: Foreign Bodies; Humans; Radiography; Risk Factors; Skin; Soft Tissue Injuries; Ultrasonography

PubMed: 32538598
DOI: No ID Found

Authors: Miaoxin Zhang, Junchen Wan, Qi Zhou...

OBJECTIVES

foreign body ingestions are encountered in the clinical practice and sometimes require endoscopic management. However, time trends and epidemiology of these cases have not been fully clarified. Whether seasons and festivals have an effect on the occurrence has been poorly described.

METHOD

from 2009 to 2020, 1,152 consecutive foreign body ingestion cases were enrolled in our endoscopic center. Case records were reviewed for demographic data, foreign body type and location, outpatient or hospitalization, adverse events and dates. Annual time trends and seasonal variation were analyzed as well as the influence of Chinese legal festivals on the incidence. The impact of SARS-CoV-2 pandemic on the potential delay for clinical consultation of these cases was preliminarily explored. Clinical features of these cases were demonstrated.

RESULTS

the overall success rate was 99.7 % and the adverse events rate was 2.4 %. There was an uptrend in the annual frequency of food foreign body ingestion endoscopic extraction from 0.65 in 2009 to 8.86 in 2020 per 1,000 esophagogastroduodenoscopy patients (r = 0.902, p < 0.001). Furthermore, the frequency of endoscopic extraction significantly increased in winter (p < 0.001) and during Chinese New Year celebratory season (p = 0.003). The duration of hospitalization may be longer in the pandemic period (p = 0.0049).

CONCLUSION

considering the uptrend of the annual frequency of food related foreign body endoscopic extraction, the publicity about the danger of foreign body ingestion should be enhanced. Arrangement of endoscopic physicians and assistants during the high-incidence season should be emphasized.

Topics: Humans; Retrospective Studies; COVID-19; SARS-CoV-2; Upper Gastrointestinal Tract; Foreign Bodies; China; Eating

PubMed: 36896925
DOI: 10.17235/reed.2023.9426/2022

Authors: Ping-Yang Hong, Ling Wang, Yan-Ping Du...

The symptoms of tracheobronchial foreign body in the elderly are not typical, so they are often missed or misdiagnosed. This study aims to depict the clinical characteristics of tracheobronchial foreign body inhalation in the elderly. We retrospectively analysed the clinical data of elder patients (age ≥ 65 years) diagnosed with tracheal and bronchial foreign bodies. The data included age, sex, clinical symptoms, type and location of foreign bodies, prehospital duration, Chest CT, bronchoscopic findings, and frequencies and tools for removing these elderly patients' tracheal and bronchial foreign bodies. All patients were followed up for a half year. Fifty-nine cases were included, of which only 32.2% had a definite aspiration history. Disease duration > 30 days accounted for 27.1% of the patients. 27.1% of the patients had a history of stroke, and 23.8% had Alzheimer's Disease. Regarding clinical symptoms, patients mainly experience cough and expectoration. The most common CT findings were abnormal density shadow (37.3%) and pulmonary infiltration (22.0%). Under bronchoscopy, purulent secretions were observed in 52.5% of patients, and granulation tissue hyperplasia was observed in 45.8%. Food (55.9%) was the most common foreign object, including seafood shells (5.1%), bones (20.3%), dentures (18.6%), and tablets (20.3%). The success rate of foreign body removal under a bronchoscope was 96.7%, 28.8% of the foreign bodies were on the left and 69.5% on the right. 5.1% of the elderly patients required rigid bronchoscopy, and 6.8% required two bronchoscopies. In elderly cohorts, tracheal foreign bodies are obscured by nonspecific clinical presentations and a paucity of aspiration history, challenging timely diagnosis. Predominantly constituted by food particles, with a notable predilection for the left bronchial tree, these cases demand skilled bronchoscopic management, occasionally requiring sophisticated approaches for successful extraction.

Topics: Humans; Foreign Bodies; Aged; Male; Female; Bronchi; Trachea; Bronchoscopy; Aged, 80 and over; Retrospective Studies; Tomography, X-Ray Computed

PubMed: 38664527
DOI: 10.1038/s41598-024-60307-z

Review

Authors: Su Il Kim, Su Young Jung, Chang Eun Song...

In adults, a large metal foreign body in the esophagus is rarely seen and is usually caused accidentally. Here, we have described an unusual case of foreign body (spoon) in the esophagus of an adult patient. A 48-year-old woman initially presented to the emergency department with marked dysphagia, drooling, and radiating pain to the chest. She had swallowed a spoon while trying to vomit because of feeling sick. Radiological images revealed a spoon stuck in the esophagus. The edge of the spoon was grabbed with forceps and safely extracted under hypnic anesthesia. No esophageal perforation was detected on evaluation with esophagography using Gastrografin on the next day. This case highlights an unusual situation in an adult patient showing long nonfood-type foreign body in the esophagus. It is important that an appropriate workup and removal of foreign body is performed according to the location and type.

Topics: Deglutition Disorders; Esophagus; Female; Foreign Bodies; Humans; Middle Aged; Pain; Sialorrhea

PubMed: 32697114
DOI: 10.1177/0145561320942680