Calcified thyroid nodule masquerading as foreign body: pitfall of lateral neck X ray

A 19 years old married female presented with severe upper abdominal pain, repeated vomiting having history of swallowing a knife 7 months ago was admitted in Mordern Clinic and Diagnostic center, Joypurhat, Bangladesh. USG abdomen & X-ray (fig-1) abdomen were done when presence of a large foreign body (knife fig-3) in abdomen was made which latter on confirmed by Endoscopy of upper GIT (fig-2). Surprisingly the patient kept it in her abdomen for 7 months without any symptoms until the symptoms got worse and compelled her to seek medical help. The knife was removed by laparotomy, gastrotomy with uneventful recovery.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.210-212

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FOREIGN BODY ASPIRATION IN CHILDREN: RADIOLOGICAL EVALUATION OF PREOPERATIVE CHEST X-RAY

10.36295/asro.2021.24439 ◽

2021 ◽

Vol 24 (04) ◽

Author(s):

Rasha Nadeem Ahmed ◽

Bassam Khaleel Al-abbasi ◽

Nashwan M-Al Hafidh

Keyword(s):

Foreign Body ◽

Foreign Body Aspiration ◽

Radiological Evaluation ◽

X Ray ◽

Chest X Ray ◽

Preoperative Chest

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Foreign Body Aspiration in Infants and Older Children: A Comparative Study

Ear Nose & Throat Journal ◽

10.1177/0145561319839900 ◽

2019 ◽

Vol 99 (1) ◽

pp. 47-51 ◽

Cited By ~ 2

Author(s):

Shorook Na’ara ◽

Igor Vainer ◽

Moran Amit ◽

Arie Gordin

Keyword(s):

Foreign Body ◽

Medical Center ◽

Age Groups ◽

Signs And Symptoms ◽

Foreign Body Aspiration ◽

Preschool Age ◽

Small Airways ◽

Older Children ◽

X Ray ◽

Young Infants

Background: Foreign body aspiration (FBA) is a major cause of morbidity and mortality in children. It is a preventable event that predominates in preschool age. The signs and symptoms mimic respiratory diseases common in the same age-group. We compared FBA in infants to FBA in older children. Methods: Retrospective analysis of all the cases of suspected FBA of children under the age of 18 years hospitalized at one medical center during 2002 to 2016. We analyzed the data according to age: up to 1 year (infants) and 1 to 18 years. Results: One hundred seventy-five children with suspected FBA were admitted; of whom, 27 (15%) were infants and 148 (85%) were older children (age 1-18 years). For the 2 age groups, adults witnessed 85% and 73%, respectively, of the incidents ( P = .4). In the neonate group, 48% presented with normal X-ray findings compared to only 20% in the older group; 15% of the older group had a positive chest X-ray for a foreign body, while none had such in the infants’ group ( P = .01). For the 2 age groups, the majority of the FBs found were from organic origin. About half of the patients were diagnosed and managed within 24 hours of the aspiration event. In 10%, repeated bronchoscopy was performed due to a retained FB remnant. In a multivariate analysis, signs and symptoms ( P < .05), location of the FB ( P < .001), and witnessed aspiration ( P < .001) were independent prognostic factors for the length of hospitalization. Conclusion: Foreign body aspiration is not uncommon in young infants; the management is challenging due to small airways, the need to use smaller bronchoscopes, and the lack of working channel forces in pediatric bronchoscopes.

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Management of an unusual presentation of foreign body aspiration

The Journal of Laryngology & Otology ◽

10.1017/s0022215100120791 ◽

1992 ◽

Vol 106 (8) ◽

pp. 751-752 ◽

Cited By ~ 11

Author(s):

Hassan H. Ramadan ◽

Nicolas Bu-Saba ◽

Anis Baraka ◽

Salman Mroueh

Keyword(s):

Foreign Body ◽

Subcutaneous Emphysema ◽

Positive Pressure Ventilation ◽

Intermittent Positive Pressure Ventilation ◽

Foreign Body Aspiration ◽

Positive Pressure ◽

Review Of The Literature ◽

X Ray ◽

Post Surgery ◽

Chest X Ray

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

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An unusual presentation of foreign body rectum

International Surgery Journal ◽

10.18203/2349-2902.isj20211924 ◽

2021 ◽

Author(s):

Samir Paruthy ◽

Shivani B. Paruthy

Keyword(s):

Foreign Body ◽

Sigmoid Colon ◽

Multidisciplinary Management ◽

Associated Injuries ◽

Lower Abdomen ◽

Anal Region ◽

X Ray ◽

Patient Reported ◽

Abdominal Examination ◽

Successful Retrieval

Retrieval of rectal foreign body (FB) is a surgical dilemma. Variables including FB size, shape, make, time of insertion, presentation in ER, associated injuries, local edema, contamination, reluctance to seek medical aid, multiple unsuccessful attempts for self-retrieval masked by improper history and concealing the actual facts makes surgical management challenging. In this study, two unusual cases of FB in rectum and retrievals were presented. Case 1 was a 22 year old boy with a metallic glass tumbler in rectum reported after 12 days with constipation and pelvic pain. Repeated self-attempts for removal by the patient further pushed the FB upwards. Retrieval of rectal FB was done from rectum with repair and diversion colostomy which was closed later. Patient confessed this was his thirteenth attempt with the same object with successful retrieval all the time in last nine months. Case 2 was a 27 year old boy who inserted a sharp iron rod (used for picking ice) in the anal region which migrated to sigmoid colon without perforation of the viscera. Patient reported after three days with sharp shooting pain in left lower abdomen which aggravated on defecation. Abdominal examination revealed no sign of peritonitis, X-ray and CECT abdomen unexpectedly revealed no viscera perforation. Retrieval of FB stuck at sigmoid colon was undertaken with repair and diversion colostomy and closed later. From the study it was concluded that the retrieval of FB with proper psychological evaluation along with rehabilitation of the patient in society was a multidisciplinary management. Actual algorithm of management of these cases was beyond the surgical clinics and one-time emergency FB retrievals.

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Intravesical foreign body in a 12-year-old boy

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180582 ◽

2018 ◽

Vol 5 (2) ◽

pp. 678

Author(s):

Pramod S. ◽

Anukethan J. ◽

Ravikiran K.

Keyword(s):

Urinary Tract ◽

Foreign Body ◽

Lower Urinary Tract ◽

Psychiatric Evaluation ◽

Psychiatric Condition ◽

X Ray ◽

Sexual Stimulation ◽

Diagnostic Modalities ◽

Lower Urinary

Self-insertion of foreign body in lower urinary tract is rare in children. It is commonly seen in adults. The reason for self-insertion may be accidental, due to psychiatric illness, curiosity, sexual stimulation or therapeutic in cases of stricture. Most of the cases reported are in adults. Here we present a 12-year-old child presenting with self-insertion of metallic hair pin into the lower urinary tract with symptoms of dysuria and retention of urine. X-ray and ultrasonography were diagnostic modalities which aided in the diagnosis. The child underwent successful cystoscopic removal of foreign body after thorough investigation. Post removal child underwent psychiatric evaluation. He was not suffering from any psychiatric condition. He admitted having inserted the hair pin out of curiosity. Child was passing urine in good stream at time of discharge. At six months follow up child remains asymptomatic.

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PERFORATION OF THE ESOPHAGUS BY A FOREIGN BODY, WITH REPORT OF A CASE PRESENTING UNUSUAL X-RAY SIGNS

The Laryngoscope ◽

10.1288/00005537-192410000-00005 ◽

1924 ◽

Vol 34 (10) ◽

pp. 821???825 ◽

Cited By ~ 4

Author(s):

SAMUEL IGLAUER ◽

J. LOUIS RANSOHOFF

Keyword(s):

Foreign Body ◽

X Ray

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The Gynecologic Examination of the Prepubertal Child with Vulvovaginitis: Use of the Knee-Chest Position

PEDIATRICS ◽

10.1542/peds.65.4.758 ◽

1980 ◽

Vol 65 (4) ◽

pp. 758-760 ◽

Cited By ~ 1

Author(s):

S. Jean Emans ◽

D. P. Goldstein

Keyword(s):

Abdominal Pain ◽

Foreign Body ◽

Young Child ◽

Vaginal Bleeding ◽

Age Group ◽

X Ray ◽

Rectal Examination ◽

Good View ◽

Prepubertal Child ◽

Common Complaint

Vulvovaginitis is a common complaint in the prepubertal child. The proximity of the vagina to the anus and the thin uncornified vaginal epithelium make the young child especially susceptible to vulvovaginal infection. Not only is hygiene often suboptimal in this age group, but pinworm infestations, bubblebaths, harsh soaps, and tight-fitting nylon tights can all contribute to the vulvar irritation. Because children are frequently sent to gynecologists, traumatized by a rectal examination as the first part of the evaluation, or sent for an x-ray of the vagina with the hope of excluding a radiopaque foreign body, we believed it would be useful to present our approach to the gynecologic evaluation of the prepubertal child in which the kneechest position is used for visualizing the vagina. METHODS The evaluation of a prepubertal child with vulvovaginitis in the Gynecology Clinic of Children's Hospital is done in the following order: (1) history; (2) inspection of the perineum with the child supine; (3) visualization of the vagina and cervix in kneechest position; (4) cultures; and (5) a rectal examination in girls with vaginal bleeding or abdominal pain. The knee-chest position (Figure) provides a particularly good view of the vagina and cervix without instrumentation. The little girl is asked "to lie on her tummy with her bottom in the air." She is reassured that the examiner plans "to take a look" but "will not put anything inside her." The child rests her head to one side on folded arms and supports her remaining weight on bended knees (6 to 8 in apart).

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Tracheobronchial foreign body aspiration in children: a 5-year retrospective study from Shanghai, China

10.21203/rs.2.11329/v1 ◽

2019 ◽

Author(s):

Guodong Ding ◽

Beirong Wu ◽

Angela Vinturache ◽

Chen Cai ◽

Min Lu ◽

...

Keyword(s):

Foreign Body ◽

Descriptive Analysis ◽

Sudden Onset ◽

Rigid Bronchoscopy ◽

Flexible Bronchoscopy ◽

Older Children ◽

Female Ratio ◽

X Ray ◽

Presenting Symptoms ◽

First Choice

Abstract Background Foreign body (FB) aspiration is a common and serious problem in childhood, but little information is available about this condition in Chinese context. We aimed to characterize the clinical and epidemiological features of airway FBs in a pediatric Chinese population. Methods A retrospective review of medical records of children aged 0-14 years who attended with a diagnosis of FB aspiration the Shanghai Children's Hospital between 2013 and 2017 was carried out. Descriptive analysis was used to assess patient's demographics, clinical, radiographic, bronchoscopic findings, time to presentation, and characteristics of the FBs. Results Among the 200 patients included in the study, 92% were under 3 years of age, with a peak incidence of FB aspiration occurring between 1 and 2 years. The male to female ratio was 2.6:1. Twenty-three percent of the patients were admitted within 24 hours of the event, 40% within 1 week, 30% within 1 month, and 7% more than 1 month after aspiration. Eleven percent were laryngotracheal FBs and 89% were bronchial FBs. The most common presenting symptoms of laryngotracheal FBs were cough, dyspnea, and wheezing; those of bronchial FBs were cough, decreased air entry, and wheezing. Chest X-ray was normal in four-fifths of the children with laryngotracheal FBs, whereas most common abnormal x-ray findings in children with bronchial FBs were mediastinal shift, obstructive emphysema, and pneumonia. In children younger than 2 years FBs were more frequently found in the left bronchus, whereas in older children FBs were more frequently found in the right bronchus. Ninety-three percent of the removed FBs were organic materials such as food items and the most frequently aspirated FBs were peanuts. Flexible bronchoscopy was successfully performed in 80.5% of the patients, while rigid bronchoscopy or direct laryngoscopy in 17.5% of the patients. Four patients were subjected to thoracic surgery and 1 died during bronchoscopy due to acute respiratory failure. Conclusions Tracheobronchial FBs should be suspected in children who have sudden onset of cough and wheezing episode, even when physical and radiographic evidence is absent. Flexible bronchoscopy has become the first choice in China used for FB removal from airways in children.

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A gyermekkori alsó légúti idegentest-aspiráció diagnosztikája a klinikai gyakorlatban

Orvosi Hetilap ◽

10.1556/650.2018.31165 ◽

2018 ◽

Vol 159 (51) ◽

pp. 2162-2166

Author(s):

Dániel Hajnal ◽

Tamás Kovács

Keyword(s):

Foreign Body ◽

Standard Procedure ◽

False Negative ◽

Radiological Finding ◽

Paediatric Population ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

X Ray ◽

Co Morbidity ◽

Chest X Ray

Abstract: Introduction and aim: Rigid bronchoscopic foreign body removal is the gold standard procedure for foreign body aspiration. We have analysed our results of bronchoscopies and the accuracy of diagnosis among the paediatric population in Southeast Hungary. Method: A retrospective study of children admitted because of suspected solid foreign body aspiration between 2006 and 2017 was performed. Results: From among 220 admitted patients, 86 were suspected of solid particle aspiration. Presenting history was certain in 68.6% (n = 59/86). Sudden choking-like symptoms were present in 61/86 patients (70.9%), coughing in 81/86 patients (94.2%). Thoracic auscultation was positive in 67/86 cases (77.9%), chest X-ray in 75/86 patients (87.2%), while fluoroscopy only in 12/75 cases (16%). 92 bronchoscopies in 86 patients were performed. In 57 bronchoscopies, solid foreign body was found (66.2%) and the removal was successful in 56 cases. Thoracic auscultation was negative in patients with foreign body only in 6/57 cases (10.5%). In the same group, chest X-ray was negative in 33/57 cases (57.9%) and fluoroscopy was positive only in 12/57 patients (21.1%). Pneumonia or prolonged bronchitis was present in 4/86 patients (4.6%). Severe bronchial bleeding occurred in 2/86 cases (2.3%). Mortality was 1.2%, a child with severe co-morbidity and chronic aspiration passed away. Bronchoscopy was negative in 29/86 patients (33.7%). Complications were significantly higher in chronic cases than in the acute ones. Conclusion: Rigid bronchoscopy is indicated if solid foreign body aspiration is suspected and positive anamnesis, typical symptoms (coughing, choking) or positive chest auscultations are present. Diagnosis predominantly based on radiological finding is controversial due to the high possibility of false negative results. Early intervention within the first 24 hours is recommended to avoid complications. Orv Hetil. 2018; 159(51): 2162–2166.

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