Push Enteroscopy Guided Removal of a Sharp Foreign Body from the Midjejunum in a Child

Abstract Background The majority of foreign bodies entering the small intestine are passed spontaneously. However, in case of a sharp object, its removal is an urgency due to a higher risk of intestinal perforation, and endoscopic intervention is an appropriate management strategy as surgery is associated with greater morbidity. Although enteroscopy is the standard practice for the removal of a foreign body in the small intestine, gastroduodenoscopy may be used for small intestinal foreign body removal. Case Presentation We describe here the case of a 21-month-old child in whom a 5-cm, sharp-pointed nail in the midjejunum was removed successfully by a gastroduodenoscopy. This case highlights the difficulties in the removal of a sharp foreign body in a pediatric patient and the use of push enteroscopy. Conclusion Gastroduodenoscopy can be used for the removal of a foreign body in the small intestine in pediatric population in a resource-limited setup by performing push enteroscopy.

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Improvising in Endoscopy: Endoscopic Removal of Sharp Foreign Bodies in the Upper GI Tract, Using a Handmade Protective Device

Case Reports in Gastrointestinal Medicine ◽

10.1155/2020/8881702 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Konstantinos Miltiadou ◽

Zisimangelos Solomos ◽

Dimitrios Lygkos ◽

Alexandros Chatzidakis ◽

Evripidis Rizos ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Foreign Body Ingestion ◽

Protective Device ◽

Endoscopic Removal ◽

Gi Tract ◽

Case Presentation ◽

Upper Gi ◽

Sharp Foreign Body ◽

Commercial Device

Introduction. Foreign body ingestion is a common problem in large-volume endoscopic departments. Several techniques and devices have been described for the safe endoscopic removal of these objects. However, these devices may not be suitable in every clinical setting or—as in our case—they may not even be available. Case Presentation. We report the case of a 34-year-old patient, presenting with sharp foreign body ingestion. The foreign bodies were safely removed using a handmade protective hood due to lack of a commercial device. In our case, improvisation proved to be of great benefit for the patient as well as for the endoscopist. Discussion. Improvised interventions can be of special interest in the setting of insufficiently funded or equipped endoscopic departments.

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How we do it: impacted oesophageal foreign body removal using a dilatation balloon

The Journal of Laryngology & Otology ◽

10.1017/s002221512100178x ◽

2021 ◽

pp. 1-3

Author(s):

P D Chakravarty ◽

T Kunanandam ◽

G Walker

Keyword(s):

Foreign Body ◽

Granulation Tissue ◽

Foreign Bodies ◽

Fluoroscopic Guidance ◽

Tertiary Referral ◽

Foreign Body Removal ◽

Novel Technique ◽

Common Presentation ◽

Reproducible Technique ◽

Rigid Oesophagoscopy

Abstract Background Ingested foreign bodies are a common presentation to paediatric ENT services. Depending on the site, these are usually managed with flexible or rigid oesophagoscopy and retrieval. This paper presents a novel technique for removing a hollow foreign body that could not be removed using conventional means. Method and results After rigid and flexible approaches failed, a guidewire was passed through the foreign body under fluoroscopic guidance and a dilatation balloon passed through the lumen of the object. Inflating the balloon allowed dilatation of the inflamed mucosa above and below the object, facilitating straightforward removal under traction. Conclusion This is a novel and reproducible technique that uses equipment readily available in tertiary referral centres. Employed in this context, the technique enabled removal of an impacted object surrounded by granulation tissue, and would be appropriate for other objects with a lumen.

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Difficult button battery ear foreign body removal: the magnetic solution

The Journal of Laryngology & Otology ◽

10.1017/s0022215114003053 ◽

2014 ◽

Vol 129 (1) ◽

pp. 93-94 ◽

Cited By ~ 4

Author(s):

W Nivatvongs ◽

M Ghabour ◽

G Dhanasekar

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Ear Canal ◽

Foreign Body Removal ◽

Button Battery ◽

Operating Theatres

AbstractBackground:Removing a button battery from the ear can be a tricky and challenging procedure.Method and Results:We describe the innovative use of a magnetic telescopic rod to successfully remove a button battery from the ear canal of a nine-year-old boy.Conclusion:We propose that this equipment should be available in ENT clinics and operating theatres to be used for removing foreign bodies made from ferrous materials.

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Foreign Body Aspiration: Potential Cause of Coughing and Wheezing

Pediatrics in Review ◽

10.1542/pir.10.2.59 ◽

1988 ◽

Vol 10 (2) ◽

pp. 59-63

Author(s):

H. James Holroyd

Keyword(s):

Foreign Body ◽

Respiratory Symptoms ◽

Foreign Bodies ◽

Pediatric Population ◽

Congenital Defects ◽

Natural Tendency ◽

History Of ◽

Possible Cause ◽

Cardiopulmonary System ◽

Infants And Young Children

As many as half of routine ill-patient visits in pediatrics practice involve respiratory symptoms. It is not surprising that we see so much coughing and wheezing when we consider that children are still developing immunologically and are, therefore, more susceptible to infection. In early life, most of these infectious diseases occur in the respiratory and gastrointestinal tracts. In addition, the gradual exposure of the constitutionally allergic child to environmental allergens pre-disposes to the development of respiratory symptoms. Childhood is also a time for congenital defects of the cardiopulmonary system to become apparent. A sometimes overlooked cause of respiratory symptoms in infants and young children—and one that can become rapidly and severely complicated if misdiagnosed—is the aspiration of foreign bodies. Aspiration or ingestion of foreign bodies remains a significant cause of morbidity and mortality in the pediatric population. Children between 8 months and 4 years of age are at highest risk. Not all cases of aspiration are of the acute, obstructive variety, and pediatricians should consider a foreign body as a possible cause of coughing and wheezing even when no definite history of aspiration is obtained. Children of course are curious and their natural tendency is to reach out and explore new objects. Bringing objects to their mouths to taste and to test textures is common.

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Flexible bronchoscopy in foreign body removal in the pediatric population: A Systematic Review

10.22541/au.163675091.12588733/v1 ◽

2021 ◽

Author(s):

Anastasios-Panagiotis Chantzaras ◽

Panagiota Panagiotou ◽

Spyridon Karageorgos ◽

Konstantinos Douros

Keyword(s):

Systematic Review ◽

Foreign Body ◽

Pediatric Population ◽

Bronchial Tree ◽

Tracheobronchial Tree ◽

Flexible Bronchoscopy ◽

Safe Alternative ◽

Gold Standard Method ◽

Foreign Body Removal ◽

The Right

Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.

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Accuracy of ultrasonography in detecting radiolucent soft-tissue foreign bodies

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734408 ◽

2014 ◽

Vol 24 (02) ◽

pp. 196-200

Author(s):

Morteza Tahmasebi ◽

Hamdollah Zareizadeh ◽

Azim Motamedfar

Keyword(s):

Foreign Body ◽

Soft Tissue ◽

High Frequency ◽

Foreign Bodies ◽

Linear Array ◽

Foreign Body Removal ◽

Retained Foreign Body ◽

Array Transducer ◽

Highly Sensitive ◽

Objective Detection

Abstract Background and Objective: Detection of radiolucent soft-tissue foreign bodies is a challenging problem, which is especially further complicated when retained foreign body is highly suggested by clinicians but radiography is negative. So, blind exploration is sometimes hazardous for patients. The purpose of this study was to determine the accuracy of ultrasonography (USG) in detecting radiolucent soft-tissue foreign bodies in the extremities. Materials and Methods: From November 2011 to January 2012, patients with clinically suspected radiolucent soft-tissue foreign body and negative radiography were evaluated by USG with a 12-MHz linear array transducer. The patients with positive clinical and USG examination were included in our study and underwent exploration or USG removal. Results: Fifty-one patients underwent foreign body removal under ultrasonography-guided or surgical exploration and 47 patients had foreign body (31, 12, 3, and 1 case had thorn, wood, glass, and plastic, respectively). Ultrasound was positive in 50 patients. USG falsely predicted the presence of foreign body in four cases and was falsely negative in one of the cases. Accuracy, sensitivity, and positive predictive value were determined as 90.2%, 97.9%, and 92%, respectively. Conclusions: The real-time high-frequency USG is a highly sensitive and accurate tool for detecting and removing radiolucent foreign bodies which are difficult to be visualized by routine radiography.

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A Cross-Knotted Suture Basket Technique for Large Nonmagnetic Intraocular Foreign Body Removal

Journal of Ophthalmology ◽

10.1155/2020/1061462 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Jian Cao ◽

Baihua Chen ◽

Yun Li

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Intraocular Foreign Body ◽

Effective Alternative ◽

Foreign Body Removal ◽

Novel Technique ◽

Clinical Investigations ◽

Vicryl Suture ◽

The Cross ◽

Set Up

Purpose. To report a novel technique of cross-knotted suture basket and to test its effectiveness in large nonmagnetic intraocular foreign body (IOFB) removal. Methods. A 7/0 Vicryl suture was cut in half and cross-knotted, and four ends were introduced into a 23G needle to form a basket. Pig eyes were used to set up the IOFB model, and the effectiveness of the suture basket in the removal of large nonmagnetic intraocular foreign bodies was tested. Results. Several modifications can be made to adapt to different situations. For the materials (stone, metal, glass, and wood) and shapes (irregular, spherical, and rectangle) of large IOFB tested, the cross-knotted suture basket successfully removed all kinds of IOFBs. Conclusion. The suture basket technique provides an accessible, safe, and effective alternative in large nonmagnetic IOFB removal. It can be adapted and interchangedand also worth’s further clinical investigations.

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Will children ever learn? Removal of nasal and aural foreign bodies: a study of hospital episode statistics

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0115 ◽

2018 ◽

Vol 100 (8) ◽

pp. 632-634 ◽

Cited By ~ 1

Author(s):

S Morris ◽

MS Osborne ◽

AL McDermott

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Hospital Episode Statistics ◽

Hospital Data ◽

Foreign Body Removal ◽

Hospital Episode ◽

Risk Of Injury ◽

Adults And Children ◽

Button Batteries ◽

Nose And Throat

Introduction Foreign body removal is a common reason for children to attend the emergency department. Generally, aural and nasal foreign bodies are not associated with immediate morbidity unless they are button batteries. There can be consequences of migration and removal. Methods Hospital Episode Statistics for 2010–2016 were used to calculate the number of nasal and aural foreign bodies that have been removed in hospital. Data for adults and children have been compared. Results 8752 nasal and 17,325 aural foreign bodies have been removed from adults and children over the course of 6 years. Children were responsible for 95% of the 8353 nasal and 85% of the 14,875 aural foreign body presentations. Children aged 1–4 years are most at risk of injury. Conclusion Children are more likely to present to hospital than adults with a foreign body in the ear or nose. Aural bodies were more likely to need removal in hospital for both populations. Authors believe that these require identification and removal by an ear, nose and throat specialist to prevent morbidity. The overall number of procedures performed annually in children has not reduced over the study period; an average of 1218 nasal and 2479 aural foreign body removals are performed each year with an annual cost of £2,880,148 to NHS England.

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Denture Impaction Causing an Upper Esophageal Diverticulum

Case Reports in Gastrointestinal Medicine ◽

10.1155/2019/9621383 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Shireen Samargandy ◽

Hani Marzouki ◽

Talal Al-Khatib ◽

Mazin Merdad

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

The Elderly ◽

Barium Swallow ◽

Diagnostic Challenge ◽

Case Presentation ◽

History Of ◽

Endoscopic Diverticulotomy ◽

Tomography Scan ◽

Rule Out

Background. Dentures are a common cause of inadvertent foreign body ingestion particularly in the elderly. Due to their radiolucent nature, they often present a diagnostic challenge to care providing physicians. Case Presentation. A 66-year-old female presented to our otolaryngology clinic with a 2-year history of dysphagia. Her physical examination was unremarkable. Computed tomography scan of the neck and barium swallow suggested Zenker diverticulum. She was planned for endoscopic diverticulotomy; however, during surgery, a foreign body was incidentally found and retrieved, which was a partial lower denture. The diverticulum resolved thereafter, and the patient's symptoms abated. Conclusion. The authors recommend evaluating the esophagus endoscopically first in cases of upper esophageal diverticular formation, even when planning an open repair approach, to rule out any concealed foreign bodies.

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Risk Management and Recommendations for the Prevention of Fatal Foreign Body Aspiration: Four Cases Aged 1.5 to 3 Years and Mini-Review of the Literature

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134700 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4700

Author(s):

Angelo Montana ◽

Monica Salerno ◽

Alessandro Feola ◽

Alessio Asmundo ◽

Nunzio Di Nunno ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Pediatric Population ◽

Foreign Body Aspiration ◽

Health Concern ◽

Upper Airways ◽

Significant Public Health Concern ◽

Correct Execution ◽

Significant Public Health ◽

Free Environment

(1) Background: Foreign body aspiration (FBA) is a significant public health concern among the pediatric population, and fatalities are dramatic for families. It typically involves organic foreign bodies (mainly food) aspirated by children under three years old, usually at home or school. This review aimed to focus on the preventive measures around four actual cases of fatal foreign body aspiration, emphasizing the correct execution of the Heimlich maneuver and cardiopulmonary resuscitation, supervised mealtimes, and high-risk foods. (2) Methods: Four fatal cases of foreign body aspiration in children are presented here. The children were in a free environment, such as school, home, and the countryside, and were in the presence of teachers, parents, and a grandmother who did not supervise the children adequately. A literature review was performed via the MEDLINE database using the key terms: “foreign body aspiration,” “infant choking, 1.5 to 3 years,” “food and foreign body aspiration,” “common household,” “prevention of foreign body aspiration,” “guidelines,” “recommendations,” “training of caregivers (parents, educators),” “resuscitation,” “Heimlich maneuver,” and “disengagement of the upper airways.” We focused on the prevention of foreign body aspiration. (3) Results: a complete postmortem examination was performed. In three cases, the foreign bodies were food (mozzarella cheese, pear, or raw bean), while in one case, the foreign body was a pebble. (4) Conclusions: This review aimed to discuss recent scientific literature and provide a perspective on the benefits of a dedicated approach to the management of fatal foreign body aspiration in children by caregivers who usually have no experience with the best ways of supervising children in a safe environment, especially regarding the correct execution of resuscitation maneuvers, such as the Heimlich maneuver. Recommendation updates could improve healthcare quality in a pediatric setting and reduce medico-legal implications.

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