scholarly journals P-L05 Enterohepatic migration of ingested fishbone resulting in hepatic abscess- Case report and review of literature

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Niamh Grayson ◽  
Hiba Shanti ◽  
Ameet G. Patel
Keyword(s):  
Foreign Body ◽  
Liver Abscess ◽  
Foreign Bodies ◽  
Epigastric Pain ◽  
Dense Body ◽  
Left Lobe ◽  
Published Data ◽  
Gastric Fistula ◽  
Delayed Presentation ◽  
Diagnostic Dilemma

Abstract Background Ingestion of foreign bodies is common, particularly in children. In adults, most foreign body ingestions are related to food bolus or bone. The majority present with pharyngeal symptoms. Most foreign bodies exit the gastrointestinal tract without complication. However, around 1% result in perforation. Patients may have a delayed presentation with nonspecific symptoms and pose a diagnostic dilemma. We report a rare case of silent migration of a fishbone into the liver and a review of the literature.   Methods We present the case of a 56 year old man who presented with a liver abscess second to an ingested fishbone. We conducted a PUBMED search and reviewed the published data over a period of thirty years. We identified 52 similar cases and compared the presentation, site of perforation and location of the fish bone. We observed the different approaches in presentation and management of such patients. Results A 56-year-old man presented to his local hospital with dull epigastric pain and raised inflammatory markers. CT scan revealed a 4 cm abscess in the left lobe of the liver, with a linear radio-dense body within. The patient was given antibiotics and the abscess was aspirated. The patient was transferred to our Hepatopancreaticobiliary unit for further management. Laparoscopy was performed. The left lateral segment of the liver was adherent to the gastric antrum. The hepato-gastric fistula was disconnected. The fishbone was retrieved from the liver. The abscess was drained and wash out performed. The patient was discharged the following day. Conclusions Left lobe liver abscess should raise suspicion of foreign body. Although antibiotic treatment may be effective in the short term, there is no long-term data regarding recurrence. We believe that laparoscopic drainage of the abscess and extraction of the foreign body offer control of the source of sepsis and reduces the risk of recurrence.

scholarly journals Challenges in Management of Tracheobronchial Foreign Bodies with Delayed Presentation: An Institutional Experience

2021 ◽  
Author(s):  
Darwin Kaushal ◽  
Amit Goyal ◽  
Kapil Soni ◽  
Bikram Choudhury ◽  
Nithin Prakasan Nair ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Preoperative Planning ◽  
Rigid Bronchoscopy ◽  
Delayed Presentation ◽  
Betel Nut ◽  
Key Factors ◽  
Tracheobronchial Foreign Body ◽  
Institutional Experience ◽  
Definitive Management

Abstract Introduction Airway foreign bodies are emergencies involving multidisciplinary departments like Pediatrics, Aneasthesiology and Otorhinolaryngology. It is always a challenge to diagnose and manage patients who present late to our emergencies. Objective In the present study, we aim to analyze the various challenges faced during the management of tracheobronchial foreign bodies with delayed presentation. Methods A retrospective hospital record-based analysis of patients who presented to us with tracheobronchial foreign bodies from January 2017 to February 2020 was performed. All patients until the age of 16 years old were included in the present study. We assessed the demographics, preoperative, intraoperative and postoperative data of the patients. Results Seventeen patients were analyzed in the study. Among these, 44.4% of the patients had delayed presentation (> 1 month). The majority of the patients had an organic foreign body (Supari or betel nut). All patients underwent rigid bronchoscopy, followed by optical forceps-assisted removal of the foreign body. A total of 82% of the patients had granulations around the foreign body. Conclusion Management of delayed presentation tracheobronchial foreign body is a big challenge for Otorhinolaryngologists. The key factors for preventing complications in the definitive management of tracheobronchial foreign bodies are preoperative planning, multi-discipline teamwork, surgeon expertise and technique.

scholarly journals Fish Bone Migrating into the Thyroid Gland

2014 ◽  
Vol 5 (1) ◽  
pp. 42-44
Author(s):  
Jay Kantilal Kotecha
Keyword(s):  
Foreign Body ◽  
Soft Tissue ◽  
Thyroid Gland ◽  
Foreign Bodies ◽  
Fish Bone ◽  
Left Lobe ◽  
Rare Phenomenon ◽  
Head Neck

ABSTRACT Many cases have been reported in the literature about foreign bodies lodged in the hypopharynx. A foreign body penetrating the esophagus and migrating into the soft tissue of neck is a rare phenomenon. We report a case of 35 years male who ingested a fish bone which then migrated into left lobe of thyroid and the role of imaging in its detection and management. How to cite this article Kotecha JK. Fish Bone migrating into the Thyroid Gland. Int J Head Neck Surg 2014;5(1):42-44.

scholarly journals Evaluation of predictors of mortality in patients of ruptured liver abscess: a prospective study

2021 ◽  
Vol 8 (12) ◽  
pp. 3639
Author(s):  
Syed A. Faridi ◽  
Syed H. Harris ◽  
Yasir Alvi
Keyword(s):  
Prognostic Factors ◽  
Prospective Study ◽  
Liver Abscess ◽  
Laboratory Data ◽  
Left Lobe ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Delayed Presentation ◽  
Predictors Of Mortality ◽  
A Prospective Study

Background: Ruptured liver abscess is a rare condition which is associated with high mortality. Ruptured liver abscess should be assessed carefully especially in patients with poor prognostic factors, which highlight the need for early diagnosis to further improve our results of management. The aim of the present study was to evaluate the predictors of mortality in patients of ruptured liver abscess.Methods: This was a prospective study, performed at Jawaharlal Nehru medical college, AMU, Aligarh between October 2015 to October 2017. For each case-patient, we reviewed demographic data, underlying medical conditions, clinical features, laboratory data, imaging and microbial findings and treatment. The prognostic factors independently related to mortality were then identified using univariate and multivariate analysis considering significance at p<0.05.Results: The overall in-hospital mortality was 27% (11 out of 40). On multivariate regression analysis, the factors that independently predicted mortality were shock at presentation, time of presentation (>48 hours), left lobe abscess and APACHE II score on admission more than 15.Conclusions: The independent predictors of mortality in ruptured liver abscess are shock at presentation, delayed presentation, higher APACHE II score on admission and left lobe abscess.

scholarly journals Unusual Presentation of Gastric Perforation by Foreign Body: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
V. S. R. Rao ◽  
R. Sarkar ◽  
Richard Turner ◽  
K. R. Wedgwood
Keyword(s):  
Case Report ◽  
Gastrointestinal Tract ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Gastric Perforation ◽  
Interesting Case ◽  
Atypical Presentation ◽  
Diagnostic Dilemma ◽  
Ingested Foreign Body ◽  
High Index Of Suspicion

Perforation of the gastrointestinal tract by ingested foreign body is rare. The majority of patients do not recall ingestion of the foreign body, and dietary foreign bodies are most commonly involved. We present an interesting case where the offending foreign body gave rise to a diagnostic dilemma masquerading as a pancreatic mass. A high index of suspicion is indicated especially when dealing with atypical presentation and nonspecific symptoms as highlighted in this case.

scholarly journals Case series of retained rectal foreign body. A Malaysian experience.

2021 ◽  
Vol 16 (2) ◽  
pp. 78-82
Author(s):  
Wei Soon Pang ◽  
Jih Huei Tan ◽  
Henry Chor Lip Tan ◽  
Jonathan Khee Ghee Tan
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Medical Condition ◽  
Abdominal Mass ◽  
Age Groups ◽  
Case Series ◽  
Abdominal Radiograph ◽  
Delayed Presentation ◽  
Elderly Male ◽  
Proximal Migration

Retained rectal foreign body, with its associated social stigma, is a medical condition that is infrequently reported in Malaysia. We report the surgical management of five cases of retained foreign objects in the rectum seen over a one-year period. There were three young and two elderly male patients. One of the elderly patients presented with altered bowel habits and an abdominal mass that mimicked a symptomatic colonic tumor. All patients had an abdominal radiograph which clinched the diagnosis of a retained foreign rectal body. Successfully retrieved objects included two bottles, one bidet device, and two sex toys. Open surgery for retrieval of the impacted rectal foreign body was required in one patient. All underwent successful retrievals without any adverse postoperative complications. In our case series, retained rectal foreign bodies were observed only in the male gender. The age presentation was bimodal, with age groups in the twenties and sixties. The treatment options used for the retrieval of these impacted foreign bodies included transanal extraction or explorative laparotomy. Proximal migration and delayed presentation are possible indications for the latter approach.

scholarly journals A Rare Case of Foreign Body Ingestion, Mimicking as Mesenteric Cyst. "Case Report"

2020 ◽  
Vol 1 (1) ◽  
pp. 56-59
Author(s):  
Saleem Ullah Khan ◽  
Muhammad Kamran ◽  
Asim Ur Rehman ◽  
Muhammad Ramzan ◽  
Imran Hashim ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Pediatric Population ◽  
Signs And Symptoms ◽  
Foreign Body Ingestion ◽  
Mesenteric Cyst ◽  
Radiological Investigation ◽  
Diagnostic Dilemma ◽  
Operative Recovery

Background: Foreign body ingestion by children is a commonly encountered problem and accounts for a significant emergency visits among pediatric population. Although these ingested foreign bodies pass spontaneously and uneventfully, a subset of such bodies may become trapped in the digestive tract, eventually leading to significant injury. Most of these bodies are radio-opaque and detectable radiologically, but some radio-lucent may become a diagnostic dilemma and subtle management issue. Case Report: We report a case of a one-year girl who presented after accidental ingestion of foreign body with signs and symptoms of acute intestinal obstruction. Initially we were unable to diagnose the cause, but later the radiological investigation suspected a mesenteric cyst. After failure to respond to conservative measures she underwent exploratory laparotomy, and a jelly ball was removed from the gut. The patient had uneventful post-operative recovery and was kept on follow-up for three months without any complication. Conclusion: These patients do not respond to conservative measures and need surgery on an emergency basis. It is likely that if left untreated may have caused Intestinal perforation and irreversible shock. Radiolucent foreign bodies are difficult to diagnose and need high level of suspicion. Need of the hour is to educate the parents to be extra vigilant as “prevention is better than cure”.

Foreign body-related oesophageal perforation: a case series at a community-based hospital in Nepal

2020 ◽  
Vol 50 (4) ◽  
pp. 349-354
Author(s):  
Narendra Pandit ◽  
Tek N Yadav ◽  
Kunal B Deo ◽  
Laligen Awale ◽  
Lokesh S Jaiswal ◽  
...  
Keyword(s):  
Foreign Body ◽  
Mortality Rate ◽  
Early Diagnosis ◽  
Nutritional Support ◽  
Case Series ◽  
Postoperative Mortality ◽  
Oesophageal Perforation ◽  
Delayed Presentation ◽  
Community Based ◽  
Diagnostic Dilemma

Oesophageal perforation is rare, associated with diagnostic dilemma, delayed presentation and high mortality rate (36%). Early diagnosis and treatment are crucial for a good outcome. Treatment is by non-operative methods (antibiotics, drainage of collections, oesophageal stenting and nutritional support) or by surgery, depending on the condition of the patient, timing of presentation and expertise. During a five-year period (2015–2019), we managed seven cases of oesophageal perforation due to a foreign body. Of them, 4 (57%) received operative intervention, while 3 (43%) were managed non-operatively. One postoperative mortality ensued; there was a mean hospital stay of 20 days.

scholarly journals The Diagnostic Dilemma of Ruptured Liver Metastasis in a Patient with Lung Cancer

2021 ◽  
Author(s):  
K S Jayanth ◽  
Shivakumar Madan ◽  
Balakrishnan Gurushankari ◽  
Sathasivam Sureshkumar ◽  
Amaranathan Anandhi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Metastasis ◽  
Liver Abscess ◽  
Spontaneous Rupture ◽  
Left Lung ◽  
Left Lobe ◽  
Diagnostic Dilemma ◽  
Adenocarcinoma Of The Lung ◽  
Thyroid Transcription Factor ◽  
Enhanced Computed Tomography

Spontaneous rupture of a metastatic liver tumour is rarely documented in literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary. Here we report a case of ruptured liver metastasis from an adenocarcinoma of the lung mimicking ruptured liver abscess, challenging the clinical diagnosis. A 42-year-female presented in July 2020 with complaints of abdominal pain, breathlessness, fever. On examination, the patient was tachypneic with a right hypochondriac mass. A contrast-enhanced computed tomography of abdomen and thorax revealed an ill-defined heterogeneously enhancing lesion in the liver with a communicating subcapsular collection and hypo enhancing lesions in the left lobe and heterogeneously enhancing lesion in the left lung. Adenocarcinoma of the lung with hepatic metastasis was confirmed with a core needle biopsy. The patient was managed conservatively with intravenous antibiotics, intercostal drainage tube and Gefitinib. However, despite best efforts, the patient succumbed to the disease. Keywords: Liver secondaries; Spontaneous rupture; Hepatocellular carcinoma; Thyroid transcription factor; Liver abscess.

scholarly journals Unusual presentation of a rectal foreign body: a diagnostic dilemma

2019 ◽  
Vol 6 (7) ◽  
pp. 2587
Author(s):  
Pei Pei Lee ◽  
Jitt Aun Chuah ◽  
Ratha Krishnan Sriram
Keyword(s):  
Foreign Body ◽  
Acute Urinary Retention ◽  
Foreign Bodies ◽  
Correct Diagnosis ◽  
Medical Attention ◽  
Pelvic Cavity ◽  
Diagnostic Dilemma ◽  
Rectal Foreign Bodies ◽  
History Of ◽  
Abdominal Perineal Resection

Rectal foreign bodies present a challenge to surgeons from obtaining the correct diagnosis to managing the patient due to a wide array of presentation. Diagnostic dilemmas often arise as patients are sometimes unwilling to disclose the actual history and seek medical attention late. We present a case of a 65 year old Asian gentleman who present with history of per-rectal bleeding, tenesmus, acute urinary retention, constitutional symptoms with investigations suggestive of rectal malignancy. Intraoperatively identified a rubber-like foreign body tightly packed in the pelvic-cavity with severe injury to the rectum requiring abdominal-perineal resection. 

scholarly journals INTRAOCULAR FOREIGN BODY-A PECULIAR CHALLENGE

2015 ◽  
Vol 05 (02) ◽  
pp. 084-087
Author(s):  
Keshav K Bhat ◽  
Chinnappa A G. ◽  
Muralee Mohan ◽  
Harish Shetty ◽  
Suman Banerjee
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Blunt Dissection ◽  
Diagnostic Dilemma ◽  
Retained Foreign Body ◽  
Foreign Body Extraction ◽  
Long Time ◽  
Tomography Scan

AbstractIntraorbital foreign bodies often present a confusing clinical picture and managing them remains a challenging experience to the oral and maxillofacial surgeons. Wooden foreign bodies are notorious for remaining quiescent for a long time, before presenting with a variety of complications. The wound of entry may often be small and self-sealing. Wooden foreign bodies also show a propensity to break during attempted removal. Intraorbital wood is often not detected by standard diagnostic tests like the computed tomography scan, adding to the diagnostic dilemma. A retained foreign body can give rise to serious complications, the most devastating of which is loss of the eye. This interventional case report of an unusual case of a wooden intraorbital foreign body reviews the clinical features, radiological appearance and surgical management. Details of ocular history, preoperative ocular examination findings including visual acuity, computed tomography findings were noted. Early surgical exploration was carried out with blunt dissection and careful hemostasis. Thus the foreign body extraction greatly influenced the visual prognosis and final outcome of the patient.

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