The Blind Leading the Blindable

2020 ◽  
pp. 99-104
Author(s):  
Pat Croskerry
Keyword(s):  
Foreign Body ◽  
Malignant Melanoma ◽  
High Velocity ◽  
Metallic Foreign Body ◽  
Aged Patient ◽  
Tertiary Referral ◽  
Pigmented Lesion ◽  
History Of ◽  
Metallic Object ◽  
Rule Out

In this case, a middle-aged patient is referred to a tertiary referral eye hospital by an ophthalmologist for the diagnostic assessment of a pigmented lesion on the sclera of his left eye. Ostensibly, the referral is to rule out malignant melanoma. The patient has a history of a penetrating injury to his left eye from a high-velocity metallic object 10 years earlier. He is seen by multiple ophthalmologists who ruled out melanoma, concluding the lesion is a metallic foreign body exterior to the globe that did not require removal. However, an obvious and important detail is missed by all but one ophthalmologist.

scholarly journals Denture Impaction Causing an Upper Esophageal Diverticulum

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.

scholarly journals Primary Malignant Melanoma of Maxilla: Report of a Case with Discussion

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
G. Shirisha Rani ◽  
T. Vinay Kumar ◽  
Balaram Kolasani ◽  
Md Rezwana Begum ◽  
Anu Priya Srinivasan
Keyword(s):  
Surgical Treatment ◽  
Malignant Melanoma ◽  
Oral Cavity ◽  
Head And Neck ◽  
Cutaneous Melanoma ◽  
Dental Clinic ◽  
Oral Melanoma ◽  
Pigmented Lesion ◽  
Oral Malignant Melanoma ◽  
Rule Out

Primary oral malignant melanoma, very rare neoplasm of melanocytic origin, usually presents as a bluish black to tan-brown colored lesion Which is accounting for 0.2 to 8% of all melanomas, 1.6% of all head and neck malignancies, and 0.5% of all oral neoplasia. In general, the prognosis of oral melanoma is poor and worse than that of cutaneous melanoma. Here a case of oral malignant melanoma is presented, which was undetected during the first visit to a dental clinic. When a simple oral surgical treatment was carried out in that region, it resulted in the appearance of a massive pigmented lesion which was histopathologically diagnosed as malignant melanoma. This paper is presented to reemphasize the fact that any pigmented lesion in the oral cavity should be viewed with suspicion and proper investigation (biopsy) should be carried out to rule out any untoward experiences later.

scholarly journals Malignant melanoma presenting as an isolated pleural effusion

2015 ◽  
Vol 75 (2) ◽  
Author(s):  
M. Shameem ◽  
J. Akhtar ◽  
U. Baneen ◽  
N. Ahmad Khan ◽  
R. Bhargava ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Melanoma ◽  
Pleural Fluid ◽  
Past History ◽  
Mediastinal Lymphadenopathy ◽  
Rare Presentation ◽  
Pigmented Lesion ◽  
S 100 ◽  
History Of ◽  
Enhanced Computed Tomography

Isolated pleural effusion is a very rare presentation of malignant melanoma. A 46 year-old male patient presented to us with complaints of shortness of breath during the previous month. A contrast enhanced computed tomography (CECT) imaging scan of his thorax showed right-sided pleural effusion with the absence of any mass lesion or mediastinal lymphadenopathy. Cytology of his pleural fluid showed pigmented cells suggestive of malignant melanoma. Staining of the pleural fluid cells with immunohistological markers for melanoma (HMB 45 and S 100) were positive. An examination of his skin did not reveal any pigmented lesion, nor was there a past history of malignant melanoma for this patient. The patient responded well to therapy for malignant melanoma and has remained asymptomatic for the last year. This patient was diagnosed with a rare case of primary malignant melanoma of the pleura presenting as isolated pleural effusion.

An Incidental Finding of an Intraosseous Metallic Object Within the Os Calcis

2012 ◽  
Vol 5 (5) ◽  
pp. 330-333 ◽  
Author(s):  
Osman Khan Chaudhary ◽  
Alex Trompeter ◽  
Palanisamy Ramesh
Keyword(s):  
Foreign Body ◽  
Incidental Finding ◽  
Single Case ◽  
Metallic Foreign Body ◽  
Therapeutic Level ◽  
Management Options ◽  
Os Calcis ◽  
Single Case Report ◽  
Metallic Object

The authors present a case of an incidental finding of a metallic foreign body located within the calcaneus of a 17-year-old girl. Although the presence of foreign material is a common occurrence in the foot, intraosseous metallic bodies are rare, especially so when they present as an incidental finding. A literature review of PubMed using keywords metallic, foreign body, and calcaneus revealed only a single case report, which did not present as an incidental finding. The presentation described here is rare and provides a platform for discussion about possible management options. Levels of Evidence: Therapeutic, Level IV: Case study

scholarly journals Acute Abdomen and Liver Abscess Caused by Penetrating Metallic Foreign Body in a Mare

2019 ◽  
Vol 69 (2) ◽  
pp. 237-243
Author(s):  
Geórgia Camargo Góss ◽  
Claudia Acosta Duarte ◽  
Claudia Medeiros Rodrigues ◽  
Ricardo Pozzobon ◽  
Maria Elisa Trost ◽  
...  
Keyword(s):  
Foreign Body ◽  
Abscess Formation ◽  
Diffuse Peritonitis ◽  
Metallic Foreign Body ◽  
Abdominal Adhesions ◽  
Current Case ◽  
Abdominal Abscesses ◽  
Abdominal Organs ◽  
History Of ◽  
Present Case Study

Abstract The ingestion of sharp foreign bodies that cause penetrating wounds to the gut and surrounding structures and its consequences are not often seen in equine medicine. When animals ingest these objects, they tend to have colic episodes and peritonitis, as well as to be prone to abscess formation. The aim of the current case report is to describe liver abscesses and peritonitis, with abdominal adhesions, caused by a penetrating metallic foreign body that was swallowed by a Crioulo mare, which had been showing a history of recurrent colic episodes for 4 months. The animal was subjected to median celiotomy due to suspect enterolithiasis. During the procedure, abdominal adhesions, blood clots in the intestinal loops and enteroliths were observed. These severe changes led to the mare death while she was still recovering from anaesthesia. Necropsy findings revealed abscess formation in the liver, abdominal adhesions, diffuse peritonitis and a penetrating foreign body in the liver. The relevance of the present case study lies on the fact that the assessed mare presented a stable chronic condition, although she had peritonitis and abdominal abscesses. This observation reinforces the importance of assessing all abdominal organs in horses with recurrent colic episodes. The evaluation of abdominal organs through complementary exams and necropsy can help identifying foreign objects inside these animals and it contributes to the challenging diagnosis of colic syndrome.

scholarly journals Rare cause of foreign body in urinary bladder

2020 ◽  
Vol 7 (9) ◽  
pp. 3166
Author(s):  
Sunil Gokhroo
Keyword(s):  
Foreign Body ◽  
Urinary Bladder ◽  
Metallic Foreign Body ◽  
Perianal Region ◽  
Metallic Wire ◽  
Detailed History ◽  
Tinea Cruris ◽  
X Ray ◽  
History Of ◽  
Local Examination

Foreign body in urinary bladder is not an uncommon entity. Mostly it happens due to iatrogenic reasons or for sexual gratification. Here we are reporting a common foreign body in urinary bladder with a rare cause which is not reported in literature earlier. A 50-year-old married man referred from village with history of inserting electric wire in urethra and X-ray pelvis showing coiled metallic foreign body in the bladder region. There was dysuria, burning and sometimes hematuria. All other investigations were normal. On examination his both groins and perianal region were involved with Tinea cruris. Patient told that he had intense itching which was not benefitted by skin treatment. He himself started doing some manipulation in urethra with a piece of wire to get some relief in itching. The metallic wire was removed by cystoscopy under spinal anaesthesia and C-arm guidance. Post-operative course was uneventful, and patient was sent to dermatologist for treatment of Tinea cruris. After 1 month there were no urinary symptoms and patient had improvement in Tinea symptoms. We recommend that whenever anyone comes across a case of foreign body in urinary bladder, detailed history should be taken, and local examination should be done to find any organic cause for the same and treated to prevent recurrence and stigma to the patient.

Foreign Body Induced Osteomyelitis in the Hand – Commonly Missed Clinical and Radiological Diagnosis

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Meghna Regmi ◽  
Sanjay Desai ◽  
Sandeep Patwardhan ◽  
Wipula Deshmukh ◽  
Tushar Kapoor ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Foreign Body ◽  
Chronic Osteomyelitis ◽  
Medical Attention ◽  
Not Given ◽  
Retrospective Evaluation ◽  
History Of ◽  
Ct And Mri ◽  
Rule Out ◽  
Body Case

Introduction: Thorn prick is commonly seen in people that are involved in gardening. In some cases, they are unaware of the precedent thorn prick or present for medical attention quite late and forget about the history of thorn prick. In such cases, it is challenging for the clinicians and the radiologist to rule out the cause of the osteomyelitis caused by an unrecognized foreign body. Case Report: A 14-year-old girl presented with a swelling of the hand and discharging sinuses with a radiographic picture of osteomyelitis of the 5th metacarpal. The CT and MRI showed features consistent with osteomyelitis as well, possibly tuberculous in etiology. Even after the completion of AKT (anti-tubercular treatment), the patient continued to have discharging sinuses out of which a plant thorn spontaneously egressed, and subsequently, the patient was completely relieved of her symptoms. Retrospective evaluation of the MRI showed the presence of a foreign body that was hyperdense on CT and was initially thought to be a sequestrum. Conclusion: Hence, even though a definite history of trauma/thorn prick is not given (although highly unusual in the case of hand), an organic foreign body should be considered in the etiologic differential diagnosis of non-responding chronic osteomyelitis and discharging sinuses. Keywords: Thorn, osteomyelitis, hand.

scholarly journals Impacted Intra Sphenoid Foreign Body in an Adult: A Rare Event and a Lucky Survivor

2016 ◽  
Vol 17 (2) ◽  
pp. 115-117
Author(s):  
Sourabha Kumar Patro ◽  
Roshan Verma ◽  
Naresh K Panda
Keyword(s):  
Foreign Body ◽  
Skull Base ◽  
High Velocity ◽  
Traffic Accidents ◽  
Foreign Bodies ◽  
Road Traffic ◽  
Rare Event ◽  
Metallic Foreign Body ◽  
Road Traffic Accidents ◽  
Endoscopic Removal

Nasal foreign bodies are rare events occurring mostly in children. However they can be seen in adults as a result of trauma resulting from road traffic accidents and bullet injuries. However these foreign bodies, if associated with high velocity, can cause greater harm at skull base by casing injury to vital structures. Hence safe planning and removal is warranted. We present a case of a 48 year old female with an impacted metallic foreign body in the sphenoid. Endoscopic removal of the foreign body was was done.J MEDICINE July 2016; 17 (2) : 115-117

Case Exercise: Toxic Exposure-Related Illness: Causation, Diagnosis, and Permanent Impairment

2007 ◽  
Vol 12 (2) ◽  
pp. 4-8
Author(s):  
Frederick Fung
Keyword(s):  
Concentration Level ◽  
Treatment Plan ◽  
Toxic Exposure ◽  
Dose Response Relationship ◽  
Specialty Board ◽  
History Of ◽  
Subjective Complaints ◽  
Based Medicine ◽  
Illness Causation ◽  
Rule Out

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.

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