Generalised urticaria following ingestion of a nickel-plated coin in a 4-year-old girl

2020 ◽  
Vol 13 (9) ◽  
pp. e234601 ◽  
Author(s):  
Isabelle Duchesnay ◽  
Michael H Livingston ◽  
Lisa VanHouwelingen ◽  
J Mark Walton
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Nickel Content ◽  
Endoscopic Removal ◽  
Nickel Plating ◽  
Postoperative Course ◽  
Abdominal Radiographs

We report the case of a 4-year-old girl who presented to the emergency department after ingestion of a nickel-plated coin. Abdominal radiographs confirmed the presence of a coin in her stomach but she was otherwise asymptomatic. She was discharged with assurances that the foreign body would pass spontaneously. The patient developed significant generalised urticaria the next day, which became progressively more severe. Her symptoms prompted endoscopic removal of the nickel-plated coin and a postoperative course of corticosteroids and antihistamine therapy. This is the first reported case of generalised urticaria secondary to ingestion of a coin with nickel plating only (2% nickel content overall). A review of similar cases is provided.

scholarly journals Successful Endoscopic Removal of 42 Magnetic Balls

2017 ◽  
Vol 08 (02) ◽  
pp. 081-082
Author(s):  
Michael Dole ◽  
Girish Hiremath
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Surgical Management ◽  
Surgical Procedures ◽  
Clinical Case ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Endoscopic Removal ◽  
Emergency Department Presentation ◽  
Gastrointestinal Mucosa

ABSTRACTForeign body ingestion in pediatric patients is a common emergency department presentation. Despite a ban and recall in 2014 for the magnetic toy “Buckyballs” due to posing a deadly risk if ingested, clinical cases continue to occur. The need for surgical management in the setting of multiple magnet ingestions is related to compromised blood supply when at least two magnets are attracted while separated by gastrointestinal mucosa, and previous studies have indicated that the majority of multiple magnet ingestions require surgical intervention. In the setting of a known recent ingestion, endoscopic removal can potentially safely avoid the morbidity and mortality associated with surgical procedures. We present an interesting clinical case of multiple magnetic ingestion managed with endoscopic procedure.

scholarly journals Recurrent trichobezoar in a patient with Rapunzel syndrome

2021 ◽  
Vol 17 (1) ◽  
pp. 64-66
Author(s):  
Joanna Godlewska ◽  
◽  
Justyna Orpiszewska ◽  
Wojciech Górecki ◽  
◽  
...  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Psychiatric Treatment ◽  
Psychological Care ◽  
Invasive Treatment ◽  
Rapunzel Syndrome ◽  
Postoperative Course ◽  
Proximal Small Intestine ◽  
Proximal Intestine

Rapunzel syndrome is a condition where a trichobezoar is formed in the stomach and proximal intestine due to hair ingestion. A 6-year-old girl presented to emergency department with abdominal pain, vomiting and a palpable epigastric mass. Laparotomy was performed for gastric foreign body; a trichobezoar that filled the stomach, duodenum and proximal small intestine was removed. Postoperative course was uncomplicated; the patient was discharged for further out-patient follow-up and psychological care. After 7 months, the girl presented with a recurrence. A recurrent trichobezoar was removed via laparotomy. The girl was started on psychiatric treatment and iron substitution for anaemia. Ten weeks after discharge, follow-up gastroscopy was negative for gastric foreign body. There are no guidelines for follow-up after trichobezoar removal. Since the disease may be recurrent, follow-up endoscopy should be considered in order to enable an early diagnosis and less invasive treatment.

scholarly journals Rectal foreign body: a case report

2017 ◽  
Vol 4 (3) ◽  
pp. 1119
Author(s):  
Robin George Cheereth ◽  
George Abraham Ninan
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Computerized Tomography ◽  
Anal Incontinence ◽  
Foreign Bodies ◽  
Primary Repair ◽  
Abdominal Radiographs ◽  
Early Decision ◽  
Emergent Laparotomy

Colorectal foreign bodies are infrequently encounteredand present a dilemma for management. The diagnosis may be confirmedby plain abdominal radiographs and rectal examination, butabdominal computerized tomography with 3-D reconstruction can be decisive in thefurther management and must be advised without reconsideration. Transanal removal is only possible for very low-lying objects, while patients with high-lying foreign bodiesusually require anoperative intervention. An early decision of laparotomy should only be madeafter subjecting the patient to suitable investigations to determineexactly the localization of the object, in order toavoid any inadvertent damage to the adjoining vasculatureas well as anal incontinence. We report the case of a youngadult male who presented in the emergency department with a Hand Held Bidet Shower inserted per rectum. Transanal removal was unsuccessful and Emergent laparotomy with colotomy and primary repair was necessary for safe removal of the same.

Gorilla Glue Ingestion in Dogs: 22 Cases (2005–2019)

2021 ◽  
Author(s):  
Sarah Friday ◽  
Christina Murphy ◽  
Daniel Lopez ◽  
Philipp Mayhew ◽  
David Holt
Keyword(s):  
Foreign Body ◽  
Case Reports ◽  
Clinical Findings ◽  
Surgical Removal ◽  
Mechanical Obstruction ◽  
Endoscopic Removal ◽  
Short Term ◽  
Methylene Diphenyl Diisocyanate ◽  
Abdominal Palpation ◽  
Abdominal Radiographs

ABSTRACT Gorilla Glue contains methylene diphenyl diisocyanate that expands significantly and hardens once exposed to moisture. Case reports of methylene diphenyl diisocyanate glue ingestion in dogs document gastrointestinal foreign body formation and mechanical obstruction. Medical record queries from four veterinary hospitals identified 22 dogs with Gorilla Glue ingestion. Records were evaluated retrospectively to characterize clinical presentation, diagnostic findings, treatment, and patient outcome. Vomiting was the most common clinical sign (n = 11), with a median time from ingestion to presentation of 42 hr. Abnormal abdominal palpation (e.g., pain) was the most reported examination finding (n = 13). Radiographs were performed in 18/22 dogs, with Gorilla Glue expansion described as granular or mottled soft tissue with gas in the stomach. In 73% (11/15) of dogs requiring surgery, history, clinical findings, and survey abdominal radiographs sufficed to proceed with celiotomy. Surgical removal of the Gorilla Glue foreign body was performed via gastrotomy (n = 14) or gastrotomy and duodenotomy (n = 1). Endoscopic removal was performed in one dog. One dog with suspected mechanical obstruction was euthanized owing to financial constraints. Remaining cases were managed conservatively (n = 5). Short-term prognosis following appropriate fluid therapy and surgical or endoscopic removal was very good.

Duodenogastric Intussusception with Concurrent Gastric Foreign Body in a Dog: A Case Report and Literature Review

2013 ◽  
Vol 49 (1) ◽  
pp. 64-69 ◽  
Author(s):  
David A. Allman ◽  
Michael P. Pastori
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Foreign Body ◽  
Soft Tissue ◽  
Soft Tissue Mass ◽  
Foreign Object ◽  
Endoscopic Removal ◽  
Tissue Mass ◽  
Abdominal Radiographs

A 3 yr old spayed female boxer weighing 22.8 kg was presented for severe, acute vomiting and tenesmus. Tachycardia, tachypnea, dehydration, and abdominal pain were present on physical examination. Abdominal radiographs showed a foreign object (golf ball) in the fundus of the stomach, and a larger, round, soft-tissue opacity mass in the region of the pylorus. Endoscopic removal of the foreign object was unsuccessful. A large soft-tissue mass (duodenogastric intussusception) was visualized with endoscopy, but was not correctly diagnosed until surgery. A midline exploratory celiotomy was performed and the duodenogastric intussusception was diagnosed and manually reduced. Severe pyloric wall edema and minimal bruising were present. A routine fundic gastrotomy was performed and the foreign object was removed. A right-sided incisional gastropexy and duodenopexy were performed in attempt to prevent recurrence of the intussusception. The dog was discharged from the hospital 38 hrs after surgery, and was normal on follow-up 1 yr after surgery. The dog in this report is the sixth documented case of duodenogastric/pylorogastric intussusception in the veterinary literature. This is the first reported case with a concurrent gastric foreign body and endoscopic visualization of the intussusception.

Use of Ophthalmic Sonography to Evaluate for Intraocular Foreign Body in Both Outpatient and Emergency Department/Urgent Care Patients

2021 ◽  
pp. 875647932110332
Author(s):  
Patrick J. Fish
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Outpatient Setting ◽  
Intraocular Foreign Body ◽  
Urgent Care ◽  
Posterior Chamber ◽  
Emergency Department Setting ◽  
Before And After ◽  
Glass Metal

Intraocular foreign bodies (IOFB) present differently depending on the type of material (wood, glass, metal) for the IOFB, extent of the injury, and location of the injury. IOFB and the injury can cause a perforation or penetration of the globe which can require more extensive treatment including surgery. Proper evaluation of the IOFB and injury can help to determine extent of the injury, the prognosis of the vision, and health of the eye before and after treatment but may be difficult for the physician depending on the view of the posterior chamber being compromised by media or simply by patient sensitivity. The extent of the injury may also prevent proper evaluation due to swelling, lacerations on the lids, or pain. Proper ophthalmic sonography can provide a quick evaluation of the globe for any IOFB in both the outpatient setting as well as emergency department setting. Evaluation via sonography may allow the physician to accurately diagnose and properly treat the patient to help restore and prevent further loss of vision.

Unsuspected Foreign Bodies of the Aerodigestive Tract

1978 ◽  
Vol 87 (4) ◽  
pp. 515-518 ◽  
Author(s):  
William Banks ◽  
William P. Potsic
Keyword(s):  
Foreign Body ◽  
Early Diagnosis ◽  
Chart Review ◽  
Foreign Bodies ◽  
Failure To Thrive ◽  
Late Complications ◽  
Aerodigestive Tract ◽  
Endoscopic Removal ◽  
Children's Hospital ◽  
Prolonged Duration

The well-known tendency for children to place loose objects in their months not infrequently leads to the entrapment of foreign bodies in the aerodigestive tract. With prompt and adequate removal few complications occur. However, when the foreign body goes undetected or is neglected the patient may develop dysphagia, pneumonia, failure to thrive, lung or mediastinal abscesses, bronchopulmonary or bronchoesophageal fistulas, or erosion of major vessels. Fifteen cases of retained foreign bodies were identified in a chart review between 1971 and 1977 at the Children's Hospital of Philadelphia, calling attention to the problems of aerodigestive foreign bodies of prolonged duration. Early and late complications are discussed and early diagnosis and endoscopic removal emphasized.

scholarly journals Pharmacological Management of Esophageal Food Bolus Impaction

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Yasir Mohammed Khayyat
Keyword(s):  
Foreign Body ◽  
Channel Blockers ◽  
Endoscopic Removal ◽  
Food Bolus ◽  
Pharmacological Management ◽  
Mesh Terms ◽  
Food Bolus Impaction ◽  
Bolus Impaction ◽  
Effervescent Agents ◽  
Manual Review

Background. Soft esophageal bolus impaction is an emergency that requires skilled endoscopic removal if persistent obstructive symptoms do not resolve spontaneously after careful observation. Expedited care of these patients is crucial to avoid respiratory and mechanical complications. Other possible options for management include medical agents used to manage it prior to performing endoscopy if access to endoscopy was not available or declined by the patient.Aim. To review the available pharmacological and other nonmedicinal options and their mechanism of relief for soft esophageal impaction.Method. Pubmed, Medline and Ovid were used for search of MESH terms pertinent including “foreign body, esophageal, esophageal bolus and medical” for pharmacological and non medicinial agents used for management of esophageal soft bolus impaction as well as manual review of the cross-references.Results. Several agents were identified including Buscopan, Glucagon, nitrates, calcium channel blockers, and papaveretum. Non medicinal agents are water, effervescent agents, and papain. No evidence was found to suggest preference or effectiveness of use of a certain pharmacological agent compared to others. Buscopan, Glucagon, benzodiazepines, and nitrates were studied extensively and may be used in selected patients with caution. Use of papain is obsolete in management of soft bolus impaction.

Idiopathic megacolon and megarectum in an adult treated with laparoscopic modified Duhamel procedure

2021 ◽  
Vol 14 (6) ◽  
pp. e240209
Author(s):  
Maureen Elvira Padernal Villanueva ◽  
Marc Paul Jose Lopez ◽  
Mark Augustine S Onglao
Keyword(s):  
Emergency Department ◽  
Chronic Constipation ◽  
Ganglion Cells ◽  
Rectal Biopsy ◽  
Full Thickness ◽  
Postoperative Course ◽  
Idiopathic Megacolon ◽  
Duhamel Procedure ◽  
Idiopathic Megarectum ◽  
Sigmoid Loop Colostomy

Idiopathic megacolon (IMC) and idiopathic megarectum (IMR) describe an abnormality of the colon or rectum, characterised by a permanent dilatation of the bowel diameter in the absence of an identifiable cause. We present a 23-year-old woman with chronic constipation and excessive straining during defecation who presented at the emergency department in partial gut obstruction with a palpable fecaloma. Manual faecal disimpaction and a sigmoid loop colostomy was initially done. A full thickness rectal biopsy was positive for ganglion cells. Further workup led to the diagnosis of chronic IMC and IMR. The patient underwent laparoscopic modified Duhamel procedure, with an uneventful postoperative course.

Foreign Body Ingestions in Children: Risk of Complication Varies With Site of Initial Health Care Contact

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 121-127 ◽  
Author(s):  
Ronald I. Paul ◽  
Katherine Kaufer Christoffel ◽  
Helen J. Binns ◽  
David M. Jaffe ◽  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Tertiary Care ◽  
Standard Of Care ◽  
Pediatric Emergency ◽  
Adverse Outcomes ◽  
Pediatric Emergency Department ◽  
Parent Supervision ◽  
Tertiary Care Hospitals ◽  
Patient Enrollment

Current recommendations for the management of pediatric foreign body ingestions are based on studies of patients cared for at tertiary care hospitals; they call for aggressive evaluation because of a high incidence of complications. Two hundred forty-four children with suspected foreign body ingestions were prospectively followed to analyze adverse outcomes, ie, procedures, complications, and hospitalizations. Patient enrollment into the study was from three sources: (1) patients who referred themselves to a tertiary pediatric emergency department, (2) patients referred to the same tertiary pediatric emergency department after an initial evaluation by another hospital or physician, and (3) Patients who reported their foreign body ingestions to a private pediatric practitioner participating in the study. Most children were well toddlers in normal circumstances, under parent supervision at the time of ingestion. Coins were the most common item ingested (46%). Procedures were done in 53 (24%) of 221 patients and complications occurred in 48 (22%) of 221. Complications were higher in patients referred to the emergency department (63%) than in emergency department self-referred patients (13%) or private practice patients (7%) (x2, P < .01). These findings demonstrate the risk of drawing conclusions regarding a universal standard of care from studies involving only hospital-based patients.

Sign in / Sign up

Export Citation Format

Share Document