Ileocecal Fistula Caused by Multiple Foreign Magnetic Bodies Ingestion

The incidence of accidental foreign body (FBs) ingestion is 100,000 cases/year in the US, with over than 80% of cases occurring in children below 5 years of age. Although a single FB may pass spontaneously and uneventfully through the digestive tract, the ingestion of multiple magnetics can cause serious morbidity due to proximate attraction through the intestinal wall. Morbidity and mortality depend on a prompt and correct diagnosis which is often difficult and delayed due to the patient's age and because the accidental ingestion may go unnoticed. We report our experience in the treatment of an 11-year-old child who presented to the emergency department with increasing abdominal pain, vomiting, diarrhea, and fever. Surgery evidenced an ileocecal fistula secondary to multiple magnetic FB ingestion with attraction by both sides of the intestinal wall. A 5-centimeter ileal resection was performed, and the cecal fistula was closed with a longitudinal manual suture. The child was discharged at postoperative day 8. After one year, the patient’s clinical condition was good.

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A Rake’s Progress

The Cognitive Autopsy ◽

10.1093/med/9780190088743.003.0025 ◽

2020 ◽

pp. 169-174

Author(s):

Pat Croskerry

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Shoulder Pain ◽

Heart Attack ◽

Correct Diagnosis ◽

Uneventful Recovery ◽

Left Shoulder ◽

Loss Of Consciousness ◽

Middle Aged ◽

Rake's Progress

This case discusses a middle-aged male who experiences abdominal pain and loss of consciousness at a mall. His wife believes he is having a heart attack and rushes him to a nearby emergency department. He is also experiencing some left shoulder pain and diaphoresis, which is misinterpreted at triage. This communication error leads to him being misassigned to a cardiac area. Eventually, the correct diagnosis is made, and the patient makes an uneventful recovery.

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Effectively reducing amylase testing using computer order entry in the emergency department: quality improvement without eliminating physician choice

Journal of Innovation in Health Informatics ◽

10.14236/jhi.v24i3.907 ◽

2017 ◽

Vol 24 (3) ◽

pp. 257 ◽

Cited By ~ 3

Author(s):

Cassie Jaeger ◽

Paul Sullivan ◽

James Waymack ◽

David Griffen Griffen

Keyword(s):

Emergency Department ◽

Acute Pancreatitis ◽

Abdominal Pain ◽

Diagnostic Testing ◽

Value Added ◽

Diagnostic Value ◽

Order Entry ◽

Computerized Provider Order Entry ◽

Quality Patient Care ◽

One Year

Background Amylase and lipase, pancreatic biomarkers, are measured in acute pancreatitis diagnosis. Since amylase testing does not add diagnostic value, lipase testing alone is recommended. Despite new recommendations, many physicians and staff continue to test both amylase and lipase.Objective To reduce unnecessary diagnostic testing in acute pancreatitis.Methods The pre-checked amylase test within the Emergency Department’s Computerized Provider Order Entry (CPOE) abdominal pain order set was changed to an un-checked state, but kept as an option to order with a single click. Amylase testing, lipase testing and cost were measured for one year pre and post intervention.Results Simple de-selection intervention reduced redundant amylase testing from 71% to 9%, resulting in a percent of decrease of 87% and an annualized saving of approximately $719,000 in charges.Conclusion CPOE de-selection is an effective tool to reduce non-value added activity and reduce cost while maintaining quality patient care and physician choice.

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Unusual case of mobile phone simulation SIM card’s outer case ingestion: wedged at laryngeal surface of epiglottis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190789 ◽

2019 ◽

Vol 5 (2) ◽

pp. 514

Author(s):

Rachna Dhingra ◽

Jai Lal Davessar ◽

Shruti Sharma ◽

Kanwalpreet Kaur

Keyword(s):

Emergency Department ◽

Foreign Body ◽

Mobile Phone ◽

Unusual Case ◽

Foreign Bodies ◽

Pediatric Population ◽

Title Page ◽

Common Occurrence ◽

Accidental Ingestion ◽

Emergency Department Attendance

<div class="page" title="Page 2"><div class="layoutArea"><div class="column"><p class="abstract">Accidental ingestion of foreign bodies in the pediatric population is usually small pieces from toys or other household objects and subsequent emergency department attendance is a common occurrence. Here we describe an unusual case of accidental swallowing where the foreign body is outer case of mobile phone simulation (SIM) card.</p></div></div></div>

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A Complicated Case of Foreign Body Oesophagus in an Infant

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2015.v23i1.36 ◽

2015 ◽

Vol 23 (1) ◽

pp. 31-33

Author(s):

Arvind Kumar Verma ◽

Ruma Guha ◽

Chiranjib Das ◽

Saumendra Nath Bandopadhyay

Keyword(s):

Foreign Body ◽

Elderly People ◽

Foreign Bodies ◽

Psychiatric Patients ◽

Technical Difficulty ◽

Accidental Ingestion ◽

Complicated Case ◽

Delay In Diagnosis ◽

One Year ◽

Safety Pin

Ingestion of foreign bodies is common primarily in children, psychiatric patients, alcoholics and elderly people who use dentures. Selivanov et al. reported that, in most cases of foreign body ingestion, the most common foreign bodies ingested were coins, bones, food debris, safety pins and razor blades. Rarity, technical difficulty in removing the foreign body, complications associated with the delay in diagnosis and treatment, migration of the foreign body extraluminally, site, shape and position of the sharp end of a safety pin makes this case interesting and worth reporting. We are reporting a case of a one year child presenting to us with accidental ingestion of a safety pin. The case was difficult because the protected end of the safety pin was broken which made both the ends of the foreign body sharp. Also, the ends of safety pin were wide apart and pointing upwards.

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Abdominal Surgery

Clinical SAQs for the Final FRCEM ◽

10.1093/med/9780198814672.003.0001 ◽

2019 ◽

pp. 1-18

Author(s):

Ashis Banerjee ◽

Anisa J. N. Jafar ◽

Angshuman Mukherjee ◽

Christian Solomonides ◽

Erik Witt

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Foreign Body ◽

Abdominal Surgery ◽

Sigmoid Volvulus ◽

Short Answer ◽

Ingested Foreign Body ◽

Accompanying Symptoms ◽

Short Answer Questions ◽

Emergency Doctor

This chapter on abdominal surgery contains eight clinical Short Answer Questions (SAQs) with explanations and sources for further reading. Possible causes and accompanying symptoms of abdominal pain that may present in the emergency department include appendicitis, cholecystitis, cholangitis, ingested foreign body, rectal bleeding, gastric or sigmoid volvulus and post-laparoscopy complications.. It will be up to the emergency doctor to assess, diagnose, and decide upon a treatment path for each patient. The cases described in this chapter are all situations any emergency doctor is likely to encounter at some point in his or her career. The materials in this chapter will greatly aid revision for the Final FRCEM examination.

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Differences in healthcare visit frequency and type one year prior to stroke among young versus middle-aged adults

BMC Health Services Research ◽

10.1186/s12913-021-06064-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Brandi L. Vollmer ◽

Xing Chen ◽

Erin R. Kulick ◽

Mitchell S. V. Elkind ◽

Amelia K. Boehme

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Healthcare Utilization ◽

Preventive Care ◽

Age Groups ◽

Emergency Department Visits ◽

The Us ◽

Potential Risk Factors ◽

One Year ◽

Middle Aged Adults

Abstract Background The incidence and prevalence of stroke among the young are increasing in the US. Data on healthcare utilization prior to stroke is limited. We hypothesized those < 45 years were less likely than those 45–65 years old to utilize healthcare in the 1 year prior to stroke. Methods Patients 18–65 years old who had a stroke between 2008 and 2013 in MarketScan Commercial Claims and Encounters Databases were included. We used descriptive statistics and logistic regression to examine healthcare utilization and risk factors between age groups 18–44 and 45–65 years. Healthcare utilization was categorized by visit type (no visits, inpatient visits only, emergency department visits only, outpatient patient visits only, or a combination of inpatient, outpatient or emergency department visits) during the year prior to stroke hospitalization. Results Of those 18–44 years old, 14.1% had no visits in the year prior to stroke compared to 11.2% of individuals aged 45–65 [OR = 1.30 (95% CI 1.25,1.35)]. Patients 18–44 years old had higher odds of having preventive care procedures associated with an outpatient visit and lower odds of having cardiovascular procedures compared to patients aged 45–65 years. Of stroke patients aged 18–45 and 45–65 years, 16.8 and 13.2% respectively had no known risk for stroke. Conclusions Patients aged 45–65 were less commonly seeking preventive care and appeared to be seeking care to manage existing conditions more than patients aged 18–44 years. However, as greater than 10% of both age groups had no prior risk, further exploration of potential risk factors is needed.

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Mimickers of Acute Appendicitis

10.5772/intechopen.96351 ◽

2021 ◽

Author(s):

Esam Amer

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Emergency Department ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Imaging Modality ◽

Correct Diagnosis ◽

Emergency Setting ◽

Magnetic Resonance Imaging Mri ◽

Clinical Conditions

Acute appendicitis (AA) is a common surgical diagnosis in patients presenting to the Emergency Department with acute abdominal pain. A wide variety of other clinical conditions can present with a very similar presentation to acute appendicitis and therefore it can be occasionally challenging to make the correct diagnosis. In this review paper, the focus is to shed some light on the differential diagnosis of acute appendicitis which includes a variety of gastrointestinal, vascular, urological, and gynaecological conditions. In the emergency setting there are three main imaging modalities to evaluate patients presenting with abdominal pain, this includes computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI). The choice of imaging modality for each clinical condition is variable and as such being familiar with those differential diagnoses is vital in deciding what is the best imaging modality for every patient presenting with abdominal pain.

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A Curious Case of the Persistent Body Stuffer

Case Reports in Emergency Medicine ◽

10.1155/2019/3948054 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Muhammad Durrani ◽

Carla Dugas ◽

Samaresh Dasgupta

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Abdominal Pain ◽

Foreign Body ◽

Outlet Obstruction ◽

Oral Contrast ◽

Foreign Body Removal ◽

Plastic Bags ◽

Small Leak ◽

Body Stuffer

A 29-year-old male presented to our emergency department with complaint of abdominal pain after allegedly ingesting a 4-gram packet of heroin in an attempt to evade detection. Initial evaluation including computed tomography (CT) of the abdomen/pelvis with intravenous and oral contrast, as well as laboratory workup was negative and the patient was discharged. The patient returned 3 days later with complaint of “I feel high” and severe constipation, and demonstrated an opiate toxidrome requiring naloxone with improvement of symptoms. A repeat CT of the abdomen/pelvis, this time without contrast revealed a 2.1 × 1.8 cm foreign body in the gastric antrum. The patient was promptly taken to endoscopy with surgical backup. Foreign body removal included multiple plastic bags encasing heroin, which had sustained a small leak causing a gastric outlet obstruction as well as a slow opiate toxidrome. The foreign body was removed and the patient was observed and discharged with a favorable outcome.

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Opposites attract: a case of magnet ingestion

CJEM ◽

10.1017/s1481803500011696 ◽

2009 ◽

Vol 11 (05) ◽

pp. 493-495 ◽

Cited By ~ 12

Author(s):

Helen H.L. Wong ◽

Bruce A. Phillips

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Gastrointestinal Tract ◽

Foreign Body ◽

Bowel Wall ◽

Pediatric Population ◽

Abdominal Radiography ◽

Mild Abdominal Pain ◽

Magnet Ingestion ◽

Pass Through

ABSTRACT Foreign-body ingestion is relatively common in the pediatric population and most objects pass through the gastrointestinal tract with minimal complications. Popular toy magnetic construction sets have resulted in numerous reports in the literature of serious complications including death following ingestion of multiple magnets. We report a case of a 5-year-old girl who presented to our emergency department with nonbilious vomiting and mild abdominal pain after accidentally ingesting 2 magnets 10 hours apart. Abdominal radiography showed the presence of 2 magnets, and a laparoscopy revealed multiple areas of bowel wall necrosis and perforation requiring subsequent laparotomy for repair of the bowel wall and retrieval of the magnets. This report aims to alert emergency care physicians of the necessity for early surgical referral with any multiple magnet ingestion to prevent severe complications.

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Enterovesical Fistula Caused by a Toothpick

Case Reports in Urology ◽

10.1155/2015/902673 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Flavia Tombolini ◽

Vito Lacetera ◽

Giovanni Muzzonigro

Keyword(s):

Abdominal Pain ◽

Surgical Treatment ◽

Foreign Body ◽

Sigmoid Colon ◽

Computer Tomography ◽

Complete Resolution ◽

Fistulous Tract ◽

Segmental Resection ◽

Accidental Ingestion ◽

Enterovesical Fistula

We present a case of enterovesical fistula caused by an accidental ingestion of a foreign body. A 23-year-old man presented to our hospital with pneumaturia, fecaluria, and abdominal pain but no recent possible causes of enterovesical fistula at anamnesis. Cystoscopy, cystography, and also colonoscopy were not able to detect the fistulous tract. Computer tomography (CT) revealed a fistula between bladder and bowels caused by a toothpick accidentally swallowed 2 years earlier. We tried to remove the foreign body endoscopically by cystoscopy and colonoscopy but with no success. The failure of endoscopic procedures required a surgical treatment. The patient underwent laparoscopic segmental resection of the sigmoid colon to remove the fistulous tract and the foreign body. The cystography revealed no external leakage of contrast from the bladder with complete resolution of the problem.

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