Orbital tumour or a retained foreign body? An uncommon case of missed diagnosis

2021 ◽  
pp. 004947552098125
Author(s):  
Anju Rastogi ◽  
Tanvi Gaonker ◽  
Shweta Dhiman ◽  
Ketaki Rajurkar
Keyword(s):  
Foreign Body ◽  
Delayed Presentation ◽  
Inflammatory Infiltration ◽  
Orbital Tumour ◽  
Retained Foreign Body ◽  
Oral Steroids ◽  
Wooden Foreign Body ◽  
Missed Diagnosis ◽  
Uncommon Case ◽  
One Year

We report a case who presented with decreased vision, significant hypotropia, proptosis and gross limitation of extraocular motility for one year. Suspecting an orbital tumour, we asked for a computed tomography of the orbit which revealed a mass lesion in the inferior orbit. However, incisional biopsy reported inflammatory infiltration. Diagnosing it as orbital inflammatory disease, a course of oral steroids was given for four weeks. It was only after the reduction in inflammation that a foreign body was palpable in the inferior fornix. Surgical exploration revealed a large wooden foreign body measuring 3.3 × 1 × 0.3 cm. Though intraorbital foreign bodies are not rare, ambiguous history, delayed presentation and nonspecific CT findings made this case diagnostically challenging.

Juxtapontine abscess around a retained wooden fragment following a penetrating eye injury: surgical management via a transtentorial approach

2012 ◽  
Vol 9 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Sunil K. Gupta ◽  
Alok A. Umredkar
Keyword(s):  
Foreign Body ◽  
Brain Abscess ◽  
Surgical Management ◽  
Penetrating Injury ◽  
Eye Injury ◽  
Retained Foreign Body ◽  
Penetrating Eye Injury ◽  
Wooden Foreign Body ◽  
Transtentorial Approach

Penetrating injury through the orbit with a retained intracranial wooden foreign body is rare. The authors report the case of a child with a juxtapontine brain abscess secondary to a retained foreign body. The pitfalls in diagnosis and the surgical management for removal of the wooden fragment and drainage of the abscess are discussed.

scholarly journals Delayed Presentation of Submucosal Retained Toothbrush from Self-Inflicted Injury in Patient with Schizophrenia

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Caleb H. Creswell ◽  
Tony L. Kille ◽  
Matthew R. Hoffman ◽  
Tabassum Kennedy ◽  
Seth H. Dailey
Keyword(s):  
Foreign Body ◽  
Posterior Pharyngeal Wall ◽  
Psychiatric Disease ◽  
Delayed Presentation ◽  
Ct Reconstruction ◽  
Pharyngeal Wall ◽  
Retained Foreign Body ◽  
Body Sensation ◽  
History Of ◽  
The Right

Foreign body ingestion occurs in not only children but also adults, particularly those with history of neurologic disease, alcohol use, or psychiatric disease. We present the case of a 40-year-old male with schizophrenia who presented to the emergency room with a long history of pharyngeal foreign body sensation which had recently progressed to include trismus, odynophagia, and dyspnea. Flexible laryngoscopy demonstrated fullness of the right posterior pharyngeal wall and computed tomography (CT) showed a linear opaque foreign body extending from the level of the oropharynx to the thyroid ala. Further history elicited that he stabbed himself in the pharynx two years prior with a toothbrush following a command hallucination. The toothbrush was removed uneventfully via an external approach. The patient was discharged with psychiatry follow-up. This case is unusual due to the submucosal location of the foreign body and the length of retention. It demonstrates the atypical nature which patients with comorbid psychiatric illness may present following foreign body injury and the use of an external surgical approach for the removal of a retained foreign body based on CT reconstruction.

scholarly journals Retained Foreign Body in a Diabetic Patient’s Hand

2018 ◽  
Vol 12 (1) ◽  
pp. 203-207
Author(s):  
Frank Liaw ◽  
Odhrán Murray ◽  
Yan Yu Tan ◽  
Timothy Hems
Keyword(s):  
Foreign Body ◽  
Metacarpophalangeal Joint ◽  
Acute Injury ◽  
Delayed Presentation ◽  
Retained Foreign Body ◽  
Increased Risk ◽  
Limb Injuries ◽  
Previous Trauma ◽  
Risk Patients ◽  
History Of

Background: Diabetic peripheral neuropathy puts patients at increased risk of acute injury by foreign bodies and also contributes to delayed presentation and diagnosis. Case report: We describe a 57-year-old patient with poorly controlled type 1 diabetes who presented with a three-week history of worsening swelling and erythema in the metacarpophalangeal joint of his left thumb. He denied any previous trauma or injury and was initially treated with intravenous antibiotics. Subsequent imaging revealed septic arthritis and osteomyelitis secondary to a retained foreign body, which was surgically removed in theatre. Conclusion: This is the first reported case of a retained foreign body in the hand of a diabetic patient, and demonstrates the importance of early radiological imaging of peripheral limb injuries in high-risk patients.

Imaging and surgical approach to a pediatric penetrating intradural wooden splinter: case report

2018 ◽  
Vol 21 (4) ◽  
pp. 409-413
Author(s):  
Gabrielle Santangelo ◽  
Jonathan Stone ◽  
Tyler Schmidt ◽  
G. Edward Vates ◽  
Howard Silberstein ◽  
...  
Keyword(s):  
Foreign Body ◽  
Spinal Injury ◽  
Cauda Equina ◽  
Prophylactic Antibiotics ◽  
Csf Leak ◽  
Wood Floor ◽  
Penetrating Wound ◽  
Retained Foreign Body ◽  
Lower Back ◽  
Wooden Foreign Body

Penetrating spinal injuries by wood are infrequently reported. They are particularly rare in children. Only 6 cases of wooden fragments causing penetrating intradural spinal injury have been reported. The authors report a case of a 3-year-old girl who suffered a penetrating wound on her lower back after sliding on a wood floor. A portion of the extraspinal part of the wooden splinter was removed prior to presentation; however, a high suspicion for retained foreign body was maintained. Findings on CT were equivocal, but the diagnosis was confirmed on MRI. An incomplete cauda equina syndrome was noted on examination. She was taken to the operating room for removal of the wooden foreign body, repair of a durotomy, and repair of a CSF leak. At 8 months after surgery, the patient had fully recovered without sequelae. The roles of imaging modalities, prophylactic antibiotics, and surgery are discussed.

Intraorbital Wooden Foreign Body with Intracranial Extension : A Case Report

2018 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Amanda N Shinta ◽  
Purjanto Tepo Utomo ◽  
Agus Supartoto
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Frontal Lobe ◽  
Vital Sign ◽  
Intracranial Extension ◽  
Ocular Motility ◽  
Light Perception ◽  
Bone Segment ◽  
Wooden Foreign Body ◽  
Wooden Stick

Purpose : The aim of this study is to report a case of intraorbital wooden foreign body with intracranial extension to the frontal lobe and its management. Method : This is a descriptive study: A 53 year-old male referred due to wooden stick stucked in the orbital cavity causing protruding eyeball and vital sign instability. Result : Right eye examination revealed light perception visual acuity, with bad light projection and bad color perception, inwardly folded upper eyelid, proptosis, conjunctival chemosis, corneal erosion and edema, dilated pupil with sluggish pupillary light reflex and limited ocular movement in all direction. Vital sign was unstable with decreasing blood pressure, increasing temperature and heart rate. CT Scan showed complete fracture of the orbital roof due to penetration of the wooden stick, pneumoencephalus, cerebral edema and hematoma. Emergency craniotomy was performed to remove the penetrating wooden stick and bone segment in the frontal lobe and fracture repair. Ophthalmologist pulled the remaining stick, released the superior rectus muscle and repaired the lacerated eyelid. Outcome visual acuity was no light perception with lagophthalmos and limited ocular motility. Patient was admitted to Intensive Care Unit one day post-operatively and treated with systemic and topical antibiotic. Conclusion : Any case presenting with intraorbital foreign body must undergo immediate neuroimaging to exclude any intracranial extension, especially in patients with worsening general condition.

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 Intraorbital wooden foreign body detected by computed tomography and magnetic resonance imaging

2016 ◽  
Vol 30 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Alfredo Di Gaeta ◽  
Francesco Giurazza ◽  
Eugenio Capobianco ◽  
Alvaro Diano ◽  
Mario Muto
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Magnetic Resonance ◽  
Delayed Diagnosis ◽  
Clinical History ◽  
Definitive Diagnosis ◽  
Double Vision ◽  
Resonance Imaging ◽  
Wooden Foreign Body ◽  
The Right

To identify and localize an intraorbital wooden foreign body is often a challenging radiological issue; delayed diagnosis can lead to serious adverse complications. Preliminary radiographic interpretations are often integrated with computed tomography and magnetic resonance, which play a crucial role in reaching the correct definitive diagnosis. We report on a 40 years old male complaining of pain in the right orbit referred to our hospital for evaluation of eyeball pain and double vision with an unclear clinical history. Computed tomography and magnetic resonance scans supposed the presence of an abscess caused by a foreign intraorbital body, confirmed by surgical findings.

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