An Unusually Large Object Removed From the Upper Esophagus in a Patient With Self Harm Syndrome

A 32-year-old female with a history of bipolar disorder and schizophrenia was transported to our tertiary-care hospital after swallowing a large toilet paper holder bracket. Removal of the large foreign body required coordination between anesthesiology, otolaryngology, and trauma surgery. A tracheostomy airway was established, and the object was removed transorally. The object was found to be a toilet paper holder bracket measuring 7.5 cm × 5.4 cm × 5.4 cm with a 2.6 cm screw protruding from the end. A review of articles describing the removal of foreign bodies from the upper aerodigestive tract found our object to be the largest foreign body ingestion described in literature. One report suggested that 18% of adult patients with foreign body ingestions had primary neuropsychiatric disorders. Our patient’s psychiatric disorder was a major underlying factor leading to the ingestion, with our patient reporting hallucinations instructing her to ingest household objects.

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Endoscopic removal of foreign bodies from the upper aerodigestive tract: a retrospective study from a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192712 ◽

2019 ◽

Vol 5 (4) ◽

pp. 960

Author(s):

Sreeja Raj Vellamparambil ◽

Arjun Gopinath Menon ◽

Ariyamparambil Rajagopalan Vinayakumar

Keyword(s):

Retrospective Study ◽

Foreign Body ◽

Digestive Tract ◽

Clinical Examination ◽

Foreign Bodies ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Aerodigestive Tract ◽

Care Hospital ◽

Upper Aerodigestive Tract

Background: Foreign bodies (FB) in the upper aero-digestive tract pose major challenges to the otorhinolaryngologist in both diagnosis and management. Aspirated and ingested foreign bodies are often emergencies, leading to inadequate study, poor preparation and improper attempts at removal. A retrospective analysis was done on cases which were managed for the upper aero-digestive tract FBs in a tertiary care hospital in South India and the result is presented in this article.Methods: Retrospective study was done on 100 patients diagnosed as cases of foreign body in upper aerodigestive tract on the basis of detailed history, clinical examination and radiological investigation. They underwent per oral endoscopy under general anaesthesia for retrieval of foreign body. Results: Age group more prone for foreign body ingestion or aspiration was <10 years and >50 years. Most common site of impaction in oesophagus is cricopharynx and in airway is right bronchus. Most common type of FB is chicken bone. Most common symptom in FB ingestion is FB sensation and in case of FB aspiration it is cough. Most (82%) of the FBs were radio opaque.Conclusions: Accurate history and clinical examination were the keystones in diagnosis and prevention of complications of FB lodgement in aerodigestive tract. Negative history and or normal imaging do not rule out a foreign body.

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Tracheo-bronchial foreign bodies: our experience at a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20161848 ◽

2016 ◽

Author(s):

Shashidhar S. Suligavi ◽

Mallikarjun N. Patil ◽

S. S. Doddamani ◽

Chandrashekarayya S. Hiremath ◽

Afshan Fathima

Keyword(s):

Foreign Body ◽

Early Diagnosis ◽

Foreign Bodies ◽

Tertiary Care ◽

Case Series ◽

Team Work ◽

Care Hospital ◽

Retrospective Case ◽

Presenting Symptoms ◽

Case Series Study

Background:Tracheo- bronchial foreign bodies have always posed a challenge to the ENT surgeon as they present with varied symptomatology ranging from a simple cough and fever to more grave respiratory distress. It requires a strong suspicion, early diagnosis and timely intervention to reduce the overall morbidity and mortality .This study was undertaken to highlight our experiences in handling cases of tracheo- bronchial foreign bodies (FB) at our setup.Methods:It is a retrospective case series study conducted in S. Nijalingappa Medical College between January 2011 and January 2015. Results:Most commonly affected were children between 1year to 3years of age. Chronic cough and wheeze were the commonest presenting symptoms. Vegetative foreign body was found to be the commonest variety of foreign body. The mortality rate in our study was 4.7% (n=3).Conclusions:A good clinical acumen, team work, early diagnosis and timely intervention are all needed to reduce the overall mortality and morbidity associated with tracheo- bronchial foreign bodies.

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Migration of Ingested Fish Bone from Upper Aerodigestive Tract to the Skin of the Neck

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2015.v23i2.51 ◽

2015 ◽

Vol 23 (2) ◽

pp. 81-83

Author(s):

Mukulika Saha ◽

Amit Chakrabarti ◽

Amit Bikram Maity ◽

Satadal Mandal

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Muscular Contraction ◽

Fish Bone ◽

Surrounding Tissue ◽

Upper Aerodigestive Tract ◽

Intact Skin ◽

Hollow Viscus ◽

Unusual Event ◽

History Of

IntroductionIngested foreign bodies commonly get impacted in the upper aero digestive tract, but only a few of these foreign bodies have perforated the oesophagus and an even smaller number of these have migrated extraluminally. Case reportA 43 year old male patient presented with history of accidental ingestion of fish bone (F.B) 3 weeks back. On examination a sharp pointed swelling was seen over right side of neck and on palpation a pointed object was felt beneath the intact skin. Digital X-ray, ultrasonography of the neck and CT scan neck showed a linear obliquely placed foreign body on right side of neck at the level of thyroid gland. The foreign body was easily removed by an incision over the skin and was confirmed to be a fish bone. DiscussionHorizontally oriented foreign bodies are more likely to penetrate the lumen of a hollow viscus. The muscular contraction of the neck might account for this unusual event to some extent, one possible factor being that the presence of the foreign body in the soft tissue might have led to inflammation and oedema, which made the texture of the surrounding tissue loose and lax ; a sort of gel-sol interconversion.

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Migration of a Swallowed Blunt Foreign Body to the Neck

Case Reports in Otolaryngology ◽

10.1155/2014/646785 ◽

2014 ◽

Vol 2014 ◽

pp. 1-2

Author(s):

Kerem Ozturk ◽

Goksel Turhal ◽

Sercan Gode ◽

Atilla Yavuzer

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Primary Closure ◽

Foreign Bodies ◽

Barium Swallow ◽

X Rays ◽

Upper Aerodigestive Tract ◽

Computed Tomography Scans ◽

History Of ◽

The Right

Ingestion of foreign bodies is a common problem in the otolaryngology practice. Reports of extraluminal migration of the foreign bodies from the upper aerodigestive tract are rare. Penetration and extraluminal migration of ingested foreign bodies may cause severe vascular and suppurative complications, even death. We report a 4-year-old girl who presented with a mass and partial extrusion of a foreign body in the neck. She had a history of ingesting the plastic top piece of a knitting needle approximately 1 year ago. She had been asymptomatic until the present time. The examination revealed a red, blunt, rectangular plastic foreign body half embedded in the skin of the right neck. Esophagography with barium swallow, cervical X-rays, and computed tomography scans were obtained. The foreign body was easily removed under general anesthesia. Primary closure and direct laryngoscopy was also performed. The patient recovered very well without any complications.

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A152 FOREIGN BODY INGESTIONS AT A TERTIARY CARE CENTRE - A QUALITY ASSURANCE STUDY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.151 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 16-17

Author(s):

T Mullen ◽

G Williams

Keyword(s):

Quality Assurance ◽

Foreign Body ◽

Foreign Bodies ◽

Tertiary Care ◽

Therapeutic Interventions ◽

Care Hospital ◽

Food Bolus ◽

Tertiary Care Centre ◽

Endoscopic Techniques ◽

Endoscopic Method

Abstract Background Foreign body ingestion and esophageal food bolus impaction are common emergencies encountered by gastroenterologists. If not treated in a timely fashion these can result in significant morbidity, or even mortality. The mainstay of diagnosis and therapy is endoscopy. Guidelines regarding timing of endoscopy have been published by both the American and European Societies of Gastrointestinal Endoscopy, and both suggest emergent endoscopy, meaning within 2 to 6 hours, for complete esophageal obstructions. There is relatively sparse data regarding the endoscopic techniques used in real world practice. Aims This is a quality assurance study looking at the endoscopic practices at an adult tertiary care hospital in Halifax, Nova Scotia with respect to foreign body and food impaction management. Methods The hospital records of all patients presenting with ingested foreign bodies or esophageal food bolus impactions between May 2018 and July 2019 were included. Patients were identified by searching the call-back forms used by our department which documents all on-call endoscopy cases. This was then cross-referenced by endoscopy nursing charting which documents every endoscopy performed. Information such as demographics, obstruction type, endoscopic method of removal, complications, time between consultation and endoscopy, underlying pathology, and others were analyzed. Results 70 cases were identified. Average patient age was 51.3 years old (range 16–96). 18 (25.7%) were female and 52 (74.3%) were male. 64 cases (91.4%) were esophageal food impactions and 6 (8.57%) were foreign body ingestions. Of the food impactions, 39 cases (60.9%) were cleared by the push/slide-by technique only and 10 (16.7%) were relieved using instruments such as snares, forceps, or nets. 15 (23.4%) passed spontaneously prior to scope, of which 7 received glucagon. An overtube was used in 1 case (0.16%). Complications occurred in 5 (7.8%) cases and included 3 mucosal tears, 2 of which required therapeutic interventions, and 2 episodes of oxygen desaturation in which the procedure was aborted. Complete obstructions occurred in 42 (65.6%) cases with average time of consultation to endoscopy of 2.4 hours. However, 3 (7.1%) cases exceeded 6 hours. The most common pathology was eosinophilic esophagitis with 20 cases (31.3%). Ingested foreign bodies included 2 long objects, 3 sharp objects, and a cylindrical battery, and all but one were in the stomach. 5 (83.3%) cases used an overtube. No complications occurred. Conclusions At our institution 67/70 (95.7%) cases were performed within the timelines recommended by society guidelines. No complications occurred in the cases not performed within those time limits. An overtube was used in only one case in which a food bolus was retrieved out of the esophagus. Overall this study suggests that our centre is meeting recommended targets, however there is room for improvement. Funding Agencies None

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Study on prevalence of foreign bodies in ENT

Integrative Journal of Medical Sciences ◽

10.15342/ijms.7.219 ◽

2020 ◽

Vol 7 ◽

Author(s):

Shilpi Agrawal ◽

Haritosh K. Velankar

Keyword(s):

Foreign Body ◽

Emergency Room ◽

General Anaesthesia ◽

Foreign Bodies ◽

Tertiary Care ◽

Age Groups ◽

Care Hospital ◽

Cross Sectional ◽

Common Location ◽

Nose And Throat

Introduction- Foreign body is a substance that doesn’t belong to a location where it is found. Ear,nose and throat are common location for occurence of foreign bodies. It is a common problem encountered in both adults and children. Objective- 1) To analyse the different kinds of foreign bodies in ear ,nose and throat and their prevalence in different age groups. 2) To analyse the most prevalent site of foreign body among ear, nose and throat.Methods- A cross-sectional study was performed in our tertiary care hospital in Navi-mumbai. The study period was from august 2017 to august 2019. The study population were the patients who came to the out patient department and emergency room of this hospital.Result- A total of 100 patients as sample size with foreign bodies in ear, nose or throat were taken on first come basis. 62 were males and 38 were females. Of the 100 patients, 36 had foreign body in ear, 47 in nose and 17 in the throat. The foreign body was removed under local anaesthesia in 4% patients, with general anaesthesia in 30 % and with no anaesthesia at all in 66% patients. The most common age group affected was less than 10 years among both male and female patients.Conclusion- The most frequent site of foreign body occurrence was found to be nose. The most common site requiring general anaesthesia for foreign body removal was throat. Although most of the foreign bodies could be removed without any anaesthesia in the emergency room or outpatient department.

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Surgical Procedure among Patients with Foreign Body Obstruction in Food Passage in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5704 ◽

2021 ◽

Vol 59 (237) ◽

Author(s):

Krishna Chandra Rijal ◽

Krishna Prasad Koirala ◽

Ashish Khadgi

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Care Center ◽

Tertiary Care ◽

Neck Surgery ◽

Cross Sectional Study ◽

Care Hospital ◽

Food Passage ◽

Cross Sectional ◽

Foreign Body Obstruction

Introduction: Foreign body is any object in a region it is not meant to be, where it can cause harm if immediate medical attention is not sought. Its removal by surgical procedure is one of the commonest surgeries done. The objective is to find out prevalence of the patients who underwent operation for foreign bodies obstruction in food passage in the Department of Otorhinolaryngology-Head and Neck Surgery in a tertiary care centre. Methods: A descriptive cross-sectional study conducted among patients operated in the Department of Otorhinolaryngology and Head and Neck Surgery of a tertiary care center from August 2014 to May 2017. Ethical approval was received from the Institutional Review Committee of the Institute. Convenience sampling method was used. Statistical Package for the Social Sciences was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total 700 patients having operation in department, 115 (16.42%) (95% Confidence Interval = 13.67–19.16) had operation for foreign body obstruction in the food passage. Among 115 patients, 62 (53.90%) were males and 53 (46.10%) were females. Most common foreign bodies ingested in children was coin 17 (14.78%) and bone chips 40 (34.78%) in adults. Cricopharynx 90 (78.26%) is the commonest site for foreign body lodgement. Conclusions: Prevalence of the patients who underwent operation for foreign bodies obstruction in food passage in a tertiary care hospital is high. Their removal by rigid oesophagoscopy is one of the commonest surgical procedures done in tertiary care center.

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Challenges in treating patients with foreign bodies in hypopharynx and esophagus: our experience in a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213902 ◽

2021 ◽

Vol 7 (10) ◽

pp. 1660

Author(s):

Nambiar Sapna S. ◽

Swathilal S. A. ◽

Sunilkumar K. P. ◽

Soumya Aravind M. V.

Keyword(s):

Foreign Body ◽

Esophageal Perforation ◽

Foreign Bodies ◽

Tertiary Care ◽

Care Hospital ◽

Foreign Body Removal ◽

Rigid Endoscopy ◽

Sudden Decrease ◽

High Index Of Suspicion ◽

A Prospective Study

Background: Foreign bodies (FBs) of the hypopharynx and esophagus are among the common otolaryngologic emergencies. Every new case poses a clinical challenge with need for optimal treatment strategy. The objective of our study is to highlight a few of the challenges faced while treating these patients.Methods: A prospective study was done on all patients who reported to the ENT casualty, Government Medical College Kozhikode with history or suspicion of foreign body throat from January 2020 to January 2021. A total of 160 patients reported of which 48 (30%) patients required further evaluation with rigid endoscopy and foreign body removal in the operative room. A few challenges like migration of foreign bodies, dilemma in diagnosis with FB mimicking ossified cartilages on X-ray, FB removal in mentally challenged patients and treatment of esophageal perforation post rigid endoscopy are discussed.Results: Only 48 (30%) patients of the total 160 patients required rigid endoscopy and foreign body removal in the operating room. The foreign body was obtained in 42 (87.5%) patients while 6 (12.5%) patients improved post rigid endoscopy though foreign body was not obtained. One patient with denture in the esophagus developed esophageal perforation requiring prolonged hospital stay.Conclusions: A high index of suspicion among patients presenting with dysphagia, neck pain and sudden decrease in food intake is warranted. Early diagnosis with appropriate imaging modalities is essential for confirmation of diagnosis. Dentures are among FBs that necessitate more caution. Esophageal perforation, a rare but life-threatening complication must be diagnosed timely with appropriate surgical intervention.

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Nosocomial Transmission of Methicillin-Resistant Staphylococcus aureus: A Blinded Study to Establish Baseline Acquisition Rates

Infection Control and Hospital Epidemiology ◽

10.1086/502224 ◽

2003 ◽

Vol 24 (6) ◽

pp. 415-421 ◽

Cited By ~ 52

Author(s):

Joel T. Fishbain ◽

Joseph C. Lee ◽

Honghung D. Nguyen ◽

Jeffery A. Mikita ◽

Cecilia P. Mikita ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Transmission Rate ◽

Tertiary Care ◽

Pediatric Intensive Care ◽

Nosocomial Transmission ◽

Surveillance Culture ◽

Care Hospital ◽

Average Hospital ◽

Methicillin Resistant ◽

History Of

AbstractObjective:To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.Design:A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA Risk factors associated with the likelihood of MRSA colonization on admission were investigated.Setting:Tertiary-care military medical facility.Participants:All patients admitted to the medicine, surgery, and pediatric wards, and to the medical, surgical, and pediatric intensive care units were eligible for inclusion.Results:Five hundred thirty-five admission and 374 discharge samples were collected during the study period. One hundred forty-one patients were colonized with methicillin-susceptible S. aureus (MSSA) and 20 patients (3.7%) were colonized with MRSA on admission. Of the 354 susceptible patients, 6 acquired MRSA during the study for a transmission rate of 1.7%. Patients colonized with MRSA on admission were more likely to be older than non-colonized or MSSA-colonized patients, to have received antibiotics within the past year, to have been hospitalized within the prior 3 years, or to have a known history of MRSA. Patients acquiring MRSA had an average hospital stay of 17.7 days compared with 5.3 days for those who did not acquire MRSA. Pulsed-field gel electrophoresis of the 6 MRSA isolates from patients who acquired MRSA revealed 4 distinct band patterns.Conclusions:Most patients colonized with MRSA were identified on admission samples. Surveillance cultures of patients admitted may help to prevent MRSA transmission and infection.

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Endobronchial Foreign Body Presenting as Exacerbation of Asthma

Case Reports in Emergency Medicine ◽

10.1155/2017/6863083 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

James E. Tsang ◽

June Sun ◽

Gaik C. Ooi ◽

Kenneth W. Tsang

Keyword(s):

Foreign Body ◽

Respiratory Distress ◽

Foreign Bodies ◽

Main Bronchus ◽

Fiberoptic Bronchoscopy ◽

Clinical History ◽

Medical Personnel ◽

History Of ◽

Normal Chest ◽

Low Dose Computed Tomography

Airway foreign bodies are a leading cause of death among children and require urgent recognition by medical personnel. While most cases are diagnosed readily from a clinical history of acute respiratory distress, some cases remain more indolent and present later. We report the case of a 7-year-old boy who aspirated a “LEGO” toy and presented with a week history of increasing respiratory distress compatible with known asthma. Despite a normal chest X-ray, a low-dose computed tomography showed the presence of a foreign body in the left main bronchus, which was subsequently removed by fiberoptic bronchoscopy. Our case serves to reemphasize the importance of considering airway foreign bodies as a cause of respiratory distress, especially in young children.

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