Is There a Need for Repeat Radiologic Examination of Children with Esophageal Coin Foreign Body?

2016 ◽  
Vol 156 (1) ◽  
pp. 173-179 ◽  
Author(s):  
Kavita Dedhia ◽  
Yue-Fang Chang ◽  
Rachel Leonardis ◽  
David H. Chi
Keyword(s):  
Foreign Body ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Cost Effective ◽  
Surgical Removal ◽  
Factors Affecting ◽  
X Ray ◽  
Institutional Review ◽  
Chest X Ray

Objectives To determine factors associated with the passage of coins. To determine the need for repeat preoperative chest x-ray (CXR) for esophageal coin foreign body. Setting Academic tertiary care center. Design Case series with chart review. Subjects and Methods Patient information was retrieved from an Institutional Review Board–approved database. We identified 1359 children with esophageal coin foreign bodies from 2001 to 2013. Patients with both initial diagnostic and immediate preoperative CXR were included. Results A total of 406 patients met inclusion criteria. The average age was 47 months (range, 1.8-194 months). On preoperative CXR, the position changed in 29 patients (7%). Age, type of coin, and location of coin were all statistically significant factors affecting the passage of the coin ( P < .0001). Coins in the distal esophagus were 9.3 times more likely to pass than coins in the proximal esophagus. The longer the object was in the esophagus, the less likely it was to pass. Conclusions This study characterizes when esophageal coins may pass. Age, type of coin, location of coin at initial x-ray, and length of time are all important considerations to determine if the coin will pass. This information may be used to counsel families about the likelihood of coins to pass and whether repeat x-ray is necessary prior to surgical removal. Additionally, it may be more cost-effective to obtain repeat films in select patients and prevent those from going to the operating theater who are more likely to pass the coin spontaneously.

scholarly journals Clinical profile of tracheo-bronchial foreign body inhalation at tertiary care center

2020 ◽  
Vol 6 (8) ◽  
pp. 1520
Author(s):  
Vivek Samor ◽  
Vijay Kumar ◽  
Deep Chand ◽  
Gaurav Gupta ◽  
Mamta . ◽  
...  
Keyword(s):  
Foreign Body ◽  
Early Recognition ◽  
Main Bronchus ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Diagnostic Study ◽  
Age Group ◽  
X Ray ◽  
Bronchial Foreign Body ◽  
Chest X Ray

<p class="abstract"><strong>Background:</strong> Inhalation of foreign bodies can be life threatening and are common in paediatric age group with peak incidence in the age group of 1-3 years. The objectives were to study the clinical profile of foreign body (FB) inhalation and to study the complications of tracheo-bronchial foreign body and rigid bronchoscopy.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional hospital based diagnostic study conducted for 1 year, done on 50 patients with FB inhalation, included consecutively in study after obtaining informed consent. Patients were assessed and interviewed for socio demographic details and examined using chest X-ray PA view, routine investigations and pre-anaesthetic evaluation. After all investigations a diagnostic bronchoscopy under general anaesthesia was performed to extract the foreign body. Data were analyzed through tables and diagrams and appropriate test of significance by Epi Info software.  </p><p class="abstract"><strong>Results:</strong> Total 50 FB inhalation cases (up to 10 years) in which 40% presented within 5 days to 2 weeks after inhalation. 92% were presents with cough and on chest examination 88% found to had decreased air entry, 72% presents with decreased movement and dull percussion on affected side. 70% of patients had abnormal chest X-ray finding. Foreign body found were groundnut (44%) followed by supari (32%) mostly in right main bronchus. We observed 10% patients with pneumonia, 4% had granuloma and 2% had bronchospasm.</p><p><strong>Conclusions:</strong> Prevention is best, but early recognition remains a critical factor in the treatment of FB inhalation in children. </p>

scholarly journals Unusual Cases of Pure Malignant Germ Cell Tumors of the Ovary: A Case Series on 10 Years Experience at a Tertiary Care Center

2021 ◽  
Author(s):  
Lajya Devi Goyal ◽  
Balpreet Kaur ◽  
Gitanjali Goyal ◽  
Parveen Rajora
Keyword(s):  
Germ Cell ◽  
Care Center ◽  
Tertiary Care ◽  
Survival Rates ◽  
Germ Cell Tumors ◽  
Case Series ◽  
Immature Teratoma ◽  
Surgical Removal ◽  
Fertility Sparing ◽  
Bep Chemotherapy

Background: Malignant ovarian germ cell tumors (MOGCTs) are rare female cancers, constituting  up to 10% of ovarian cancers. Dysgerminoma is the most common histological variant. Surgical removal of the tumor with optimal debulking is the treatment of choice. Multidrug chemotherapy following surgery offers high remission rates. Considering the prevalence of these tumors in adolescent and young females, fertility-sparing treatment is of paramount importance. Methods: The data of all patients with ovarian malignancy admitted at a tertiary-care-teaching hospital from September 2009-March 2019 were analyzed. Ten patients of MOGCTs were treated in this period. The clinical features, radiological and biochemical findings, and management and treatment outcome were evaluated. Results: The median age of patients was 23 years. Histological subtypes included immature teratoma (n=3), endodermal sinus tumor (n=4), and dysgerminoma (n=3). Tumor markers namely AFP, βHCG, and LDH increased in all except the patients with immature teratoma. Two patients with dysgerminoma were in the second trimester of pregnancy. All patients except one underwent surgery followed by BEP chemotherapy. Two patients had developed metastasis within six months of treatment and died. In seven patients, no evidence of disease was reported till date. Conclusion: Management of antenatal patients with dysgerminoma by surgery followed by BEP chemotherapy has favorable prognosis. Fertility-sparing surgery with adjuvant chemotherapy offers great advantage in young girls. However, risk stratification based on prognostic factors should be implemented in order to individualize the treatment for achieving higher survival rates. The option for oocyte-cryopreser-vation prior to surgery must be discussed with patients desiring future fertlity.

scholarly journals Gastric Foreign Bodies in Prison Inmates

2021 ◽  
Vol 12 (02) ◽  
pp. 067-070
Author(s):  
Manish Kumar ◽  
Sanjeev Sachdeva ◽  
Ajay Kumar ◽  
Ujjwal Sonika ◽  
Manish Gupta ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Prison Inmates ◽  
Endoscopic Removal ◽  
Retrospective Case ◽  
Secondary Gain ◽  
Baseline Characteristics

Abstract Objective Gastric foreign bodies are a common problem brought to an endoscopist. Prisoners are more prone to ingesting unusual foreign bodies for a secondary gain. The objective of this study was to study the profile of foreign body ingestion among the prisoners brought to a tertiary care center. Methods This is a retrospective case series. All the prisoners brought for endoscopic removal of foreign bodies between January 2018 to December 2019 were included in the analysis. Patients’ baseline characteristics, type of foreign body, management, and outcome were noted Results A total of eight inmates presented with ingestion of foreign body to our department. Most common foreign bodies ingested were drug packets and mobile phones. All ingestions were for secondary gain. Endoscopic removal was successful in all cases. Conclusion Endoscopic removal can be tried with all necessary precautions by an expert endoscopist.

scholarly journals Clinical, Radiological Features and Outcome of COVID-19 patients in a Secondary Hospital in Jakarta, Indonesia

2020 ◽  
Vol 14 (07) ◽  
pp. 750-757 ◽  
Author(s):  
Muhammad Hafiz ◽  
Aziza Ghanie Icksan ◽  
Annisa Dian Harlivasari ◽  
Rizky Aulia ◽  
Febrina Susanti ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Diagnostic Testing ◽  
Case Series ◽  
Cost Effective ◽  
Inflammation Marker ◽  
Laboratory Findings ◽  
X Ray ◽  
First Case ◽  
Case Series Study ◽  
Chest X Ray

Introduction: The numbers of people infected with SARS-CoV-2 in Indonesia especially in Jakarta as the epicenter continue to rise. Limited published clinical data, scarcity and long turn over time of diagnostic testing put clinician in dilemma to make diagnosis. Methodology: This is an observational case series study from confirmed COVID-19 patient in our hospital from first case admission on 17 March 30 April, 2020. We collected patient’s demography, symptoms, comorbidities, therapy, laboratory, chest x-ray and ECG consecutively. Results: Between 17 March 2020 and 30 April 2020, there were 30 confirmed COVID-19 cases, 16 (53.3%) were male. Clinical symptoms were dyspnea in 22 (73.3%) and dry cough 16 (53.3%). Comorbidities were diabetes in 14 (46.6%), hypertension 10 (33.3%) and Coronary Artery Disease (CAD) in 10 (33.3%) patients respectively. Laboratory findings showed lymphopenia in 21 (70%) patients, increased inflammation marker in Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) and Lactate Dehydrogenase (LDH) 21 (70%), 23 (76.6%) and 12 (40%) patients respectively. Twenty-seven (90%) cases had abnormal Chest X-Ray (CXR) and mostly severe 18 (60%). Descriptive finding for images included consolidation 16 (53.3%) and Ground Glass Opacities (GGO) in 10 (33.3%) patients. Conclusions: Based on our findings, most cases of COVID-19 admitted in secondary referral hospital were already in moderate to severe stages. This is most likely due to late referral from primary care and unspecific clinical features resemblance of other infectious diseases. Inflammation marker and CXR are cost effective findings and can be used as marker to determine further referral.

scholarly journals Bronchial Foreign Body Alerting of a Bronchial Tumor: The Need of a Follow-Up Radiography

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Nahida El-Rifai ◽  
Samar Shahine ◽  
Hassan Sidani ◽  
Ali Sabeh Aion ◽  
Antoine Deschildre ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pediatric Population ◽  
Left Lung ◽  
World Health ◽  
Surgical Removal ◽  
Low Grade ◽  
Intermediate Cell ◽  
X Ray ◽  
Chest X Ray ◽  
Complete Collapse

Lung tumors are extremely rare in the pediatric population, comprising only 0.2% of all malignancies in children. Among them, mucoepidermoid carcinoma (MEC) is even rarer with a reported frequency of 0.1% to 0.2%. MEC is defined by the World Health Organization as a tumor characterized by a combination of mucus-secreting, squamous, and intermediate cell types. We describe the case of a 4-year-old girl who presented with a history of intermittent fever and nonproductive cough of 1-month duration after foreign body aspiration. The chest X-ray showed complete collapse of the left lung. After removal of the foreign body, the lung expanded well after. However, the control chest X-ray done after 5 days showed again complete collapse of the left lung. The biopsy specimen taken during bronchoscopy confirmed the diagnosis of low-grade MEC. Fluorescence in situ hybridization (FISH) confirmed the presence of MAML2 rearrangement. Complete surgical resection with preservation of lung parenchyma was performed. No adjuvant therapy was needed. Repeat bronchoscopy was performed 2 months after surgery and showed no recurrence of the tumor. In conclusion, a remote chest X-ray after removal of a foreign body is necessary to avoid missing a rare serious underlying disease such as MEC. According to the size and the location of the tumor, complete surgical removal is sufficient without additional treatment in case of low-grade tumor. The presence of MAML2 rearrangement confers a favorable outcome and may have long-term implications for the clinical management.

scholarly journals Vitamin C Deficiency in Inflammatory Bowel Disease: The Forgotten Micronutrient

2021 ◽  
Author(s):  
Katie A Dunleavy ◽  
Ryan C Ungaro ◽  
Laura Manning ◽  
Stephanie Gold ◽  
Joshua Novak ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin C ◽  
Bowel Disease ◽  
Fruits And Vegetables ◽  
Nutritional Assessment ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Vitamin C Deficiency ◽  
Inflammatory Bowel

Abstract Background Micronutrient deficiencies are common in patients with inflammatory bowel disease (IBD). To date, the literature has focused on vitamin D, vitamin B12, and iron deficiencies. Methods We report a case series of 20 patients with IBD and vitamin C deficiency treated at a single tertiary care center. Results Sixteen (80%) patients had symptoms of clinical scurvy, including arthralgia, dry brittle hair, pigmented rash, gingivitis, easy bruising and/or brittle nails. Eighteen patients underwent a nutritional assessment, 10 (56%) patients reported complete avoidance of fruits and vegetables, and 3 (17%) reported reduced intake of fruits and vegetables. Conclusions Vitamin C deficiency should be considered in IBD patients, particularly those with reduced fruit/vegetable intake, as it can lead to significant signs and symptoms.

FOREIGN BODY ASPIRATION IN CHILDREN: RADIOLOGICAL EVALUATION OF PREOPERATIVE CHEST X-RAY

2021 ◽  
Vol 24 (04) ◽  
Author(s):  
Rasha Nadeem Ahmed ◽  
Bassam Khaleel Al-abbasi ◽  
Nashwan M-Al Hafidh
Keyword(s):  
Foreign Body ◽  
Foreign Body Aspiration ◽  
Radiological Evaluation ◽  
X Ray ◽  
Chest X Ray ◽  
Preoperative Chest

Management of an unusual presentation of foreign body aspiration

1992 ◽  
Vol 106 (8) ◽  
pp. 751-752 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Nicolas Bu-Saba ◽  
Anis Baraka ◽  
Salman Mroueh
Keyword(s):  
Foreign Body ◽  
Subcutaneous Emphysema ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Foreign Body Aspiration ◽  
Positive Pressure ◽  
Review Of The Literature ◽  
X Ray ◽  
Post Surgery ◽  
Chest X Ray

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

scholarly journals Factors Affecting Radiation Dose in Computed Tomography Angiograms for Pulmonary Embolism: A Retrospective Cohort Study

2020 ◽  
Vol 10 ◽  
pp. 74
Author(s):  
Prashant Nagpal ◽  
Sarv Priya ◽  
Ali Eskandari ◽  
Aidan Mullan ◽  
Tanya Aggarwal ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Radiation Dose ◽  
Care Center ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Factors Affecting ◽  
Model Based ◽  
Pulmonary Angiogram ◽  
The Mean

Objectives: Computed tomography pulmonary angiogram (CTPA) is one of the most commonly ordered and frequently overused tests. The purpose of this study was to evaluate the mean radiation dose to patients getting CTPA and to identify factors that are associated with higher dose. Material and Methods: This institutionally approved retrospective study included all patients who had a CTPA to rule out acute pulmonary embolism between 2016 and 2018 in a tertiary care center. Patient data (age, sex, body mass index [BMI], and patient location), CT scanner type, image reconstruction methodology, and radiation dose parameters (dose-length product [DLP]) were recorded. Effective dose estimates were obtained by multiplying DLP by conversion coefficient (0.014 mSv•mGy−1•cm−1). Multivariate logistic regression analysis was performed to determine the factors affecting the radiation dose. Results: There were 2342 patients (1099 men and 1243 women) with a mean age of 58.1 years (range 0.2–104.4 years) and BMI of 31.3 kg/m2 (range 12–91.5 kg/m2). The mean effective radiation dose was 5.512 mSv (median – 4.27 mSv; range 0.1–43.0 mSv). Patient factors, including BMI >25 kg/m2, male sex, age >18 years, and intensive care unit (ICU) location, were associated with significantly higher dose (P < 0.05). CT scanning using third generation dual-source scanner with model-based iterative reconstruction (IR) had significantly lower dose (mean: 4.90 mSv) versus single-source (64-slice) scanner with filtered back projection (mean: 9.29 mSv, P < 0.001). Conclusion: Patients with high BMI and ICU referrals are associated with high CT radiation dose. They are most likely to benefit by scanning on newer generation scanner using advance model-based IR techniques.

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