Laparoscopic removal of an aberrant acupuncture needle in the gluteus that reached the pelvic cavity: a case report

Abstract Background Intrapelvic aberrant needles are rare in clinical practice. Long-term foreign bodies in the abdominal cavity may form granulation tissue or an abscess, and may cause organ injury. Therefore, such foreign bodies need prompt removal. Case presentation A 26-year-old male athlete was referred to our hospital for investigation of an aberrant acupuncture needle in the gluteus. The needle was unable to be removed during acupuncture treatment, and the end broke off and remained in the gluteus. Abdominal X-ray examination showed a thin, 40-mm-long, metallic foreign body resembling an acupuncture needle. Abdominal computed tomography showed an abnormal shadow in the gluteus. However, it was unclear whether the tip of the needle reached the pelvic cavity. Thus, it was decided to surgically extract the needle via laparoscopic surgery under X-ray guidance as a safe and minimally invasive method. Although X-ray fluoroscopy confirmed that the aberrant needle was located in the gluteus, the needle could not be felt with the forceps, as the peritoneum surrounding the needle had granulomatous changes due to inflammation. Therefore, the retroperitoneum was further dissected to search for the needle. Once the needle was identified, its flexibility enabled it to be easily removed by grasping it directly with a needle holder. The length of the aberrant needle was 40 mm. The postoperative course was uneventful, and the patient was discharged from hospital on postoperative day 2. Conclusions When a foreign body remains in the gluteus and its tip touches intrapelvic organs, such as the rectum, it is critical to determine the best approach for its safe removal. Given the anatomical location of the foreign body and the patient background, laparoscopic removal was considered the best approach in the present case.

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Role of HRUS in Detection and Localization of Foreign Bodies

TAJ Journal of Teachers Association ◽

10.3329/taj.v23i1.41129 ◽

2010 ◽

Vol 23 (1) ◽

pp. 33-37

Author(s):

KZ Shah ◽

N Begum ◽

MS Ali ◽

M Hossain ◽

P Ahmed

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Clinical Presentation ◽

Conventional Radiography ◽

Anatomical Location ◽

X Ray ◽

Linear Probe ◽

Detection And Localization ◽

Ct And Mri

Prick injuries with metallic and non-metallic foreign body are commonly encountered cases in surgery and orthopedics OPD. Detection and localization is difficult task with conventional radiography. Ultrasonography, CT and MRI are other modes of evaluation but CT and MRI are expensive and not easily available.About 35 patients were evaluated with USG (7.5-10 MHz Linear probe) and X-ray for clinically suspicious non-radiopaque foreign body in soft tissue and extremities. Clinical presentation, symptoms anatomical location, and foreign body retrieved after surgery were recorded. X-ray detect only 3 foreign bodies where as HRUS detected 34 patient. Most of the cases FBs were present in ankle and foot. Majority of the foreign bodies were plant thorn and wood pieces. Plain X-ray is not sensitive for detection of non-radiopaque foreign bodies but USG is sensitive and specific for detection and localization in that cases. TAJ 2010; 23(1): 33-37

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The Role of Ultrasonography in Detection and Localization of Radiolucent Foreign Body in Soft Tissues of Extremities

Journal of Nepal Medical Association ◽

10.31729/jnma.174 ◽

2009 ◽

Vol 48 (173) ◽

Cited By ~ 1

Author(s):

Dipak Shrestha ◽

UK Sharma ◽

R Mohammad ◽

D Dhoju

Keyword(s):

Foreign Body ◽

Soft Tissue ◽

Foreign Bodies ◽

Anatomical Location ◽

Local Health ◽

Duration Of Symptoms ◽

X Ray ◽

Linear Probe ◽

Detection And Localization ◽

Ct And Mri

INTRODUCTION:Retained non-radiopaque foreign body inside soft tissue can be a cause of prolonged morbidity. Detection and localization is difficult task with conventional radiography. Ultrasonography, CT and MRI are other modes of evaluation but both of CT and MRI are expensive and not easily available.METHODS:Twenty three patients were evaluated with ultrasonography (8 MHz linear probe) and X-ray for clinically suspicious non-radiopaque foreignbody in soft tissue of extremities. Clinical presentation, duration of symptoms, anatomical location and foreign bodies retrieved after surgical explorations were recorded.RESULTS:X-ray could not detect any foreign body in all 23 patients. Ultrasound findings were suggestive of foreign body in 19 patients (male: female=2:1, mean age 31.68+/-11.8 years, range 12 - 54 years) which was confirmed after surgical exploration except in one where only foreign bodygranuloma was found. 4 (21%) were not aware of prick injury. Fifteen patients had attempted removal of foreign body themselves or at medical shop or local health post. Interval between injury / symptoms appearance to hospital ranged from 4-56 days. Foot and ankle was involved in 10 (52.6%), calf in 3 (15%), dorsum of hand in 2 (10.5%), palm in 2 (10.5%), shoulder in 1 (5.2%) and knee in 1 (5.2%) case. Foreign bodies retrieved were wood in 12 (63%), thorn in 4 (21%) and bamboo twig in 2 (10.5%) patients.CONCLUSION:Plain X-ray isn't sensitive for detection of non-radiopaque foreign body in soft tissue. Ultrasonography is sensitive and specific fordetection and localization of foreign body which should be included in evaluation for clinically suspicious retained non-radiopaque foreign body in softtissue of extremities.KEYWORDS:non-radiopaque foreign body; sensitivity; specificity; ultrasonography

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Rare complications of intrauterine contraception with formation of foreign bodies in the abdominal cavity and urine bladder

Journal of obstetrics and women s diseases ◽

10.17816/jowd88665 ◽

2004 ◽

Vol 53 (4) ◽

pp. 86-88

Author(s):

V. М. Subbotin ◽

М. I. Davidov

Keyword(s):

Foreign Body ◽

Female Patient ◽

Foreign Bodies ◽

Abdominal Cavity ◽

Complete Recovery ◽

Uterine Wall ◽

Intrauterine Contraception ◽

Trophic Changes ◽

Urine Bladder

2 rare cases of intrauterine contraception are presented. A 53-year old female patient had been having a Lippas intrauterine contraception device (IUCD) in the abdominal cavity for 19 years before it was occasionally revealed on cholecystectomy. The next female patient who had had a T-type IUCD for 6 years developed trophic changes of the uterine wall followed by the migration and penetration of IUCD into the wall and then the urine bladder cavity. Laparotomy and cystotomy with the evacuation of the foreign body and dissection of the walls of cystouterine fistular were performed. Both patients made a complete recovery.

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MIGRATION OF THE INTRAUTERINE DEVICE TO THE ABDOMINAL CAVITY

I P Pavlov Russian Medical Biological Herald ◽

10.23888/pavlovj20172247-262 ◽

2017 ◽

Vol 25 (2) ◽

pp. 247-262

Author(s):

D. A. Rahmonov ◽

F. Sh. Rashidov ◽

E. L. Kalmykov ◽

M. M. Marizoeva ◽

O. B. Bobdjonova ◽

...

Keyword(s):

Surgical Treatment ◽

Intrauterine Device ◽

Abdominal Cavity ◽

Clinical Signs ◽

Uterine Cavity ◽

Pain Syndrome ◽

Pregnant Patient ◽

Pelvic Cavity ◽

And Migration ◽

Laparoscopic Removal

The aim: demonstration of our experience of surgical treatment of patients with migrated intrauterine device (IUD) into the abdominal cavity. The results of surgical treatment of migrated IUDs in the pelvic cavity are summarized in 17 women. The average age of the patients was 33,23,4 years. The timing of implantation of the IUDs varied from 10 days to 24 months. In all cases, the intra operational finding was T-shaped a copper device. The reason behind the women's consultation was an increase in pain syndrome in the lesser pelvis (n=15), dysuric phenomenon (n=1) and the onset of pregnancy (n=1). Perforation of the uterus and migration of the spiral occurred from 10 days to 2 years after its implantation. All patients were operated laparoscopicaly. The average duration of operations was 45,510,5 minutes. In the postoperative period there were no complications from the pelvic organs and postoperative wounds. The period of hospitalization of patients was 3,50,7 days. In all cases there was a regression of clinical signs and recovery. In one pregnant patient (gestation period 5-6 weeks) the pregnancy proceeded without particular pathological abnormalities and resulted in the birth of a full-term child. Laparoscopic removal of the IUD migrating from the uterine cavity to the abdominal cavity is the method of choice in the treatment of this group of patients, avoiding development of intra- and postoperative complications and a shorter length of stay in the hospital. The effectiveness of the procedure reaches 100%. The most common cause of complication of the IUD is the perforation of the uterus during its implantation.

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Use of Scheimpflug imaging in the management of intra-lenticular foreign body

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13176 ◽

2015 ◽

Vol 7 (1) ◽

pp. 82-84 ◽

Cited By ~ 2

Author(s):

R Singh ◽

J Ram ◽

R Gupta

Keyword(s):

Foreign Body ◽

Intraocular Lens ◽

Foreign Bodies ◽

Case Reports ◽

Slit Lamp ◽

Traumatic Cataract ◽

X Ray ◽

Scheimpflug Imaging ◽

History Of ◽

Post Traumatic

Introduction: Asymptomatic traumatic intra-lenticular foreign body is very uncommon and few case reports have been published.Objective: To report a case of post-traumatic intra-lenticular foreign body and use of Scheimpflug imaging in its management. Case: A 41-year-old male with history of injury to right eye during hammering a chisel 1 year back presented with decreased vision since 6 months. An intra-lenticular foreign body was found on slit lamp bio-microscopy and was confrmed by Scheimpflug imaging. Posterior capsule was intact on Scheimpflug imaging. Thus, Scheimpflug imaging helps in exact localization of the foreign body in the intralenticular space or behind the iris. We ruled out other foreign bodies by x-ray and ultrasonography of the orbit. The foreign body with post-traumatic cataract was removed using phacoemulsification and three piece foldable intraocular lens was implanted in the bag. Conclusion: An intra- lenticular foreign body may remain asymptomatic for months. Scheimpflug imaging can be useful in its localization. It can be removed during phacoemulsification.

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Laparoscopic Removal of a Foreign Body in the Pelvic Cavity through One Port Using a Flexible Cholangioscope

Digestive Surgery ◽

10.1159/000219325 ◽

2009 ◽

Vol 26 (3) ◽

pp. 205-208 ◽

Cited By ~ 1

Author(s):

Nobuhiro Kurita ◽

Mitsuo Shimada ◽

Toshihiro Nakao ◽

Motoya Chikakiyo ◽

Tomohiko Miyatani ◽

...

Keyword(s):

Foreign Body ◽

Pelvic Cavity ◽

Laparoscopic Removal

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Self-Inflicted Urethrovesical Foreign Bodies in Children

Case Reports in Urology ◽

10.1155/2012/134358 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3

Author(s):

Canan Ceran ◽

Sema Uguralp

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Surgical Intervention ◽

Skin Incision ◽

Definitive Treatment ◽

Endoscopic Removal ◽

X Ray ◽

History Of ◽

Endoscopic Guidance ◽

Lower Urinary

We present two cases of self-inflicted urethrovesical foreign body in children. Case 1 was a 6-year-old girl admitted with a history of self-introduction of a pin. The X-ray revealed the pin as 3.5 cm in length and in the bladder. The foreign body was removed endoscopically. Case 2 was a 13-year-old boy with a self-introduced packing needle, 13 cm in length, partially in the urethra. The end and the tip of the needle passed through the urethra to the surrounding tissues. Foreign body removed via a little skin incision with endoscopic guidance. Foreign bodies are rarely found in the lower urinary tract of children. Definitive treatment is usually the endoscopic removal; however, sometimes surgical intervention may require.

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Disk Battery Ingestion A Malpractice Case that Results in Pneumonia

The Bulletin of Legal Medicine ◽

10.17986/blm.2016323756 ◽

2016 ◽

Vol 21 (3) ◽

pp. 196-198 ◽

Cited By ~ 1

Author(s):

Cihat Şarkış ◽

Selçuk Yazıcı ◽

Muhammet Can

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Neck Trauma ◽

Private Hospitals ◽

Alkaline Batteries ◽

X Ray ◽

Clinical Impairment ◽

Chest X Ray ◽

Increasing Risk ◽

Swallowed Foreign Bodies

Alkaline batteries have become the second most swallowed foreign bodies following coins. Most cases have an uncomplicated course, but some may lead to serious complications and even death.Here we report a 28 months old boy who had experienced discomfort, eating refusal, vomiting and slightly wheezing after falling from a sofa bed. He has been in three different county hospitals and two private hospitals due to complaints, has been examined by two pediatricians and a cranial surgeon. A cranial CT imaging, a cranial X-ray radiograph and a chest X-ray radiograph was obtained. Firstly, diagnosed as head and neck trauma, then diagnosed as acute bronchiolitis, and finally pneumonia. Hospitalized twice. Finally, a chest radiograph revealed a button battery in the esophagus. The foreign body was endoscopic removed. The child had a quick clinical impairment after removal of the battery.As a result, alkaline batteries with their increasing risk of engulfment poses very serious problems. The parents and physicians should be informed against increasing frequency of ingestion of alkaline batteries by infants and children. Also, clinicians should be careful about the risk of these batteries that they can cause pneumonia and infiltration which may make it difficult to detect the foreign body.

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The foreign bodies in lower respiratory tract in pediatric patients treated in referral academic department of pediatric otolaryngology

New Medicine ◽

10.25121/newmed.2020.24.1.15 ◽

2020 ◽

Vol 24 (1) ◽

Author(s):

Irina Drogobytska ◽

Maciej Pilch ◽

Lidia Zawadzka-Głos

Keyword(s):

Foreign Body ◽

Respiratory Tract ◽

Physical Examination ◽

Lower Respiratory Tract ◽

Foreign Bodies ◽

Pediatric Patients ◽

Academic Department ◽

Diagnostic Process ◽

X Ray ◽

Pediatric Otolaryngology

Introduction. Foreign bodies in lower respiratory tract for many years are big challenge for otolaryngologists. These objects could present variability of clinical symptoms. Increase of infection and mortality due to delay of accurate diagnosis. Interview is the most important part of examination of patient with suspected foreign body in airways. Any suspicion of aspiration is qualification to diagnostic bronchoscopy. Aim. This paper refers occurrence assessment, clinical course, diagnostic process and treatment of the pediatric patients with suspected foreign body in lower respiratory tract hospitalized in referral Academic Department of Pediatric Otolaryngology. Material and methods. Retrospective analysis of 74 patients with suspected foreign body in lower respiratory tract, who were hospitalized in Clinical Department of Pediatric Otolaryngology in Warsaw Medical University in 2016-2018. Analysis includes demographic data, occurrence frequency, localization and the type of foreign body, diagnostic process and treatment. Results. This study includes 42 boys (57%) and 32 girls (43%) in age of 8 months to 16-year-old. The episode of choking occurs in interview in 71 patients (96%). Foreign bodies in lower respiratory tract were confirmed and evacuated in bronchoscopy procedure in 44 cases (59.5%). In 30 cases (40.5%) there were any foreign body in airways. The most common group of patients admitted to Clinic with suspected foreign body in airways was children in age between 1 to 3-year-old, which accounted for 22 cases (50%). Coughing was the most commonly reported symptom (54.5%), wheezing (27.5%) and dyspnea (15.9%). Twenty-three patients were presenting wheezing and whirring in physical examination. Air trap found in thorax x-ray were in 22 patients (45%). The right main bronchus was the most common place of foreign body retention – 22 patients (50%). The organic foreign bodies were in 32 cases (72.7%) and non-organic in 12 (27.3%). The nuts were the most common foreign body aspirated to airways. Conclusions. Foreign body aspiration should be suspected in every patient, not only those with choking episode but also with patients who presents ambiguous change in physical examination and x-ray scan. In pediatric patient with suspected foreign body in lower respiratory tract, in every time the bronchoscopy is needed to be done, even in patients with no abnormalities in physical examination and x-ray scan.

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Case report of extensive foreign body of esophagus with spread to laryngopharynx and larynx

Russian otorhinolaryngology ◽

10.18692/1810-4800-2021-4-79-82 ◽

2021 ◽

Vol 20 (4) ◽

pp. 79-82

Author(s):

B. B. Uraskulova ◽

◽

A. O. Gyusan ◽

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Clinical Observation ◽

Irregular Shape ◽

Air Bubbles ◽

X Ray ◽

Excessive Salivation ◽

Difficulty Breathing ◽

Short Time

Foreign bodies of the respiratory tract and esophagus remain one of the pressing problems in medicine, which is associated with the possibility of developing complications that can end in death. We present our clinical observation that demonstrates the long-term presence of a large foreign body fixed in the area of the pharyngeal narrowing of the esophagus and extending into the larynx and the vestibule of the larynx. Patient T., 57 years old, went to the emergency department of the Karachay-Cherkessia Republican Clinical Hospital with complaints of severe sore throat, inability to swallow, excessive salivation, increased body temperature to 37,5 °C, difficulty breathing, mixed shortness of breath, which persist for 3 days. The examination revealed: the epiglottis is mobile, the mucous membrane of the larynx is hyperemic, edematous, with an abundance of saliva, at the level of the vestibular part of the larynx, in the area of the arytenoid cartilage and aryepiglottic folds, an irregular shape was visualized, with smooth edges, a thin, hard whitish plate. Computed tomography of the cervical spine: in the esophagus, at the level of C4-C5 vertebrae, a foreign body with a metallic density of +2900 hU units, elongated, irregular shape, measuring 2.2 by 3.3 cm, with perifocal air bubbles is determined. A preliminary diagnosis was made: Foreign body of the esophagus, laryngopharynx with a spread to the vestibule of the larynx. 3 days after the retention of the foreign body under intubation anesthesia, it is captured using forceps with serrated cups and removed during direct laryngoscopy. There were no complications during the manipulation. The combination of X-ray and endoscopic examinations with the help of innovative medical and diagnostic equipment made it possible to establish a diagnosis in a short time, choose the most effective treatment tactics and remove a foreign body through natural pathways.

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