A foreign body lodged in the sub-mental space through to the retro-pharyngeal area: a review of anatomical risks and surgical approaches

Abstract Background Foreign body inclusions are rare in head and neck. They are challenging in regard to anatomical risks and surgical approaches. This is the case of a particular foreign body with a curious trajectory, associated with a brief review of anatomical risks and surgical approaches. Case presentation This is the case of a 25-year-old male who has been attacked with a sharp object, which caused an inclusion of a part of the foreign body in the sub-mental and pharyngeal areas. The clinical exam showed a painful bulging in the sub-mental area, with moderately hemorrhagic sputum and difficulty while swallowing. The intra-oral exam showed a foreign body that was located at the right side of the base of the tongue, and which goes backwards and outwards to penetrate retro-pharyngeal mucosa. The patients underwent an angio-CT scan, which showed a curious fine and sharp metallic object, without direct signs of lesions to the jugular vein or carotid artery or any collateral branches. The patient underwent extraction through cervical approach, with satisfying bleeding control. Intra-oral exploration showed a retro-pharyngeal lesion of 2 cm, without particular bleeding. The cervical lesion and retro-pharyngeal lesions were closed. The lesion at the base of the tongue was of 1 cm, palpable but not accessible to sutures, and a naso-pharyngeal tube was inserted. The patient presented very satisfying post-operative outcome, without any complications. Conclusion When dealing with foreign bodies of head and neck, physicians must be precocious and prepared for the risk of bleeding after extraction. Thorough radiological exploration is necessary as long as the patient is stable. Direct and indirect radiological signs allow the clinician to understand the nature and the trajectory of the object, as well as the damage to collateral structures.

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Retropharyngeal Abscess in an adult with Pneumonia during COVID-19 Outbreak in China

10.21203/rs.3.rs-58631/v1 ◽

2020 ◽

Author(s):

Tianyu Wang ◽

Haibin Liu ◽

Caiquan Liang ◽

Hang Zhang ◽

Jianchun Liao ◽

...

Keyword(s):

Foreign Body ◽

Chest Ct ◽

Retropharyngeal Abscess ◽

Surgical Drainage ◽

Case Presentation ◽

Raising Awareness ◽

Cervical Approach ◽

Anterior Cervical Approach ◽

Chest Ct Scan

Abstract Background: Retropharyngeal abscesses are rarely reported in adults and occur mostly in patients with immunocompromise or as a foreign body complication. Admittedly, the treatment of retropharyngeal abscesses frequently involves surgical drainage to achieve the best results. However, when retropharyngeal abscesses occurred in a highly suspected patient with COVID-19, the managements and treatments should be caution in order to prevent the spread of the virus. Case presentation: On Feb. 13, a 40-year-old male with retropharyngeal abscesses turned to our department complaining dyspnea and dysphagia. In addition, his chest CT scan shows a suspected COVID-19 infection, thus making out Multiple Disciplinary Team (MDT) determine to perform percutaneous drainage and catheterization through left anterior cervical approach under the guidance of B-ultrasound. Finally, the patient recovered and was discharged from the hospital on Feb. 27 after 14 days of isolation. There was no recurrence after half a year follow-up. Conclusions: By presenting this case, we aim at raising awareness of different surgical drainage methods and summarizing our experience in the management of retropharyngeal abscesses during the outbreak of COVID-19.

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Case Report: Transorbital approach for the management of an orbito-temporal penetrating brain injury (skull base region) secondary to wooden spikes

F1000Research ◽

10.12688/f1000research.74382.1 ◽

2021 ◽

Vol 10 ◽

pp. 1283

Author(s):

Tedy Apriawan ◽

Abdul Hafid Bajamal ◽

Ditto Darlan ◽

Yusriandi Ramadhan

Keyword(s):

Brain Injury ◽

Foreign Body ◽

Magnetic Resonance ◽

Petrous Bone ◽

Primary Treatment ◽

Surgical Approaches ◽

Penetrating Brain Injury ◽

Body Location ◽

The Right ◽

Base Of The Skull

Background and importance: Transorbital penetrating brain injury (PBI) due to a non-projectile foreign body is rare. It can lead to life-threatening severe neurovascular damage. Surgery is the primary treatment choice; however, there are a number of approaches that can be considered based on the patient's condition in terms of foreign body location and state of the patient. Clinical presentation: An 18-year-old male carpenter was hit by a log and sustained transorbital PBI while cutting wood with a machine. Computed tomography (CT) scan showed a wooden spike that was approximately 11 cm from the left medial orbital to the superior part of the posterolateral of the petrous bone, crossing the right side at the base of the skull. CT angiography (CTA), magnetic resonance angiography (MRA), and magnetic resonance venography (MRV) revealed no internal carotid artery (ICA) and cavernous sinus lesions, respectively. We had a 3D-printed model for preoperative planning, and surgery was performed using a transorbital approach to extract the wood 14 days after the accident. The impacted wood was removed without any complications. Conclusion: There are many surgical approaches for transorbital PBI. We decided to perform the transorbital approach because it is perpendicular to the entry zone. Surgeons should consistently perform minimally invasive procedures based on the clinical and radiological findings.

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Treatment of Hepatocellular Carcinomas by Hepatic Transarterial Chemoembolization, Case Presentation and Review of the Literature

Acta Medica Transilvanica ◽

10.2478/amtsb-2020-0046 ◽

2020 ◽

Vol 25 (3) ◽

pp. 32-35

Author(s):

Andrei Florin Bloj ◽

Ioana Hălmaciu ◽

Bogdan Andrei Suciu ◽

Lucian Mărginean

Keyword(s):

Transarterial Chemoembolization ◽

Therapeutic Option ◽

Liver Lobe ◽

Liver Tumours ◽

Case Presentation ◽

Large Size ◽

Hepatocellular Carcinomas ◽

Tumour Formation ◽

Angio Ct ◽

The Right

AbstractHepatocellular carcinoma is one of the most common liver tumours. At the time of diagnosis, only 20% of patients are suitable for liver resection for curative purposes. In patients who are not suitable for surgical resection, chemoembolization of the hepatic artery is a viable therapeutic option. We present the case of a 60-year-old male patient being admitted with a diagnosis of liver tumour in the right liver lobe. Abdominal angio-CT examination revealed the existence of a tumour formation of 9x10 cm in the liver segments IV, VIII. Given the large size of the tumour, as well as the patient’s comorbidities, it was decided to practice hepatic chemoembolization with Irinotecan. The clinical evolution was favourable, the patient being discharged 48 hours after the intervention. Hepatic transarterial chemoembolization is a viable alternative in the treatment of patients with unresectable hepatocellular carcinomas, which may improve the prognosis of these patients.

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Foreign body with multiple location – trachea, nose, cavum nasi – in a child. Case presentation

Romanian Medical Journal ◽

10.37897/rmj.2015.1.9 ◽

2015 ◽

Vol 62 (1) ◽

pp. 46-48

Author(s):

Corneliu Toader ◽

◽

Mioriţa Toader ◽

Iolanda Cristina Vivisenco ◽

◽

...

Keyword(s):

Foreign Body ◽

Rare Case ◽

Foreign Bodies ◽

Case Presentation ◽

Multiple Location ◽

The Right

Pathology of tracheobronchial foreign bodies in children is a major emergency, because by their unpredictable evolution following mobilization, can cause sudden asphyxia. The most frequent location for airway foreign bodies is in the right primary bronchus, followed by the left primary bronchus and most rarely in the trachea. Sometimes in children, we can fi nd multiple airway foreign bodies. Very rare in children, we can fi nd airway foreign bodies with multiple location. The authors present a very rare case, unique in all pathology resolved along their quite vast experience – multiple foreign body with multiple location in the trachea, nose and cavum nasi in a child aged 1 year and 5 months.

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Double Magnet Ingestion Causing Intestinal Perforation with Peritonitis: Case Report and Review of the Literature

Case Reports in Surgery ◽

10.1155/2022/4348787 ◽

2022 ◽

Vol 2022 ◽

pp. 1-4

Author(s):

Yousef S. Abuzneid ◽

Hussam I. A. Alzeerelhouseini ◽

Abdelrahman Rabee ◽

Wafa Aqel ◽

Rawan F. Ayyad ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Exploratory Laparotomy ◽

Fistula Formation ◽

Uneventful Recovery ◽

Lower Quadrant ◽

Case Presentation ◽

Magnet Ingestion ◽

The Right ◽

Right Lower Quadrant

Introduction. Foreign body ingestion is a common pediatric complain, and most can be passed spontaneously; however, magnetic object ingestion is rather rare, and they can cause severe complications when multiple magnets are ingested, as they lead to entrapment of bowel walls between them, causing ischemia, pressure necrosis, perforation, and fistula formation. Case Presentation. Herein, we present a case of a 16-month-old female patient presented to our department complaining of continuous vomiting for two days along with fever and irritability. X-ray revealed dilated bowel loops with a radioopaque foreign body in the right lower quadrant. After discussing with the parents, exploratory laparotomy was done, showing two bowel perforations at the site of the magnets. Affected bowel was resected with anastomosis. The patient was discharged after 3 days with an uneventful recovery. Discussion. The diagnosis and management of magnet ingestion differ from those of small foreign bodies, which are usually managed conservatively by watchful waiting. Usually, the diagnosis is done due to complications such as peritonitis and death. On the other hand, management depends on the number, size, magnetic field, and shape of the magnet, and whether it has passed the pylorus or not. Conclusion. It is important to establish the diagnosis of this condition as early as possible to prevent complications. Despite the efforts that were made to try to prevent and minimize the risk of magnet ingestion, more investigations are required to reach a common and united strategy for management of such conditions.

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Foreign Body Granulomas in the Head and Neck

Otolaryngologic Clinics of North America ◽

10.1016/s0030-6665(20)32145-9 ◽

1982 ◽

Vol 15 (3) ◽

pp. 553-559 ◽

Cited By ~ 2

Author(s):

Richard C. Bryarly ◽

Frederick J. Stucker

Keyword(s):

Foreign Body ◽

Head And Neck

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Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. (Preprint)

10.2196/preprints.13383 ◽

2019 ◽

Author(s):

Waheed Atilade Adegbiji ◽

Shuaib Kayode Aremu ◽

AbdulAkeem Adebayo Aluko

Keyword(s):

Foreign Body ◽

Head And Neck ◽

Clinical Features ◽

University Teaching ◽

Age Group ◽

Geriatric Population ◽

Female Ratio ◽

Common Diagnosis ◽

Foreign Body Impaction ◽

Nose And Throat

BACKGROUND Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. OBJECTIVE This study aimed at determining prevalence, sociodemographic features, aetiology, clinical features, Complications and sources ofreferral of geriatric otorhinolaryngological, head and neck emergency in our center. METHODS This was a prospective hospital based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using pretested interviewers questionnaire.All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts and pie charts. RESULTS Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60-64). There were 38.6% males with male to female ratio of 1:1.5. The main aetiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumour. Main anatomical distribution of geriatric otorhinolaryngology emergency were 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study were 15.9% sinonasal tumour, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (<13 weeks) occurred in 1 week in 74.2% and 2-13 weeks In 19.7%. Commonest time of presentation was daytime in 65.9%. Major sources of referral were 43.2% general practitioner and 31.1% casualty officers. Presentation of geriatric otorhinolaryngology emergency were mainly ear, nose and throat clinic in 59.8% with accident and emergency in 28.8%. Commonest associated comorbid illnesses among the geriatric patients were 18.2% hypertension, 14.4% arthritis and 9.8% diabetes mellitus. CONCLUSIONS Geriatric otorhinolaryngological emergency are common pathology with associated with comorbid illnesses. Detailed clinical assessment are mandatory for effective management outcome.

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Embolization of the false lumen using IMPEDE-FX embolization plugs as part of treatment of an infrarenal post-dissection aneurysm: a case report

CVIR Endovascular ◽

10.1186/s42155-020-00183-6 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Anne-Jet S. Jansen ◽

Paul M. van Schaik ◽

Jasper M. Martens ◽

Michel M. P. J. Reijnen

Keyword(s):

Case Report ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

False Lumen ◽

True Lumen ◽

Case Presentation ◽

Type A Dissection ◽

Prospective Trials ◽

The Right ◽

Embolization Procedure

Abstract Background This case report demonstrates the value of IMPEDE-FX plugs in an embolization procedure of a false lumen of an infrarenal post-dissection aneurysm. Case presentation A 69-year-old patient was treated with mitral valve replacement, complicated by a Stanford type-A dissection. After 9 years he presented with an enlarging infrarenal post-dissection aneurysm. The false lumen was embolized using multiple IMPEDE-FX plugs as part of the treatment in addition to embolization of the inferior mesenteric artery and overstenting of the re-entry in the right iliac artery. At 15 months the CTA showed a fully thrombosed false lumen and remodeling of the true lumen. Conclusions The false lumen of an infrarenal post-dissection aneurysm can successfully be embolized using IMPEDE-FX embolization plugs as part of the treatment strategy. Prospective trials on patients with non-thrombosed false lumina are indicated.

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Effective erector spinae plane block for postoperative analgesia in a pyothorax patient who underwent emergency re-open thoracotomy—a case report

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-019-0044-8 ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Izumi Kawagoe ◽

Daizoh Satoh ◽

Mariko Fukui ◽

Kenji Suzuki ◽

Eiichi Inada

Keyword(s):

Postoperative Analgesia ◽

Transverse Process ◽

Erector Spinae ◽

Open Thoracotomy ◽

Case Presentation ◽

Lung Lobectomy ◽

Erector Spinae Plane Block ◽

Lower Lung ◽

The Right ◽

Vein Stenosis

Abstract Background The appropriate choice of postoperative analgesia for pyothorax surgery is unclear since local infection could contaminate the catheter used for regional blocks and bacteremia can lead to disordered coagulation. We performed erector spinae plane block (ESPB) in a pyothorax patient undergoing emergency re-open thoracotomy. Case presentation An 81-year-old male with internal jugular vein stenosis on aspirin therapy was scheduled for pyothorax drainage and residual middle lobectomy 14 days after he underwent open right lower lung lobectomy for lung cancer. ESPB was performed with injection of 20 ml of 0.375% levobupivacaine at the Th5 transverse process of the right side under ultrasound guidance. Although he needed intravenous pentazocine for pain on postoperative day 0, no more analgesics were required postoperatively. NRS score ranged from 0 to 1 thereafter. Conclusions ESPB provided effective postoperative analgesia following emergency re-open thoracotomy for our pyothorax patient. ESPB might be the appropriate choice for postoperative analgesia following pyothorax surgery.

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Emphysematous pyelonephritis with air bubble in the inferior vena cava

African Journal of Urology ◽

10.1186/s12301-020-00081-2 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Tiffany A. Perkins ◽

Alberic Rogman ◽

Murali K. Ankem

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Rare Presentation ◽

Emphysematous Pyelonephritis ◽

Case Presentation ◽

Air Bubble ◽

First Case ◽

The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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