scholarly journals Peritonitis and Necrotizing Hepatitis in Ara ararauna Caused by a Foreign Body

2021 ◽  
Vol 49 ◽  
Author(s):  
Larissa Justino ◽  
Maisa Fabiana Menck-Costa ◽  
Ana Aparecida Correa Xavier ◽  
Marielen De Souza ◽  
Beatriz Queiroz dos Santos ◽  
...  

Background: The ingestion of foreign bodies in parrots has already been described and associated with the curious behavior of the birds or with stressful conditions. Foreign bodies in the gastrointestinal tract are usually diagnosed through clinical signs, laboratory tests, and radiographic findings in the historical data. Foreign bodies are usually metallic and can lodge in any segment of the gastrointestinal tract, commonly found in the proventricle and gizzard. This study investigated a case of necrotizing hepatitis due to a foreign body in Ara ararauna (Linnaeus, 1758).Case: An approximately 9-month-old specimen of caninde macaw, had sudden death and was referred for autopsy. The macroscopic examination revealed a fibrous, thick, reddish membrane involving the left hepatic lobe and partially the gizzard in continuity with the peritoneum. Inside the capsule, the liver had a friable and necrotic appearance and the gizzard had a focal perforation area containing a foreign body (gavage probe). We performed the histopathological examination of the liver and gizzard and observed that the membrane surrounding the liver and partially the gizzard had a chronic inflammatory process with a marked proliferation of fibrous tissue and fibrin deposition. The hepatic parenchyma of the left lobe showed diffuse and marked necrosis, with signs of ischemic necrosis. In the region of transmural perforation of the gizzard, the mucosa showed a focal area of extensive necrosis accompanied by the presence of intralesional bacteria. The lesions observed are attributed to the perforation of the organs by the foreign body. It is not known whether the bird ingested the object accidently during food handling as a young or due to the curious behavior of the bird or even the stress it may have been exposed to. The post-mortem examination revealed localized peritonitis and encapsulating necrotizing hepatitis, focally extensive and accentuated, associated with foreign body perforation.Discussion: The curious habit of parrots, can provide the ingestion of foreign bodies, in which they lodge in the gastrointestinal tract. Generally, the clinical signs are nonspecific, however, proventricular impaction, stasis and even perforations in the mucosa of organs can be observed. In the present study, we suspect that the Caninde macaw accidentally ingested a gavage probe during feeding management as a young. This object lodged in the bird's ventricle, perforating the organ and reaching the liver, due to intimate contact with the gizzard, providing a picture of ventriculitis and necrotizing hepatitis. Necrotizing hepatitis due to foreign body has been reported in the literature due to ingestion of perforating foreign body with lesion in the left ventricle and lobe, however we have no knowledge of reports with the presence of a capsule involving the left hepatic lobe, similar to a capsule like this, we understand that our report is the first description of encapsulating necrotizing hepatitis in birds. We believe that this capsule of connective tissue was formed, due to the inflammatory process in the peritoneal cavity, in birds the deposition of fibrin can form a structure similar to a capsule, in order to trap cells and the agent responsible for inflammation, preventing septicemia. Transmural perforation in the gizzard, observed in this case, allowed bacterial translocation that may have contributed to the worsening of the chronic condition and death due to the accumulation of toxins or bacterial translocation of the gastric tract, leading to liver infection and sepsis. We concluded that the presence of the perforating foreign body was responsible for the peritonitis and encapsulating necrotizing hepatitis in Ara ararauna.

2014 ◽  
Vol 80 (2) ◽  
pp. 131-137 ◽  
Author(s):  
Yolanda Ribas ◽  
David Ruiz-Luna ◽  
Marina Garrido ◽  
Josep Bargalló ◽  
Francesc Campillo

The management of foreign bodies in the gastrointestinal tract is not standardized. Foreign body ingestions in prisoners are always intentional and inmates can be manipulative, which makes medical decision even more difficult. Our objective is to propose a decisional algorithm for management of foreign body ingestion in prisoners. We reviewed the records of 198 admissions for foreign body ingestion for a 10-year period. Type and number of ingested foreign bodies, radiographic findings, outcome as well as the management method including conservative, endoscopic removal, or surgical treatment were analyzed. Most cases were managed conservatively (87.6%). Endoscopy of the upper gastrointestinal tract was performed in 37 cases with a success rate of 46 per cent. In 9.3 per cent of cases, the final treatment was endoscopic. Only five patients required surgical treatment, being emergent just in one case. We advocate conservative treatment for asymptomatic patients with foreign body ingestion. Endoscopic removal is proposed for pointed objects or objects bigger than 2.5 cm located in the stomach. Objects longer than 6 to 8 cm located in the stomach should be removed by endoscopy or laparoscopy. Patients with objects in the small bowel or colon should be treated conservatively unless there are complications or they fail to progress.


2018 ◽  
Vol 46 ◽  
pp. 4
Author(s):  
Maisa Oliveira De Freitas ◽  
Carmen Vládia Soares De Sousa ◽  
Francisco Felipe De Guimarães ◽  
João Marcelo Azevedo de Paula Antunes ◽  
Gislayne Cristianne Xavier Peixoto

Background: Ingestion of foreign bodies is one of the most common cases seen among puppies of dogs in the medical clinics of small animals which may be related to their curious behavior. The diagnosis is based on the patient’s history, clinical signs, and complementary diagnostic imaging tests. The present case report describes the use of complementary imaging tests, showing a partial gastric obstruction caused by cajarana (Spondias cytherea Sonn) in a puppy.Case: At the Veterinary Hospital of the Federal Rural University of the Semi-Arid Region, a 4-month-old male Yorkshire dog was treated. The guardian reported having witnessed the ingestion of a cajarana stone by the animal. During the physical examination, the animal was active, with good nutritional status, normocorated mucosae, and a moderate degree of dehydration, besides a slight pain on palpation in the epigastric region. Hematological examinations included blood counts, blood urea, creatinine, and alkaline phosphatase. A moderate degree of polycythemia was observed, which may be explained by the dehydration caused by the episodes of vomiting. The patient had frequent episodes of vomiting after the reported event and was then referred to the diagnostic imaging sector. During the sonographic examination, a concave echogenic interface associated with a posterior acoustic shadowing was observed in the region of the stomach. The animal was sent for simple radiographs and positive contrast based on barium sulfate due to the suspicion of the presence of a foreign body. On simple radiography, in the left laterolateral view, a little radiopaque structure of circular format with poor definition was observed in the pyloric region. After the simple radiography, approximately 10 mL of barium sulfate contrast was administered orally followed by a new left lateral radiographic imaging. On performing sequenced radiographs, a discrete barium contrast contour, oval in structure, located in the pyloric region was observed, even after gastric emptying for about 1 h, reinforcing the clinical suspicion of cajarana stone ingestion. In view of these results, the animal underwent a gastrostomy for the removal of cajarana, which measured about 2.5 cm in diameter. After the surgical procedure, the animal had a good clinical recovery.Discussion: The history of the animal along with clinical signs and imaging tests are of great assistance in the investigation of gastric foreign bodies. The most common type of foreign bodies found in the gastrointestinal tract of small animals are bones, but other atypical structures may also be found, as shown in this report. Radiography (simple and with contrast) is an imaging method widely used in veterinary medicine because of its low cost and clinical accessibility. It is important for the investigation of gastrointestinal obstructions, being of fundamental importance in the management of this case. Ultrasound examination also provides crucial information when foreign bodies are suspected since the formation of intense posterior acoustic shadow (described in this case) is one of the characteristic findings of this condition. Finally, the associated radiography and ultrasonography as diagnostic imaging for the investigation of foreign bodies in the gastrointestinal tract complement each other. Depending on the nature of the foreign body, a single imaging examination may not be satisfactory to suggest the presence of a foreign body with certainty.


Author(s):  
Snigdha Elaprolu ◽  
Gowri Sankar Marimuthu ◽  
Raghul Sekar ◽  
Sunil Kumar Saxena

<p class="abstract">Unusual foreign bodies in the digestive tract are common in psychiatric patients and children requiring screening of the entire gastrointestinal tract. We here report two cases of unusual ingested blunt foreign body in the upper digestive tract managed differently.</p>


2017 ◽  
Vol 4 (10) ◽  
pp. 3277
Author(s):  
Pramod Mirji ◽  
Vikas Daddenavar ◽  
Eshwar Kalburgi

Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 2 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body (FB) ingestion admitted to department of general surgery from January 2015 to December 2016 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 23 cases were studied. Age range was 2-75 years. Males were predominant (60.87%). Coins were found most commonly (52.17%). Esophagus was the commonest site of FB lodgment (65.22%). Upper esophagus being the most common (39.13%). Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 23 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective. 


2016 ◽  
Vol 98 (2) ◽  
pp. e29-e30 ◽  
Author(s):  
YM Goh ◽  
IM Shapey ◽  
K Riyad

Foreign body ingestion is a common presentation in clinical practice, seen predominantly in children. Most foreign bodies pass through the gastrointestinal tract without any additional morbidity. We present a case of gastric perforation secondary to the ingestion of a small plastic bag. We discuss the likely pathophysiological process underlying perforation secondary to plastic bag ingestion, which is most commonly associated with the concealment of narcotics.


2017 ◽  
Vol 62 (No. 10) ◽  
pp. 579-582
Author(s):  
F. Del Signore ◽  
R. Terragni ◽  
A. Carloni ◽  
L. Stehlik ◽  
P. Proks ◽  
...  

The goal of this study was to describe the ultrasonographic and computed tomographic appearance of a penile foreign body in a dog for the first time. We describe an unusual penile localisation of a grass seed awn in an 11-year-old mixed-breed dog referred for a computed tomography study after a severe haemorrhage from the penis. A fistulous tract was observed after plain and post-contrast whole-body computed tomography acquisition; the foreign body was localised with ultrasound and removed under ultrasonographic guidance, with the complete healing of the penile lesion. Grass awns are common foreign bodies in dogs and cats and are commonly localised in the ear canal, subcutaneous tissue, interdigital space, eyelid, conjunctiva and nasal or oral cavity. These foreign bodies pose a threat due to their peculiar structure, which facilitates their easy access to the affected area and their transit through the body. Clinical signs are often non-specific, and imaging modalities such as ultrasonography and computed tomography are useful techniques for localisation. Our report demonstrates that the combination of computed tomography and ultrasound techniques was crucial for the exact localisation and mini-invasive retrieval of the grass seed.


2020 ◽  
Vol 18 (2) ◽  
pp. 36-40
Author(s):  
A. Shrestha ◽  
R.B. Gurung ◽  
P. Sharma ◽  
R. Shrestha ◽  
P. Shrestha

Background Ingested foreign body impaction on upper gastrointestinal tract is common incidence among children, older age group, mentally challenged individuals, and people the influence of alcohol. In most cases, the foreign bodies pass spontaneously and uneventfully but when this does not occur; endoscopic management to ensure removal under direct visualization is required. Relief upon removal of foreign body and prevention of complications is essential. Objective To assess the endoscopic management and outcome of foreign body impacted in the upper gastrointestinal tract. Method This is a hospital based observational retrospective cross sectional study involving 165 patients at Endoscopy Department of Dhulikhel Hospital in Nepal between November 2015 and October 2019. The data regarding the demographic profile, clinical characteristics and endoscopic findings were retrieved and analyzed to determine endoscopic interventions performed, complications and outcomes. Result One hundred and sixty five patients presenting with history of ingestion of foreign body were included in the study. The mean age of the patients was 46.8 ± 19.1 years with male predominance (60%). The most common site of foreign body impaction was oesophagus (70%). The most common foreign body encountered was bone (62.2%) among which chicken bones (91.1%) were most frequent. For the retrieval of sharp-pointed foreign bodies, rat forceps and graspers (45.7%) were most commonly used. Total 14 cases required rigid oesophagoscopy as the foreign body could not be retrieved by flexible endoscopy. Conclusion Foreign body ingestion and its impaction in the upper gastrointestinal tract has been found to be common in endoscopic practise. Early detection and timely removal of foreign bodies is of utmost importance to avoid discomfort to the patient as well as to ensure successful removal without complications.


2019 ◽  
Vol 6 (3) ◽  
pp. 726
Author(s):  
Arshed Hussain Parry ◽  
Mohammad Saleem Dar ◽  
Abdul Haseeb Wani ◽  
Tariq Ahmad Gojwari ◽  
Irfan Robbani

Background: An accidently ingested foreign body may get lodged within the lumen of gastrointestinal tract, pass uneventfully with feces or may migrate extraluminally into the surrounding tissues in which case it may lead to suppurative or vascular complications. The aim of the endeavor was to study the spectrum of imaging findings in patients with accidental ingestion of foreign bodies with trans-gastric migration of metallic foreign bodies.Methods: Total 33 patients with history of accidental ingestion of foreign bodies were subjected to preliminary radiograph of neck, chest and abdomen followed by upper gastrointestinal endoscopy. Failure to retrieve/ localize foreign body endoscopically from upper gastrointestinal tract with check radiograph reiterating the presence of foreign body in upper abdomen were subjected to computed tomography of abdomen.Results: A total of 33 patients comprising of 27 females and 6 males with mean age of 23.76 years with history of foreign body ingestion were studied. Ingested foreign bodies were lodged in pharynx (n=7), esophagus (n=3), stomach (n=13) or duodenum (n=3).  In 7 patients in whom endoscopy failed to locate and/or retrieve foreign body, computed tomography confirmed the presence of trans-gastrically migrated foreign body in the surrounding structures. The location of migrated foreign bodies was in lesser sac (n = 2), greater omentum (n = 3), lesser omentum (n = 1) and transmural (n = 1). Two patients had evidence of collection formation around the migrated foreign bodies.Conclusions: Sharp or pointed metallic foreign bodies may migrate trans-luminally with various implications. Though radiography is the preliminary workhorse for the confirmation of ingested foreign bodies, computed tomography owing to its volumetric data acquisition helps in exact localization of migrated foreign bodies and should precede any therapeutic intervention for retrieval of migrated foreign bodies.


2020 ◽  
Author(s):  
Raymond Zhun Ming Lim ◽  
Addy Aun Wei Ang ◽  
Jih Huei Tan ◽  
Ee Peng Lee ◽  
Jun Loong Chiew ◽  
...  

Abstract BackgroundIngestion of foreign bodies leading to impaction at the pharynx and oesophagus have been extensively described in English literatures. However, impactions at the gastrointestinal tract distal to the oesophagus are less commonly encountered due to the more capacious luminal diameter as it approaches the stomach. While intentional foreign body ingestions impacted distal to the oesophagus are often more complicated, literatures on the management of these distal oesophageal impactions are scarce. Case presentationWe present five cases of foreign body impaction at varying sites of gastrointestinal tract beyond the oesophagus, contrasting management approach comparing the role of endoscopy, open surgery and conservative management. Cases presented include patients aged 40 to 70 with intentional foreign bodies ingestion. The first case described a cerebral palsy patient with pica who had to undergo difficult evacuation under anaesthesia followed by colonoscopy; the second and third cases presented two different schizophrenic patients with two differing management approach. The second case was managed with multiple operations due to complications and died eventually, making the only mortality in our case series; whereas the third case was managed conservatively with acceptable outcome after multiple laparotomies prior. Fourth and fifth cases described two body packers who swallowed tobacco and two phones, respectively; the former was uneventfully managed conservatively, the latter, had to undergo surgical extraction. Individualized approach to these distal impactions of ingested foreign bodies are described with a review of available literatures which are tabulated and discussed in this case series. ConclusionEndoscopy, surgery, conservative management and sometimes a combination of approaches are utilised for the management of foreign bodies impacted distal to the oesophagus, especially in complex and recurrent cases. Decision, timing and approach of extraction must be individualised with consideration of risk weighed against the benefit of each intervention over the other.


Author(s):  
Sunil Kumar ◽  
Devendra Bahadur Singh

ABSTRACT Aspiration or ingestion of a foreign body is well-known in the pediatric as well as in the adult population. The majority of esophageal foreign bodies pass through the gastrointestinal tract without causing complications. However, large sharp foreign bodies like dentures and meat bones can get deeply embedded in the wall leading to life-threatening complications. We report a case of a neglected denture in a 55-year-old patient who presented with an unusual complaint as hoarseness of voice and was removed with the help of rigid esophagoscope. How to cite this article Kumar S, Singh DB. Hoarseness of Voice: Presentation of Neglected Denture Esophagus. Int J Prosthodont Restor Dent 2013;3(1):30-32.


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