scholarly journals Intestinal Obstruction Following Ingestion of Alginate Dental Impression Material

2020 ◽  

Introduction: No medical intervention is required for emergency department applications resulting from foreign body ingestion. Patients who need intervention are generally with complications such as obstruction, perforation or fistula. Alginate is a non-toxic and non-irritant substance that is elastic in the form of a paste preserving its elasticity under heat, which is used as a printing material for measuring the teeth in dental prosthesis applications . A case of ileus developing as a result of ingestion of alginate impression has been presented. Case report: A 74-year-old male patient presented to our emergency department due to abdominal pain nausea and vomiting . He described periumbilical pain and stated that he felt mild swelling. He had vomit one time and the content of vomit was what he had eaten. On physical examination, his abdomen was slightly distended, bowel sounds had increased slightly on auscultation and there was mild periumbilical tenderness with palpation, with no defence or rebound. On the abdominal CT evaluation, a homogeneous, lobulated, hyperintense foreign body image was detected in the distal ileus and distension in the small bowel loops proximal to the foreign body was interpreted. After general surgery consultation, distal ileal resection was performed and pink, homogenous, slightly soft charactered object was extrected. Later this object was understood to be alginate impression. Conclusion: Elderly patients in particular, ileus may occur due to foreign body associated with dental interventions, and in such cases, patients may need surgical intervention.

2021 ◽  
Vol 2 (5) ◽  
pp. 242-245
Author(s):  
Kevin Yanushefski ◽  
Sukhdip Kaur ◽  
Mary Eberhardt

Introduction: Infectious aortitis is a rare condition with mortality rates approaching 100% without surgical intervention. Symptoms and findings may be vague. Computed tomography (CT) with intravenous (IV) contrast, once the gold standard of diagnosis, may only show subtle findings. More recently, CT angiography (CTA) and magnetic resonance angiography have become the diagnostic modalities of choice. Case Report: A 58-year-old diabetic male presented to our emergency department with nausea, vomiting, diarrhea, fevers, and abdominal pain of two weeks duration. The patient had been seen just days before at another facility with the same complaints. He received an abdominal CT with IV contrast that was reported as negative and discharged with the diagnosis of gastroenteritis. He failed to improve and presented to our facility. On presentation, the patient was diaphoretic and uncomfortable. A repeat abdominal CT with IV contrast revealed a mantle of low density around the aorta. The patient was started on IV antibiotics, and a follow-up CTA of the abdomen and pelvis showed an irregular saccular aneurysm. Vascular surgery was consulted, and the patient underwent vascular reconstruction. Conclusion: Because of the high level of mortality seen in infectious aortitis and improvement in patient outcomes with surgical intervention, a high index of suspicion needs to be maintained in patients presenting with fever and chest, abdominal, and back pain, especially in the setting of risk factors and bacteremia. The clinician should be aware that the usual modality for the evaluation of abdominal pain, CT with IV contrast, may not be adequate to make the diagnosis.


2020 ◽  
Vol 4 (3) ◽  
pp. 450-453
Author(s):  
Samuel Nesemann ◽  
Kimberly Hubbard ◽  
Mehdi Siddiqui ◽  
William Fernandez

Introduction: Rectal foreign bodies (RFB) pose a challenge to emergency physicians. Patients are not often forthcoming, which can lead to delays to intervention. Thus, RFBs require a heightened clinical suspicion. In the emergency department (ED), extraction may require creative methods to prevent need for surgical intervention. Case Report: The authors present a case of a successful extraction of a RFB in the ED and review of the literature. Conclusion: Retained RFBs are an unusually problematic reason for an ED visit. Thus, it is important for emergency physicians to be comfortable managing such cases appropriately.


2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.


2015 ◽  
Vol 72 (12) ◽  
pp. 1118-1121
Author(s):  
Vasilije Jeremic ◽  
Srdjan Mijatovic ◽  
Slobodan Krstic ◽  
Sanja Dragasevic ◽  
Tamara Alempijevic

Introduction. Many factors have been indentified as a possible cause of rectal prolaps. Despite the fact that it is not a lifethreating condition, its clinical presentation varies, and sometimes it can present as an emergency. We presented a patient with prolapse of an unusually large segment of the rectosigmoid colon caused by chronic constipation, as an incarcerated segment repaired surgically. Case report. A 62-year-old female patient was referred to the Emergency Department in bad condition with severe pain in the perianal region. On examination a complete rectal prolaps as well as a part of sigmoid colon were found. Macroscopically, the prolapsed segment appeared edematous, livid, with ulcerations. An attempt to manually reduce prolapse failed, therefore resection of 50 cm of sigmoid colon with rectopexy had to be performed. No complications occurred and the patient was without symptoms six months later. Colonoscopy did not reveal any abnormality. Conclusion. Although the preoperative management and preparation of the patient was limited, emergancy surgical intervention for such a case was the strategy of choice due to magnitude of the prolapsing segment. It provided a successful and permenant solution.


2020 ◽  
Vol 10 (6) ◽  
pp. 156-157
Author(s):  
Muhammet Mesut Nezir ENGİN ◽  
Fatih ERDOĞAN ◽  
Özlem KÜÇÜK ◽  
Murat KAYA

Foreign body aspiration (FBA) is common in children. Especially in children, the majority of accidental deaths occur due to FBA. Morbidity and mortality rates increase, especially in children between the ages of one and four, and as a result of delay in diagnosis. The most common symptoms in patients with FBA are cough, dyspnea, hemoptysis, stridor and wheezing. In this case report, a patient who presented with sudden respiratory distress in the Pediatric Emergency Department was presented and the importance of anamnesis and respiratory examination in the diagnosis of FBA was emphasized.


2020 ◽  
Author(s):  
Suo-Hsien Wang ◽  
Mao-Yu Chen ◽  
Tzu-Yen Huang ◽  
Che-Chia Chang ◽  
Chih-Ying Chien

Abstract Background: Most nail gun injuries occur at the extremities due to working accidents. Injuries to the brain or thorax are relatively rare, and cases with both injuries are even rarer. Initial evaluation, resuscitation and surgical planning can be challenging. Case presentation: Here, we present a case with nail gun injuries to the brain, lung, and heart by suicide attempt. The patient presented to the emergency department under shock. After resuscitation and surgical intervention, he was discharged without significant morbidity. Conclusions: Multiple nail gun injuries, especially those to vital organs such as the brain, lung, and heart, can be challenging to emergency physicians and surgeons. Imaging tools, treatment strategies, and possible complications are discussed in this article to provide optimized outcomes in such situations.


Author(s):  
Amar K. Bhardwaj ◽  
Naif Fnais ◽  
Christopher J. Chin

Abstract Background Foreign body ingestion is a common problem in pediatrics. Each foreign body can present its’ own unique challenges during removal, and we present the management of an ingested Spotted Tussock Moth (Lophocampa maculata), more commonly known as a caterpillar. Case presentation An 18-month-old boy presented to the emergency department with difficulty handling secretions and odynophagia. It was reported he had placed a caterpillar in his mouth and then spat it out. On examination, hundreds of miniscule filaments (setae) were seen embedded in his lips and tongue. Our service was consulted out of concern for airway involvement. The patient was taken to the operating room where a direct laryngoscopy under general anesthesia with spontaneous ventilation was performed to confirm the setae were confined to the anterior tongue and lips. Once we were satisfied the airway was stable, the airway was secured, and we then began to remove the setae. The initial method used was to use Adson-Brown forceps to remove the setae, however this proved difficult and time-consuming given the volume of setae and how thin the setae were. Ultimately, a more effective technique was developed: a 4 × 4 AMD-RITMES® gauze was applied to the mucosa in order to dry up any secretions and then a piece of pink, waterproof BSN medical® tape was applied to the mucosa. After 3 s of contact it was removed. This technique was then repeated and was used to remove the vast majority of the setae. Conclusion To our knowledge, we have described the first technique to remove the caterpillar setae from the oral cavity mucosa in a fast, safe and efficient manner.


2020 ◽  
Vol 33 (13) ◽  
Author(s):  
Íris Santos Silva ◽  
Renata Martello ◽  
António Mendes ◽  
Albertino Chaves

Hematocolpos is an obstruction of the menstrual flow due to an anomaly of the genital tract, with imperforate hymen being the most common one. It is an uncommon condition, with a prevalence of 1:1000 – 1:16 000. It is usually an asymptomatic condition until the onset of menarche, when there is accumulation of blood in the vagina (hematocolpos) or in the uterus (hematometra). A rare symptom of hematocolpos could be urinary retention. Our case report is about a 12-year-old girl, with no menarche and Tanner stage M4/P5, who was admitted to our emergency department with abdominal pain and urinary retention. A brief review of this rare condition is presented, in order to remind clinicians about its existence, so that it can be diagnosed and treated as quickly as possible.


Author(s):  
Abdulmalek Alsharidah ◽  
Yahya Mahli ◽  
Nayef Alshabyli ◽  
Mohammed Alsuhaibani

Basidiobolomycosis is an uncommon emerging fungal infection caused by Basidiobolus ranarum. It frequently causes cutaneous infection, but it rarely infects visceral tissues in humans. Here, a 39-year-old previously healthy woman presented with severe left-sided abdominal pain and weight loss. She had visited several hospitals and had provisionally been diagnosed as having either a retroperitoneal malignancy or retroperitoneal fibrosis before being referred to our hospital. Abdominal computerized tomography and biopsy of the retroperitoneal mass revealed retroperitoneal basidiobolomycosis infection. She was started on antifungal treatment. This led to significant improvement, without surgical intervention. Gastrointestinal basidiobolomycosis can present in many forms, commonly involving the colon and liver with multifocal inflammatory masses. Nonetheless, retroperitoneal basidiobolomycosis presentation is extremely rare and should be considered in the differential diagnosis of a retroperitoneal mass with eosinophilia.


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