Case series of retained rectal foreign body. A Malaysian experience.

Retained rectal foreign body, with its associated social stigma, is a medical condition that is infrequently reported in Malaysia. We report the surgical management of five cases of retained foreign objects in the rectum seen over a one-year period. There were three young and two elderly male patients. One of the elderly patients presented with altered bowel habits and an abdominal mass that mimicked a symptomatic colonic tumor. All patients had an abdominal radiograph which clinched the diagnosis of a retained foreign rectal body. Successfully retrieved objects included two bottles, one bidet device, and two sex toys. Open surgery for retrieval of the impacted rectal foreign body was required in one patient. All underwent successful retrievals without any adverse postoperative complications. In our case series, retained rectal foreign bodies were observed only in the male gender. The age presentation was bimodal, with age groups in the twenties and sixties. The treatment options used for the retrieval of these impacted foreign bodies included transanal extraction or explorative laparotomy. Proximal migration and delayed presentation are possible indications for the latter approach.

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Challenges in Management of Tracheobronchial Foreign Bodies with Delayed Presentation: An Institutional Experience

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1718964 ◽

2021 ◽

Author(s):

Darwin Kaushal ◽

Amit Goyal ◽

Kapil Soni ◽

Bikram Choudhury ◽

Nithin Prakasan Nair ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Preoperative Planning ◽

Rigid Bronchoscopy ◽

Delayed Presentation ◽

Betel Nut ◽

Key Factors ◽

Tracheobronchial Foreign Body ◽

Institutional Experience ◽

Definitive Management

Abstract Introduction Airway foreign bodies are emergencies involving multidisciplinary departments like Pediatrics, Aneasthesiology and Otorhinolaryngology. It is always a challenge to diagnose and manage patients who present late to our emergencies. Objective In the present study, we aim to analyze the various challenges faced during the management of tracheobronchial foreign bodies with delayed presentation. Methods A retrospective hospital record-based analysis of patients who presented to us with tracheobronchial foreign bodies from January 2017 to February 2020 was performed. All patients until the age of 16 years old were included in the present study. We assessed the demographics, preoperative, intraoperative and postoperative data of the patients. Results Seventeen patients were analyzed in the study. Among these, 44.4% of the patients had delayed presentation (> 1 month). The majority of the patients had an organic foreign body (Supari or betel nut). All patients underwent rigid bronchoscopy, followed by optical forceps-assisted removal of the foreign body. A total of 82% of the patients had granulations around the foreign body. Conclusion Management of delayed presentation tracheobronchial foreign body is a big challenge for Otorhinolaryngologists. The key factors for preventing complications in the definitive management of tracheobronchial foreign bodies are preoperative planning, multi-discipline teamwork, surgeon expertise and technique.

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Tracheo-bronchial foreign bodies: our experience at a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20161848 ◽

2016 ◽

Author(s):

Shashidhar S. Suligavi ◽

Mallikarjun N. Patil ◽

S. S. Doddamani ◽

Chandrashekarayya S. Hiremath ◽

Afshan Fathima

Keyword(s):

Foreign Body ◽

Early Diagnosis ◽

Foreign Bodies ◽

Tertiary Care ◽

Case Series ◽

Team Work ◽

Care Hospital ◽

Retrospective Case ◽

Presenting Symptoms ◽

Case Series Study

Background:Tracheo- bronchial foreign bodies have always posed a challenge to the ENT surgeon as they present with varied symptomatology ranging from a simple cough and fever to more grave respiratory distress. It requires a strong suspicion, early diagnosis and timely intervention to reduce the overall morbidity and mortality .This study was undertaken to highlight our experiences in handling cases of tracheo- bronchial foreign bodies (FB) at our setup.Methods:It is a retrospective case series study conducted in S. Nijalingappa Medical College between January 2011 and January 2015. Results:Most commonly affected were children between 1year to 3years of age. Chronic cough and wheeze were the commonest presenting symptoms. Vegetative foreign body was found to be the commonest variety of foreign body. The mortality rate in our study was 4.7% (n=3).Conclusions:A good clinical acumen, team work, early diagnosis and timely intervention are all needed to reduce the overall mortality and morbidity associated with tracheo- bronchial foreign bodies.

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Paediatric aerodigestive foreign bodies: remember the nasopharynx

The Journal of Laryngology & Otology ◽

10.1017/s0022215110000708 ◽

2010 ◽

Vol 124 (10) ◽

pp. 1132-1135 ◽

Cited By ~ 2

Author(s):

S D MacNeil ◽

J P Moxham ◽

F K Kozak

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Case Series ◽

Aerodigestive Tract ◽

Endoscopic Approach ◽

Lower Airway ◽

Endoscopic Evaluation ◽

Tertiary Referral ◽

Children's Hospital ◽

Distal Airway

AbstractIntroduction:Nasopharyngeal foreign bodies are relatively uncommon, compared with other aerodigestive sites. They may mimic a lower airway location, or may be coughed up into the nasopharynx prior to endoscopic evaluation.Objective:To describe our experience with nasopharyngeal foreign bodies mimicking a more distal airway location.Method:Case series from a tertiary referral children's hospital.Results:We present a series of four children who were initially thought to have a lower aerodigestive tract foreign body (three respiratory, one oesophageal), but who were finally diagnosed with nasopharyngeal foreign body. The concept of panendoscopy at all foreign body removals is suggested as a means to avoid a missed nasopharyngeal foreign body.Conclusion:Although nasopharyngeal foreign bodies are uncommon, their rare ability to mimic distal sites mandates a thorough endoscopic approach to ensure that all sites (i.e. larynx, lungs, oesophagus and nasopharynx) are evaluated endoscopically.

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The Enigma in Management of Complicated Foreign Body Ingestion Impacted Distal to Oesophagus: A Case Series and Literature Review

10.21203/rs.3.rs-80657/v1 ◽

2020 ◽

Author(s):

Raymond Zhun Ming Lim ◽

Addy Aun Wei Ang ◽

Jih Huei Tan ◽

Ee Peng Lee ◽

Jun Loong Chiew ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Foreign Body ◽

Conservative Management ◽

Foreign Bodies ◽

Case Series ◽

Management Approach ◽

Luminal Diameter ◽

First Case ◽

Surgical Extraction ◽

Schizophrenic Patients

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.

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Risk Factors for Otolaryngological Foreign Bodies in Eastern Poland

Otolaryngology ◽

10.1177/0194599812455297 ◽

2012 ◽

Vol 147 (5) ◽

pp. 889-893 ◽

Cited By ~ 3

Author(s):

Beata Rybojad ◽

Artur Niedzielski ◽

Grażyna Niedzielska ◽

Paweł Rybojad

Keyword(s):

Risk Factors ◽

Foreign Body ◽

Elementary Education ◽

Urban Areas ◽

Foreign Bodies ◽

Medical Center ◽

Tertiary Care ◽

Case Series ◽

Psychomotor Development ◽

Tertiary Care Medical Center

Objective To identify the sociodemographic characteristics and risk factors associated with suspected foreign bodies in the ear, nose, throat, airway, and esophagus among Polish children. Study Design Case series with chart review. Setting Tertiary care medical center. Subjects and Methods A retrospective analysis of the medical records of patients hospitalized for a suspected foreign body (FB) between 1998 and 2008 was conducted. Data regarding place of residence, presence of siblings, parents’ educational status, seasonality, psychomotor development, age, and sex were collected and statistically analyzed. Results Of the 1011 patients with suspected foreign body insertion, 849 (84%) had a positive diagnosis. Of the confirmed foreign bodies, 96 were found in the tracheobronchial tree, 142 were found in the esophagus, and 611 were located in the external auditory canals, nasopharyngeal passage, tonsils, auricles, or lips. Sociodemographically, 596 of the children came from urban areas, with a preponderance of males (55%). Objects were removed more frequently in summer and autumn (60%). Children with siblings (53%) predominated. The majority of patients (52%) had parents with an elementary education. Food was the most frequent foreign body in children under 3 years of age. Patients with delayed psychomotor development constituted 1.6% of the analyzed population. Conclusions Being male, 1 to 3 years of age, belonging to an urban family with siblings, and having parents with an elementary education increased the risk of foreign body insertion. Training caregivers about proper nutrition and safety rules when playing with children can reduce the risk of accidents related to foreign body insertion.

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Tracheobronchial foreign body aspiration: A 13-year retrospective analysis

Medicinski pregled ◽

10.2298/mpns14s1069d ◽

2014 ◽

Vol 67 (suppl. 1) ◽

pp. 69-74

Author(s):

Danijela Dragicevic ◽

Ljiljana Jovancevic ◽

Rajko Jovic ◽

Ljiljana Vlaski ◽

Bojan Bozic

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Main Bronchus ◽

Age Groups ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Radiological Findings ◽

Tracheobronchial Foreign Body ◽

The Moment ◽

The Right

Introduction. Foreign body aspiration into the respiratory tract remains a diagnostic and therapeutic challenge in clinical practice, especially in young children, who are the most frequently affected age group. The aim of this study was to present the results of treating the patients with foreign body aspiration in all age groups. Material and Methods. The medical and radiological records of 64 patients with confirmed foreign body out of 146 patients with suspected foreign body aspiration were retrospectively analyzed during the period of 13 years (from 2001 to 2013). Results. A foreign body was found in 64 (44%) of the 146 patients of all age groups with suspected foreign body aspiration. The patients? age ranged between 11 months and 80 years. There were 84% children and 16% adults, and 63% of patients were male. Time between the moment of aspiration and admission to the Department ranged between 0.5 hours and 14 days, with majority of patients (70%) being admitted during the first 24 hour. History of respiratory drama was present in 92% of patients. Physical and radiological findings were positive in 66% and 47% of patients, rescpectively. Organic vegetable foreign bodies accounted for 75% of all cases, and they were most frequently found in the right main bronchus (63%). All foreign bodies were successfully extracted by rigid bronchoscopy, without serious complications and fatal outcomes. Conclusion. Bronchoscopy should be performed in any case of suspected foreign body aspiration, even if clinical and radiological findings are normal, in order to avoid serious and possible life-threatening complications. More should be done to raise awareness of this potentially preventable condition.

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Unusual foreign bodies of the airway: a case series regarding their management

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182720 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1089

Author(s):

Aishwarya Ullal ◽

Sanjeev Mishra ◽

R. K. Mundra

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Case Series ◽

Rigid Bronchoscopy ◽

Lateral View ◽

Virtual Bronchoscopy ◽

X Rays ◽

X Ray ◽

Radiological Studies ◽

Respiratory Reflexes

Foreign bodies in the bronchi are a common problem seen by ENT surgeons. Bronchial foreign bodies are common in children because they have difficulty in swallowing hard foodstuffs such as nuts and have an inadequately developed protective respiratory reflexes, which makes them vulnerable to inhalation of foreign bodies This is a case series of four unusual cases of foreign body airway, that presented to our ENT OPD, after taking detailed history and clinical examination, these patients were subjected to radiological studies such as chest X-rays, X-ray soft tissue lateral view, virtual bronchoscopy and CT chest to confirm the foreign body, after taking informed consent rigid bronchoscopy was performed and foreign body extracted.

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Ear, Nose, and Throat Foreign Bodies in Children: A Retrospective Study

Children ◽

10.3390/children9010063 ◽

2022 ◽

Vol 9 (1) ◽

pp. 63

Author(s):

Bin Kwon ◽

Yeso Choi ◽

Sung-Kyun Kim ◽

Seok-Jin Hong ◽

Yong-Bok Kim ◽

...

Keyword(s):

Early Childhood ◽

Retrospective Study ◽

Foreign Body ◽

Foreign Bodies ◽

Pediatric Patients ◽

Age Groups ◽

Common Location ◽

Number Of Patients ◽

Using Data ◽

Nose And Throat

Background: This study analyzed the presentation, characteristics, and management of foreign bodies in different age groups of pediatric patients with ear, nose, and throat foreign bodies. Methods: A retrospective study was performed using data from October 2012 to September 2020. A total of 1285 patients with ear, nose, and throat foreign bodies who were less than 12 years of age and who presented to the emergency room were included in this study. Their biographical data, clinical presentations, foreign body types and locations, and management outcomes were obtained from medical records and analyzed as three age groups (infancy: <2 years old; early childhood: 2–5 years old; and late childhood: 6–12 years old). Results: The early childhood group had the highest number of patients (n = 672; 52.2%). Throat was the most common location (59.2%), and bone was the most common type of foreign body. Among the children who visited our hospital, foreign bodies were actually found in only 657 patients (51.1%) and removed by an otolaryngologist in 625 (95.1%) cases. Conclusion: Our study could provide guidance for the diagnosis and management of pediatric patients who present to emergency departments with foreign bodies.

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Experiences with management of foreign body airway presenting as dire emergency

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213288 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1509

Author(s):

Aishwarya Ullal ◽

Arun P. Ajith

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Case Series ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Accidental Death ◽

Detailed History ◽

Common Causes ◽

The World ◽

To Come

Aspiration of foreign bodies by children is a common problem around the world. Foreign body aspiration is a common cause of morbidity and mortality in children, especially between ages 18 months to 3 years. Laryngeal foreign bodies pose as a dire emergency lead to choking and accidental deaths. This is a case series of five cases of laryngeal foreign bodies presenting as a dire emergency to our casualty. Detailed history and examination was done. Radiological investigations were done. Rigid bronchoscopy was performed and the foreign body was extracted restoring the airway, preventing the accidental death of the patient. Foreign bodies of the airway are the most common causes of preventable deaths among children. Quick detailed history, examination and radiological investigations are required to come to the diagnosis and prompt management. This case series throws light on how to manage laryngeal foreign bodies.

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Diagnosis and management of neglected foreign body foot in children

International Surgery Journal ◽

10.18203/2349-2902.isj20211947 ◽

2021 ◽

Author(s):

Reyaz Ahmad Wani ◽

Kumar Abdul Rashid ◽

Muneer Abas Malik

Keyword(s):

Foreign Body ◽

Case Series ◽

Clinical Suspicion ◽

Delayed Presentation ◽

Retrospective Case ◽

Female Ratio ◽

Mean Delay ◽

Extremity Trauma ◽

Healing Wound ◽

History Of

Background: Foreign body related extremity trauma is uncommon in children and mostly involves lower limb. Such cases are prone to get neglected or missed and present at a later date with complications. Careful management at the outset can avoid such complications. Clinical suspicion followed by diagnostic imaging and retrieval of foreign bodies in cases with delayed presentation is vital. Methods: A retrospective case series analysis of foreign body foot, diagnosed and managed over a period of 6 years, was carried out at our institute with the aim to highlight clinical presentation and management of cases with a neglected foreign body foot.Results: A total of 23 patients with diagnosis of foreign body foot were studied with 15 acute cases and 8 chronic neglected cases. The neglected cases ranged in age from 15 months to 96 months (Mean 58.87±28.32). Male to female ratio was 7:1. The history of trauma was concealed in 6 out of 8 cases. Three presented as abscess, 2 each as cellulitis and non-healing wound and one as a granuloma. Mean delay in foreign body removal was 57.12±67.94 days. Five patients had radiolucent while three had radiopaque foreign bodies.Conclusions: Clinical suspicion aided by radiography and/or ultrasonography is pivotal in diagnosis. Removal of foreign body can be done by wound exploration under local anaesthesia in most of the cases.

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