FOREIGN BODY INCIDENCE IN PREGNANT COWS AND BUFFALOS

Clinical study for (105) pregnant and (32) buffalo suffering from reticulopertonitis which are operated for foreign body removal by rumenotomy in different pregnancy stages. Result shown that the late stage pregnancy is the highest inicdence and all operated animals had no any complications and some of them delivered normally after 10 - 16 hr. and other within few days, this indicate that rumenotomy could be done at any stage of pregnancy even within few hours before parturition.

Endoscopic Removal of an Eroded LINX® Device Using a Mechanical Biliary Lithotriptor

Background: Magnetic sphincter augmentation (MSA) via the surgical placement of a LINX® device (LINX® Reflux Management System, Torax Medical, Shoreview, MN, USA) is an increasingly performed minimally invasive outpatient anti-reflux procedure with a low erosion rate. The most common initial approach to eroded LINX® devices is endoscopic removal. Often endoscopy centers do not have specialized devices to cut through the newer, more durable LINX® systems. In this paper we describe a unique approach for removal of a LINX® with intraluminal erosion using a commonly stocked mechanical biliary lithotripsy device. Case description: A 63-year-old male with a history of GERD and symptomatic type III paraesophageal hernia (PEH) underwent a robotic PEH repair with magnetic sphincter augmentation (1.5T, 17 bead) at an outside hospital. He developed an acute recurrence of his PEH, and subsequent upper endoscopy and contrast esophagram four weeks postoperatively revealed a gastric erosion of the LINX device, which had migrated 6 cm onto the stomach. Attempted endoscopic LINX® removal using the OVESCO remove DC Cutter device was unsuccessful. Using principles of prior endoscopic bariatric lap band foreign body removal, the entire LINX® device was successfully removed with the described biliary lithotriptor technique. Conclusion: Using a common biliary mechanical lithotriptor device and a guidewire to transect the newer 1.5T LINX® Reflux Management System is a safe, effective and familiar technique for endoscopic removal of an eroded MSA device.

Lead Airgun Projectiles Inside the Maxillary Sinuses—Therapeutic Approaches through the Years: A Systematic Review of Case Reports

Background: Shots from commonly available non-gunpowder weapons are a significant cause of facial injuries, especially in pediatric patients. A consequence of such trauma may be the placement of a projectile within the maxillary sinus, which is a therapeutic need with no guidelines for foreign body removal. The purpose of this paper is to discuss the etiology, epidemiology, diagnosis, treatment and prognosis of such cases. Materials and methods: Any cases describing the presence of airgun pellets within the maxillary sinus were included. Animal patients and non-English cases were excluded. The final search using the PubMed, BASE and Google Scholar engines was made on 13 November 2021. The JBI Critical Appraisal Checklist for Case Reports was used to assess the risk of bias. The collected data are presented in tabular form and were subjected to a comparative assessment. Results: In total, reports of seven cases of lead airgun projectiles in the maxillary sinuses were identified, qualified and analyzed. There were no cases of lead intoxication. The bullets were removed by open surgery in the form of antrostomy of the maxillary sinus or with the use of an endoscope. In none of the described cases were complications observed during surgery or postoperative observation. Discussion: This systematic review was based on case reports that differed significantly in quality. The location of the lead foreign body within the maxillary sinuses may be considered favorable over other craniofacial gunshots. The risk of lead intoxication does exist, but such a location of the bullets does not favor it. The removal of projectiles from the maxillary sinuses appears to be easily achievable and does not predispose one to complications.

Flexible bronchoscopy in foreign body removal in the pediatric population: A Systematic Review

Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.

Nasal foreign bodies: our experience

Background: The experience of a mother of a child with a foreign body stuck in its nasal cavity can be quite panicky and horrifying. The nasal foreign bodies are one of the commonest emergencies in the department of otorhinolaryngology. The common foreign body objects that are removed from the nasal cavity includes beads, pencil butts, peas or other grains, seeds, sponge, stones, paper bits, erasers, metallic objects, crayons, batteries.Methods: An observational prospective study was performed at the department of otorhinolaryngology, government medical college, Kathua, Jammu and Kashmir. In this study we examined 120 cases of foreign body nose that had presented to us from March 2019 up to March 2020. Once detected a written consent was obtained from the patient’s attendants after duly explaining the involved risks to the child. Thereafter the foreign bodies were removed using appropriate instruments. Microsoft Excel tool were used to analyze and interpretate the data.Results: Amongst the 120 patients, there were 23 adults and 97 children under 10 years. Study included 72 males and 48 females. The 86 patients had a clear history of foreign body insertion. The 12 patients were brought to our OPD with history of a long standing unilateral nasal discharge. The 12 patients had presented with history of epistaxis. Eight patients had presented with headache and recurrent episodes of rhinorrhea. Two cases presented with symptoms of pain over the nasal bridge and swelling. In our study 86% of the patients were brought with a history of foreign body insertion and only 14% a foreign body was detected when the child had presented to the outpatient department with nasal complaints. Amongst the patients 88 of them (74%) had presented with foreign bodies in their right nostril.Conclusions: Any history of insertion of a foreign body inside the nose should be thoroughly investigated. Appropriate clinical examination and diagnostic nasal endoscopy (wherever indicated) should be done. Appropriate instrument should be selected and used for foreign body removal.

Leg Impalement – A Rare Injury Pattern Case Report

Introduction: Impalement injuries are defined as rare, high-energy lesions caused by foreign bodies, usually steel bars or wooden objects, which pierce body cavities or extremities and remain interposed in the perforated body region. They usually occur with road accident or civil construction falls. Case Report:A 24-year-old male patient was admitted at the emergency department after a motorcycle accident, resulting a left leg impalement with a wooden object. A partial deep peroneal nerve palsy and a proximal third fibula fracture were observed. The foreign body removal and wound debridement were performed. The patient evolved favorably without complications, with complete neurological recovery and returning to his normal life activities. Discussion: Impalement injuries represent a challenge in pre-hospital care, emergency room, and operating room hospital care, due to its rarity and specificity: Type of object, anomalous foreign body location, and trajectory. There is a consensus that whenever possible, it should be removed in the operating room, due to the foreign body may be tamponing a major arterial laceration, thus preventing massive hemorrhage. Conclusion: Neurovascular injury exclusion, foreign body removal in the operating room, debridement, and antibiotic prophylaxis represent the treatment basis of these injuries. Keywords: Impalement, Trauma, Leg