Small spherical foreign bodies in the genitourinary tract and their management

Background Urogenital small foreign bodies (FBs) have rarely been reported in children, and their management is still challenging. This study aimed to describe the characteristics and treatment of spherical FBs no larger than 0.6 cm in the children’s genitourinary tracts. Methods The clinical data of spherical FBs removed in our hospital from June 2013 to June 2020 were recorded and retrospectively analyzed, including demographics, location, symptoms, imaging examinations and treatment methods. Results A total of 10 patients were enrolled: 6 girls and 4 boys. Their ages ranged from 5.1 to 16.8 years old, with a mean age of 9.2 years. The course of the disease ranged from 3 h to 1 year, and symptoms recurred in some cases. Their imaging characteristics were reviewed and analyzed, 6 patients underwent color Doppler ultrasonography, 1 patient was suspected to have an FB in the vagina, 7 patients underwent an X-ray examination, and FBs were revealed in 6 patients. All FBs were removed under endoscopic minimally invasive surgery. Six vaginal FBs were successfully retrieved via vaginoscopy, and in the other four cases, removal by transurethral cystoscopy failed because of mutual attraction, which was eliminated by laparoscopy under pneumovesicum. Postoperative recovery was uneventful; in a follow-up of 3 months to 2 years, there was no perforation or fistula formation, and there were no urethral strictures in boys. Conclusion Small spherical FBs are clinically rare; they are sometimes difficult to detect by imaging examinations and can be easily overlooked. Minimally invasive endoscopy remains the first-line approach for the diagnosis and removal of genitourinary spherical FBs.

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

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.

Computed tomography in traumatic orbital emergencies: a pictorial essay—imaging findings, tips, and report flowchart

Computed tomography (CT) is considered the gold standard technique for the assessment of trauma patients with suspected involvement of the eye and orbit. These traumas can result in dramatic consequences to visual function, ocular motility, and aesthetics. CT is a quick and widely available imaging modality, which provides a detailed evaluation of the orbital bony and soft tissue structures, an accurate assessment of the globes, and is used to guide the patients’ treatment planning. For a timely and accurate diagnosis, radiologists should be aware of fracture patterns and possible associated complications, ocular detachments and hemorrhages, and different appearances of intraorbital foreign bodies. This educational review aims to describe all post-traumatic orbital abnormalities that can be identified on CT, providing a list of tips and a diagnostic flowchart to help radiologists deal with this complex condition.

Liver abscess in the caudate lobe caused by a fishbone and treated by laparoscopy: a case report

Background Ingestion of fish bones leading to gastric perforation and inducing abscess formation in the caudate lobe of the liver is very rare. Case presentation A 67-year-old man presented to our hospital with a 2-day history of subxiphoid pain. There were no specific symptoms other than pain. Laboratory tests showed only an increase in the number and percentage of neutrophils. Contrast-enhanced Computerized tomography (CT) of the abdomen showed two linear dense opacities in the gastric cardia, one of which penetrated the stomach and was adjacent to the caudate lobe of the liver, with inflammatory changes in the caudate lobe. We finally diagnosed his condition as a caudate lobe abscess secondary to intestinal perforation caused by a fishbone based on the history and imaging findings. The patient underwent 3D laparoscopic partial caudate lobectomy, incision and drainage of the liver abscess, and fishbone removal. The procedure was successful and we removed the fishbone from the liver. The patient was discharged on the 9th postoperative day without other complications. Conclusions Liver abscess caused by foreign bodies requires multidisciplinary treatment. Especially when located in the caudate lobe, we must detect and remove the cause of the abscess as early as possible. Foreign bodies that perforate the gastrointestinal tract can penetrate to the liver and cause abscess formation, as in this case. When exploring the etiology of liver abscesses, we should investigate the general condition, including the whole gastrointestinal tract.

Technical Intricacies Involved in Surgical Retrieval of a Long Standing Foreign Body in Hand- A Case Report

Foreign Bodies (F.B) are not uncommon in hand as it is involved in Day to day activities. Prompt removal during the initial examination is the norm, but sometimes foreign bodies (F.B) may be missed and they remain within the soft tissue for a long time either revealing itself at a later date as a sinus, swelling or an abscess. We present a case of retained FB in the dorsum of hand and the technique involved in retrieval of such a long standing FB.

Multiple gastrointestinal magnetic foreign bodies in children

Objective: To introduce the analysis of the clinical picture, treatment strategy and complications among children having multiple foreign magnetic bodies (FB).Methods: Retrospective analysis of the treatment of 796 children from 2013 to September 2021 having stomach and intestine FB. Comprehensive study included plan radiography of the abdomen, fiberoptic gastroduodenoscopy, etc.Results: Magnets were detected in 33 (4.15%) out of 796 cases. 9 patients swallowed multiple foreign magnetic bodies (FB) within time interval. The parts fixed in different parts of gastrointestinal tract (GIT) and required surgical removal. All patients had multiple perforations of different GIT parts. It required suturing gut wall, bowel resection applying gastrointestinal anasto mosis and celiogrhaphy, resection applying anastomosis and by leaving the programmed laparostomy. Every patient recovered. Algorithm of supervision of children having FB GIT.Conclusions: Multiple foreign magnetic bodies of GIT among children in the current moment are the most dangerous foreign objects accompanied with big amount of complications. They are observed among children of any age and gender and require complicated and long surgical interventions. Multiple foreign magnetic bodies of GIT can be suspected in case of severe surgical pathology along with the lack of passage of radiopaque FB in GIT. Urgent surgical intervention is required in case of detecting it.

Risk of self-Injury by Patients using Video Otoendoscopes Aimed at home Market

These are powered by USB attachments and can be viewed on mobile phones or home PCs. They are targeted at the home market for examination of ears, nose, and mouths and even some sellers advocate using their use on pets too. They often come with attachments to allow ear cleaning of waand removal of foreign bodies etc. These are available on various online seller websites and can cost as little as £11.

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

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.