Missed foreign body inhalation for 15-years

Background: Foreign body inhalation is a life threating event in children and it is common in our country ,which is a daily practice of Thoracic .It can lead to morbidity even mortality in the hands of untrained or not well- trained doctors. Aim: Is to report a case of missed foreign body inhaled 15-years back, which is uncommonly reported in the literatures and to compare it with other studies reporting similar cases. Methods: The details, presentation, clinical findings, radiological appearance and the successful removal by a rigid bronchoscope under general anesthesia will be presented. Results: The successful removal of this long standing impacted foreign body (plastic whistle) using the rigid bronchoscope and the eventful outcome of patient’s clinical symptoms is elucidated. Conclusion: Refractory respiratory symptoms of long duration without improvement justify the need for diagnostic bronchoscopy which will offers the best chance of cure in missed foreign body inhalation.

Problems of localization of an intraocular impacted foreign body. Clinical case

The article describes a clinical case of an eye injury with presence an intraocular foreign body (IFB), the localization of which was problematic. Patient T was 28 years old, was admitted with complaints of lack of vision, redness and lacrimation from the left eye. From the anamnesis – while working, he hit metal with a hammer, and the scale flew off into the left eye. In addition to the standard ophthalmologic examination, electrophysiological examination, B-scan and UBM were performed. According to the B-scan data, high optical density IFB was detected in the shells 9 mm from the upper border of the optic disc, in the 1-hour meridian, approximately 3.5 mm long. According to the X-ray data of the orbit in 2 projections, an X-ray contrast shadow, metal density, up to 3.0 mm in size was revealed. Radiography of Baltin–Comberg was not performed due to the lack of technical capability. During a standard three-port vitrectomy in the area of possible foreign body occurrence, the retina was damaged, there was a local detachment, but the foreign body itself was not visualized. In addition, during a thorough, detailed examination using a sclerocompressor, no visible defects of the sclera were found transvitreally. In the early postoperative period, the patient was performed with a computed tomogram, where the presence of a foreign body was confirmed, which was adjacent to the posterior wall of the eyeball for 1 hour with clear contours, measuring 3х3 mm. Taking into account the non-standard situation, the absence of a foreign body in the vitreous cavity, it was decided to re-search and remove the foreign body by using of the diascleral method. For a clearer contrast, diaphanoscopy was used, which made it possible to visualize and accurately localize a foreign body in the layers of the sclera. Conclusion. In the presence of IFB for search and precise localization, it is first of all necessary to perform the radiological Baltin-Comberg method. In cases when FB is not visualized intraoperatively, is impaled into the layers of the eye and the radiological Baltin-Comberg method has not been performed, diaphanoscopy of the eye is the optimal auxiliary method for searching for «hidden» foreign bodies. Key words: intraocular foreign body, radiological method of Baltin-Comberg, diaphanoscopy of the eye.

Extraction of an Impacted Foreign Body Bronchus in an Adult Using Flexible Bronchoscopy

Foreign body aspiration (FBA) can be potentially fatal if the object is large enough to cause nearly complete obstruction of the upper airway. The object causing obstruction beyond the carina can result in less severe clinical presentation. FBA is rare in adults than in children. If the clinical history is not suggestive of FBA, then a high index of suspicion and flexible bronchoscopy can ensure proper diagnosis and prompt intervention. We present a case of an adult with aspirated betel nut in the left main bronchus, removed using flexible bronchoscopy with the aid of a Fogarty balloon catheter following the failure of rigid bronchoscopy.

Esophageal Stricture and Dermal Pathology Related to Compound Heterozygous Mutations in the TNXB Gene

The Ehlers–Danlos' syndrome (EDS) constitutes a group of connective tissue disorders that are clinically and genetically heterogeneous. Mutations in the TNXB gene have been recognized as pathogenic causing classical-like EDS due to tenascin-X deficiency. Here, we have reported a unique case of compound heterozygous mutation in TNXB gene leading to esophageal stricture and scarred skin in a 7-year-old boy who presented to us with impacted foreign body in esophagus. The child was also having tendency to atrophic skin scarring secondary to trivial trauma.

Impaled Nasopharyngeal Foreign Body

Introduction Foreign body cases are common in otolaryngologic practice, usually occurring in children. An impacted penetrating impaling foreign body can be one of the most challenging emergencies Management revolves around safe extraction of impaling object and prevention of complications. Here we share our experience with one such case of unusual foreign body impacted at an unusual site, with an extensive review of literature discussing management & prevention of complications in similar cases. Case Report A 3 year old boy presented to us in ENT emergency with a long metallic hook impaled in nasopharynx for the past 8 hours. We were able to dislodge the impacted foreign body under direct endoscopic visualisation under general anaesthesia. Discussion Any such injury might be similar but no two injuries are the same. It needs combined expertise of multidisciplinary team usually consisting of ENT surgeon, anaesthesiologist, radiologist and may also need vascular surgeon and interventional radiologist at times. Several complications are reported in literature, knowledge of which would help preparedness and thus a better outcome.

Wandering airway foreign body in early infancy

Accidental impaction of objects in the respiratory passage is a life-threatening condition. A 9-month-old male infant was admitted with fever, cough and respiratory distress without history of choking. He was treated as wheezy bronchitis with appropriate therapy but, did not show response. HRCT showed an impacted foreign body in the trachea which caused a partial luminal compromise. Two attempts to remove foreign body by rigid bronchoscope failed, and tracheostomy was performed due to fall in oxygen saturation. After stabilization, again saturation was falling and air entry was absent on right hemithorax. Considering the possibility of movement of foreign body in right bronchus, bronchoscope was reintroduced and foreign body was removed in piecemeal. This process was complicated with cardiorespiratory arrest, twice from which the patient was revived. Postoperative period was uneventful. So, high index of suspicion is required to diagnose such a foreign body of the tracheobronchial tree to prevent morbidity and mortality.