Two cases of longstanding foreign bodies in the larynx and lower laryngo-pharynx were accurately localised by direct coronal3 and limited axial CT scans of the neck. The relationship of the foreign bodies with the surrounding structures and associated changes are demonstrated clearly.
Susuk, or charm needles, are inserted and worn subcutaneously in the face and other parts of the body, as they are believed to enhance beauty and youth, and for many other reasons such as treatment of headache, aches and pains in the joints, back or abdomen. The practice of inserting susuk is a traditional belief, genuinely cultural and superstitious, and common in the south-east Asian region. We present 13 cases of susuk, which was found incidentally on the radiographs as the patients came for various types of treatment at our centre.
We experienced the case of a patient who had a foreign body in the maxillary sinus. The foreign body was an arrow accidentally triggered by the patient while fishing. The foreign body was removed via the Caldwell-Luc approach.
Cases of retained surgical guaze are rarely reported because of medico-legal and professional implications. Retained gauze for a period of more than 10 years is even rarer. A case of retained surgical gauze for 11 years, an accidental finding from a plain radiograph of a patient who had sustained proximal femoral fracture, is reported. A review of other reported cases is presented.
From 1973 to 1982,40 children with respiratory distress was bronchoscoped for suspected foreign body in the trachea-bronchial tree. In 31 children, foreign bodies were found and were successfully removed. The condition appeared to be confined to the early toddler group. Six children had pulmonary complications post-operatively. There was no death. A plea is made for early diagnosis and referral to lessen the likelihood of residual pulmonary damage.
Study site: University Hospital, Kuala Lumpur, Malaysia (current name: University Malaya Medical Centre)
Two cases oj dentures impacted in the oesophagus are presented. One patient had an intrathoracic perforation oj the oesophagus. The complications arising from. impacted foreign bodies and attempts at its removal are discussed. It is suggested that primary oesophagostomy and extraction of the foreign. body may be the better alternative than repeated attempts at extraction through the oesophagoscope.
A successful retrieval of a detached segment of a CVP catheter by percutaneous right transfemoral venous route, using a Dotter intravascular retriever basket, is reported. The procedure was monitored under fluoroscopy. Only local anaesthesia, which was infiltrated around the puncture site, was given to the patient. No significant complication was encountered. Successful retrieval of the detached catheter fragment by percutaneous means obviates the need for thoracotomy.
Dried fish bones from eight species of Malaysian fish were placed in an animal cadaver at four sites (tonsil, valleculae, larynx and oesophagus) and radiographed using a double and a single film-screen combination. The use of the single film-screen combination resulted in visibility of all fish bones placed in the larynx, two of which were not visible on the double film-screen combination. There was a 50% increase of the visibility of the fish bones in the oesophagus using the single film-screen combination. The difference in dose and cost between the two different film-screen combinations was not significant.
Tracheobronchial foreign bodies, which are common in children, are a leading cause of accidental deaths in children under four years of age. Three cases of tracheobronchial foreign bodies in children less than two years old are described. One of the foreign bodies was unsuspected; the other two were probably related to food habits. All three cases improved without sequelae following prompt bronchoscopic intervention. Young children should not be given food containing bones or hard chitinous shells.
Impacted foreign bodies in the trachea and esophagus are common. In the esophagus, these are usually bones, while for the trachea, it is commonly some form of seed or nut. The incidence of impacted dental prostheses is not highlighted in the literature. They usually have a definite history of ingestion, frequently during trauma, seizures, or sleep. Prompt management in a safe and effective manner is required if significant morbidity, and even mortality, is to be avoided.
A rare complication of per rectal extrusion of a ventricule peritoneal shunt catheter occuring in a four-month old Chinese baby boy with hydrocephalus is described. Perforation of the bowel by the shunt occurred without any peritonitis or retrograde infection of the shunt system. Its pathogenesis and diagnosis are discussed.
A retained Graefenberg , ring intrauterine. contraceptive device which looked like a fractured Lippes loop on pelvic radiography is presented, and its management outlined.
Surgical approaches are becoming increasingly minimally invasive, without compromising either safety or ease. Penetrating ocular foreign bodies has traditionally been approached either by intraocular or supraorbital access. We successfully attempted a minimally invasive approach to remove a retrobulbar foreign body under computer-assisted image guidance in a 19-year-old man involved in an industrial mishap.
We report a case of a young man who presented with a left-sided pneumothorax after suffering an accidental penetrating injury by a sewing needle to the anterior chest wall. Chest radiograph and the computed tomography of the thorax revealed that the needle was in the pleural cavity and there was an associated pneumothorax. An attempt at retrieval by direct incision failed. The sewing needle was successfully retrieved by a medical pleuroscopy. The patient recovered without any consequences and was discharged home after 24 hours of observation.