scholarly journals Complicated hypopharyngeal perforation caused by a foreign body

2007 ◽  
Vol 60 (7-8) ◽  
pp. 391-396 ◽  
Author(s):  
Karol Canji ◽  
Slobodan Mitrovic ◽  
Ljiljana Jovancevic

The paper describes a patient who ingested a piece of bone during his meal. A foreign body was suspected and admission to the hospital was recommended as well as esophagoscopy, which he refused. Approximately 48 hours after the meal, the patient was admitted to the hospital for increased temperature, neck pain, and swollen right side of neck. Assuming that the condition was a result of hypopharyngeal perforation cased by a foreign body, computed tomography was performed. A collection of pus was found in the lateral and anterior neck compartments with subcutaneous tissue edema, and a foreign body was found in the projection of the hypopharynx. A wide incision was made under general anesthesia and drainage was performed using surgical drains and nasogastric tube. Antibacterial therapy was also applied. The patient was dismissed from the hospital in good general condition. Complications involving a foreign body in the hypopharynx and/or esophagus require urgent attention and adequate diagnosis and therapy. A correct indication, good choice of surgical procedure and intensive antibacterial therapy increase the chance of cure in such patients. .

2017 ◽  
Vol 62 (No. 10) ◽  
pp. 579-582
Author(s):  
F. Del Signore ◽  
R. Terragni ◽  
A. Carloni ◽  
L. Stehlik ◽  
P. Proks ◽  
...  

The goal of this study was to describe the ultrasonographic and computed tomographic appearance of a penile foreign body in a dog for the first time. We describe an unusual penile localisation of a grass seed awn in an 11-year-old mixed-breed dog referred for a computed tomography study after a severe haemorrhage from the penis. A fistulous tract was observed after plain and post-contrast whole-body computed tomography acquisition; the foreign body was localised with ultrasound and removed under ultrasonographic guidance, with the complete healing of the penile lesion. Grass awns are common foreign bodies in dogs and cats and are commonly localised in the ear canal, subcutaneous tissue, interdigital space, eyelid, conjunctiva and nasal or oral cavity. These foreign bodies pose a threat due to their peculiar structure, which facilitates their easy access to the affected area and their transit through the body. Clinical signs are often non-specific, and imaging modalities such as ultrasonography and computed tomography are useful techniques for localisation. Our report demonstrates that the combination of computed tomography and ultrasound techniques was crucial for the exact localisation and mini-invasive retrieval of the grass seed.


1986 ◽  
Vol 26 (1) ◽  
pp. 93-95 ◽  
Author(s):  
MEIR NYSKA ◽  
SHLOMO POMERANZ ◽  
SHLOMO PORAT

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 50
Author(s):  
Jun-Ho Ha ◽  
Byeong-Ho Jeong

Foreign body (FB) aspiration occurs less frequently in adults than in children. Among the complications related to FB aspiration, pneumothorax is rarely reported in adults. Although the majority of FB aspiration cases can be diagnosed easily and accurately by using radiographs and bronchoscopy, some patients are misdiagnosed with endobronchial tumors. We describe a case of airway FB that mimicked an endobronchial tumor presenting with pneumothorax in an adult. A 77-year-old man was referred to our hospital due to pneumothorax and atelectasis of the right upper lobe caused by an endobronchial nodule. A chest tube was immediately inserted to decompress the pneumothorax. Chest computed tomography with contrast revealed an endobronchial nodule that was seen as contrast-enhanced. Flexible bronchoscopy was performed to biopsy the nodule. The bronchoscopy showed a yellow spherical nodule in the right upper lobar bronchus. Rat tooth forceps were used, because the lesion was too slippery to grasp with ellipsoid cup biopsy forceps. The whole nodule was extracted and was confirmed to be a FB, which was determined to be a green pea vegetable. After the procedure, the chest tube was removed, and the patient was discharged without any complications. This case highlights the importance of suspecting a FB as a cause of pneumothorax and presents the possibility of misdiagnosing an aspirated FB as an endobronchial tumor and selecting the appropriate instrument for removing an endobronchial FB.


2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhaorui Zhang ◽  
Binbin Xiao ◽  
Zhixin Liang

Abstract Background Pyopneumothorax secondary to Streptococcus constellatus infection is a clinically rare event, and few cases have been reported. Case presentation We report the case of a 55-year-old Han Chinese man with underlying diabetes who presented with fever of 17 days duration. A pulmonary computed tomography scan revealed right-sided massive pyopneumothorax. A culture of the pleural effusion and blood grew S. constellatus. A drug sensitivity test showed that the isolate was sensitive to linezolid, penicillin G, cefotaxime, vancomycin, and cefuroxime. Our patient was treated with linezolid for a total of 6 weeks. Subsequently, his chest computed tomography scan showed improved lung condition. Conclusion To the best of our knowledge, this is the first case of pyopneumothorax secondary to S. constellatus to be treated with linezolid. Pyopneumothorax may be caused by streptococcal infection, and linezolid is another good choice for treatment.


2016 ◽  
Vol 30 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Alfredo Di Gaeta ◽  
Francesco Giurazza ◽  
Eugenio Capobianco ◽  
Alvaro Diano ◽  
Mario Muto

To identify and localize an intraorbital wooden foreign body is often a challenging radiological issue; delayed diagnosis can lead to serious adverse complications. Preliminary radiographic interpretations are often integrated with computed tomography and magnetic resonance, which play a crucial role in reaching the correct definitive diagnosis. We report on a 40 years old male complaining of pain in the right orbit referred to our hospital for evaluation of eyeball pain and double vision with an unclear clinical history. Computed tomography and magnetic resonance scans supposed the presence of an abscess caused by a foreign intraorbital body, confirmed by surgical findings.


2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Rintaro Shibuya ◽  
Yuichiro Endo ◽  
Akihiro Fujisawa ◽  
Miki Tanioka ◽  
Yoshiki Miyachi

Pencil core granuloma is characterized by a delayed foreign-body reaction against retained fragments of pencil lead. Previous case reports presented pencil core granuloma resembling malignant melanoma, haemangioma, or soft tissue sarcoma. We present a case of pencil core granuloma arising from the palm 25 years after the initial injury. The patient presented a bluish nodule that had been present over 25 years before. The nodule initially measured 5 mm in diameter. However, five years before presentation, it suddenly enlarged to the size of 30 mm during six months. Computed tomography (CT) of the lesion revealed a linear radiopaque structure of 8 mm long with a mass on its distal end. Surgical resection revealed a bluish muddy mass and pencil lead. Histological examination revealed degenerative tissue with calcification surrounded by massive amounts of black granular material in the middle and lower dermis.


2008 ◽  
Vol 1 (6) ◽  
pp. 493-495 ◽  
Author(s):  
Vamseemohan Beeram ◽  
Sundaram Challa ◽  
Prasad Vannemreddy

✓ Craniocerebral maduromycetoma is extremely rare. The authors describe a case of maduromycetoma involving the left parietal cortex, bone, and subcutaneous tissue in a young male farm laborer who presented with left parietal scalp swelling that had progressed into a relentlessly discharging sinus. Computed tomography (CT) scanning of his brain revealed osteomyelitis of the parietal bone with an underlying homogeneously enhancing tumor. Intraoperatively, the mass was revealed to be a black lesion involving the bone, dura mater, and underlying cerebral cortex. It was friable and separated from the surrounding brain by a thick gliotic scar. Gross-total excision was performed, and the patient was placed on a 6-week regimen of itraconazole. To the authors' knowledge, this is the first instance of cerebral mycetoma with CT findings reported in the literature.


2003 ◽  
Vol 117 (8) ◽  
pp. 658-659 ◽  
Author(s):  
Yoshitaka Takiguchi ◽  
Hiro-Oki Okamura ◽  
Ken Kitamura ◽  
Seiji Kishimoto

Major late complications, following radiotherapy of head and neck carcinomas, such as laryngeal oedema, perichondritis and chondronecrosis usually occur between three and 12 months after treatment. However, the present case displayed necrosis of the laryngo-tracheal cartilage and ulceration of anterior neck skin with a tracheal fistula 44 years after irradiation. The reasons for the long interval between irradiation and late complications may be explained by long-standing hypovascularity and/or infection of the irradiated area. Histological study revealed chondronecrosis without inflammatory cells in the laryngo-tracheal cartilage and bacterial colonization of subcutaneous tissue. Necrotic tissue was removed and tracheostomy was performed. The fistula was almost completely closed using a delto-pectoral cutaneous flap and the clinical course of patient has been good. This paper demonstrates the possibility of laryngo-tracheal necrosis in cases that had received radiation as long ago as 44 years.


2021 ◽  
pp. 036354652110336
Author(s):  
Marta Cercone ◽  
Jacqueline Chevalier ◽  
John G. Kennedy ◽  
Andrew D. Miller ◽  
Lisa A. Fortier

Background: Hemiarthroplasty using a polyvinyl alcohol (PVA) hydrogel synthetic implant has been suggested as a good alternative to arthrodesis for the treatment of hallux rigidus. However, failure rates as high as 20% have been recorded. Purpose: To characterize the pathological processes in bone, cartilage, and the synovial membrane after PVA hemiarthroplasty in an ovine model with 6 months of follow-up. Study Design: Controlled laboratory study. Methods: A unilateral osteochondral defect (8-mm diameter × 10-mm depth) was made in the medial femoral condyle in 6 sheep. Animals were randomized to receive a PVA implant (n = 4) or to have an empty defect (n = 2) and were monitored for 6 months. Patellofemoral radiographs were obtained at monthly intervals, and quantitative computed tomography was performed at the end of the study. After death, the joints were macroscopically evaluated and scored. Osteochondral and synovial membrane histological findings were assessed using modified Osteoarthritis Research Society International (OARSI) and aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) scoring systems. Immunohistochemistry using Iba1 was performed to evaluate activated macrophage infiltration. Results: Overall, 2 sheep with PVA implants were euthanized at 1 and 5 months because of uncontrollable pain and lameness (failed implants). Quantitative computed tomography showed that sheep with failed implants had 2.1-fold more osteolysis than those with successful implants. The sheep with failed implants had osteoarthritis with extensive glycosaminoglycan loss and cartilage fibrillation of the condyle and opposing tibial surface on histological examination. A foreign body reaction with severe chronic lymphoplasmacytic and granulomatous inflammation with giant cells was detected surrounding the implant. The synovial membrane ALVAL score was 9 of 19 and 14 of 19 in failed implants with synovial hyperplasia and lymphoplasmacytic and macrophage infiltration. In contrast, the synovial membrane in successful implants and empty defects was normal (ALVAL score = 0/19). Immunolabeling for Iba1 in failed implants confirmed extensive and dense macrophage infiltration within the condyle and synovial membrane, with the highest immunoreactive score (9/9). Conclusion: PVA hydrogel implants had a 50% failure rate with uncontrollable pain, severe osteolysis, inflammation, and foreign body reactions. Clinical Relevance: The failure rate and pathological characteristics of the PVA implants suggest that their use should not be continued in human patients without further in vivo safety studies.


Author(s):  
Nicolas Greige ◽  
Bryce Liu ◽  
David Nash ◽  
Katie E. Weichman ◽  
Joseph A. Ricci

Abstract Background Accurate flap weight estimation is crucial for preoperative planning in microsurgical breast reconstruction; however, current flap weight estimation methods are time consuming. It was our objective to develop a parsimonious and accurate formula for the estimation of abdominal-based free flap weight. Methods Patients who underwent hemi-abdominal-based free tissue transfer for breast reconstruction at a single institution were retrospectively reviewed. Subcutaneous tissue thicknesses were measured on axial computed tomography angiograms at several predetermined points. Multivariable linear regression was used to generate the parsimonious flap weight estimation model. Split-sample validation was used to for internal validation. Results A total of 132 patients (196 flaps) were analyzed, with a mean body mass index of 31.2 ± 4.0 kg/m2 (range: 22.6–40.7). The mean intraoperative flap weight was 990 ± 344 g (range: 368–2,808). The full predictive model (R 2 = 0.68) estimated flap weight using the Eq. 91.3x + 36.4y + 6.2z – 1030.0, where x is subcutaneous tissue thickness (cm) 5 cm lateral to midline at the level of the anterior superior iliac spine (ASIS), y is distance (cm) between the skin overlying each ASIS, and z is patient weight (kg). Two-thirds split-sample validation was performed using 131 flaps to build a model and the remaining 65 flaps for validation. Upon validation, we observed a median percent error of 10.2% (interquartile range [IQR]: 4.5–18.5) and a median absolute error of 108.6 g (IQR: 45.9–170.7). Conclusion We developed and internally validated a simple and accurate formula for the preoperative estimation of hemi-abdominal-based free flap weight for breast reconstruction.


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