BACKGROUND The majority of published reports on foreign bodies(FBs)involve the rectum and applied a transanal retrieval.Usually,patients with FB above the rectum are subjected to laparotomy for removal.Here,we illustr...BACKGROUND The majority of published reports on foreign bodies(FBs)involve the rectum and applied a transanal retrieval.Usually,patients with FB above the rectum are subjected to laparotomy for removal.Here,we illustrate the case of a man with an FB that had migrated into the descending colon,and its successful removal via a laparoscopic approach.CASE SUMMARY A 43-year-old man,who had the habit of FB insertion into his anus to aid defe-cation,presented upon experience of such an FB slipping through and migrating upward to the distal colon.Plain abdominal radiograph revealed a bottle-shaped FB,positioned in the left iliac fossa region.The FB was successfully removed via a laparoscopic-assisted procedure in which we combined diagnostic laparoscopic and endoscopic techniques during surgery.The patient was monitored for 2 d postoperatively and subsequently discharged home.CONCLUSION A minimally invasive approach should be adopted to aid extraction of colorectal FB as it is effective and safe.展开更多
Rectal foreign bodies are man-made injury that occurs occasionally.The management depends on its depth and the consequence it caused.We here report a case of rectal foreign body(a glass bottle measuring about 38 mm...Rectal foreign bodies are man-made injury that occurs occasionally.The management depends on its depth and the consequence it caused.We here report a case of rectal foreign body(a glass bottle measuring about 38 mm×75 mm)which was located 13-15 cm from the anus.The patient had no sign of perforation,and we managed to remove it using endoscopy with gastrolith forceps.展开更多
BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical problems.Methods to handle such problems continue to evolve offering advantages,such...BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical problems.Methods to handle such problems continue to evolve offering advantages,such as the avoidance of surgery,reduced cost,improved visualization,reduced morbidity,and high removal success rate.However,to date,no studies have evaluated the endoscopic management of FBs in Japan.AIM To elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.METHODS A total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018.Data were collected from medical charts,and endoscopic details were collected from an endoscopic reporting system.Procedures performed with a flexible gastrointestinal endoscope were only taken into account.Patients who underwent a technique involving FB or FBI from the digestive tract were only included.Data on patient sex,patient age,outpatient,inpatient,FB type,FB location,procedure time,procedure type,removal device type,success,and technical complications were reviewed and analyzed retrospectively.RESULTS Among the 215 procedures,136(63.3%)were performed in old adults(≥60 years),180(83.7%)procedures were performed in outpatients.The most common type of FBs were press-through-pack(PTP)medications[72(33.5%)cases],FBI[47(21.9%)],Anisakis parasite(AP)[41(19.1%)cases].Most FBs were located in the esophagus[130(60.5%)cases]followed by the stomach[68(31.6%)cases].AP was commonly found in the stomach[39(57.4%)cases],and it was removed using biopsy forceps in 97.5%of the cases.The most common FBs according to anatomical location were PTP medications(40%)and dental prostheses(DP)(40%)in the laryngopharynx,PTP(48.5%)in the esophagus,AP(57.4%)in the stomach,DP(37.5%)in the small intestine and video capsule endoscopy device(75%)in the colon.A transparent cap with grasping forceps was the most commonly used device[82(38.1%)cases].The success rate of the procedure was 100%,and complication were observed in only one case(0.5%).CONCLUSION Endoscopic management of FBs and FBI in our Hospital is extremely safe and effective.展开更多
BACKGROUND Fishbone migration from the esophagus to the neck is relatively uncommon in clinical practice.Several complications secondary to esophageal perforation after ingestion of a fishbone have been described in t...BACKGROUND Fishbone migration from the esophagus to the neck is relatively uncommon in clinical practice.Several complications secondary to esophageal perforation after ingestion of a fishbone have been described in the literature.Typically,a fishbone is detected and diagnosed by imaging examination and is usually removed by a neck incision.CASE SUMMARY Herein,we report a case of a 76-year-old patient with a fishbone in the neck that had migrated from the esophagus and that was in close proximity to the common carotid artery,and the patient experienced dysphagia.An endoscopically-guided neck incision was made over the insertion point in the esophagus,but the surgery failed due to having a blurred image at the insertion site during the operation.After injection of normal saline laterally to the fishbone in the neck under ultrasound guidance,the purulent fluid outflowed to the piriform recess along the sinus tract.With endoscopic guidance,the position of the fish bone was precisely located along the direction of liquid outflow,the sinus tract was separated,and the fish bone was removed.To the best of our knowledge,this is the first case report describing bedside ultrasound-guided water injection positioning combined with endoscopy in the treatment of a cervical esophageal perforation with an abscess.CONCLUSION In conclusion,the fishbone could be located by the water injection method under the guidance of ultrasound and could be accurately located along the outflow direction of the purulent fluid of the sinus by the endoscope and was removed by incising the sinus.This method can be a nonoperative treatment option for foreign body-induced esophageal perforation.展开更多
Purpose:To describe a technique for removing deep corneal plant foreign bodies. Methods:Twelve patients (7 males and 5 females, aged 5 to 56 years).with plant foreign bodies embedded in the deep cornea were treated be...Purpose:To describe a technique for removing deep corneal plant foreign bodies. Methods:Twelve patients (7 males and 5 females, aged 5 to 56 years).with plant foreign bodies embedded in the deep cornea were treated between July 2011 and December 2012. The course of disease ranged from 1 to 11 d. Four of the patients had wooden foreign bodies, 3 had bamboo foreign bodies, and 5 had flower thorns; all underwent surgical removal. During the surgery,a novel suture needle was used to remove the foreign bodies.For injuries with a deep tunnel caused by the foreign bodies,the tunnel was cut open with a keratome. The foreign bodies were then removed and necrotic tissue was thoroughly debrided.Incisions were closed with interrupted sutures. The corneal foreign bodies were collected postoperatively for fungus and bacterial culture and appropriatemedical treatment was provided. Results: Bacteria were identified in 3 cases, fungus in 3 cases, and no bacteria or fungus in 6 cases.All corneal foreign bodies were embedded deep in the corneal stroma without incidence of full-thickness corneal penetration or intraocular infection. Conclusion:Plant foreign bodies embedded in the deep cornea should be removed immediately. During the surgery, the foreign bodies and surrounding necrotic corneal stroma should be completely removed. The injured cornea should be cut open to eliminate necrotic tissues when necessary. (Eye Science 2013; 28:30-33)展开更多
Background: There were 800 individual case reports of urogenital foreign bodies in the English literature from 1755 to 1999. The use of urogenital foreign bodies for sexual pleasure is a common occurrence in today’s ...Background: There were 800 individual case reports of urogenital foreign bodies in the English literature from 1755 to 1999. The use of urogenital foreign bodies for sexual pleasure is a common occurrence in today’s population. The aim of this discussion is the management of scrotal injury caused by magnetic urogenital foreign bodies. Case Presentation: 56-year-old male with scrotal tissue entrapped between two opposed magnet rings. Self-reported attempts at removal were unsuccessful and caused for presentation to the emergency department. Additional attempts at removal by medical staff unsuccessful in emergency department and therefore the patient proceeded to the operating room. Intraoperatively the use of two cardiac magnets allowed for removal without a need for invasive surgical procedure. Conclusion: Cardiac magnets are preferred means of removal for entrapped skin between magnetic foreign bodies that could be utilized at the bedside.展开更多
A number of techniques have been described to remove rectal foreign bodies. In this report, a novel endoscopic technique using a pneumatic dilatation balloon normally used in achalasia patients is presented. In additi...A number of techniques have been described to remove rectal foreign bodies. In this report, a novel endoscopic technique using a pneumatic dilatation balloon normally used in achalasia patients is presented. In addition, a systematic review of the literature was performed for non-operative methods to remove foreign bodies from the rectum. These results are summarised, presented as a practical at-a- glance overview and a flow chart is offered to guide the clinician in treatment decisions. The design of the flow chart was based on the aims to treat the patient preferably on an outpatient basis with minimally invasive techniques and if possible under conscious sedation rather than general anaesthesia.展开更多
A 52-year-old female presented to our clinic after accidentallyingesting a push-through pack(PTP). After determining that the PTP was present in the stomach, we successfully and safely removed it endoscopically by usi...A 52-year-old female presented to our clinic after accidentallyingesting a push-through pack(PTP). After determining that the PTP was present in the stomach, we successfully and safely removed it endoscopically by using a handmade endoscopic hood fashioned from a cut endotracheal tube. Foreign body ingestion is a common clinical problem, and most ingested foreign bodies pass spontaneously. However, the ingestion of sharp objects, such as PTPs, increases the risk of complications, and urgent endoscopy is recommended to remove such objects. Previous studies have reported the use of other devices, both commercial and handmade, for the safe endoscopic removal of foreign bodies. The novel design of our handmade hood for the removal of the PTP, which was fashioned from a cut endotracheal tube, was beneficial in terms of maintaining a wide visual field, patient safety and tolerance, and easy preparation compared to previously reported commercial and handmade devices. It may be a viable and safe device for the retrieval of PTPs and other sharp foreign bodies.展开更多
Foreign body （FB） removal represents a large part of the work in surgical practice.[1] However,FB removal may often be a surgical challenge because of the nonpalpated and close anatomical relationship of the FB to v...Foreign body （FB） removal represents a large part of the work in surgical practice.[1] However,FB removal may often be a surgical challenge because of the nonpalpated and close anatomical relationship of the FB to vital structures or due to patients with cicatricial diathesis.[2] Retained FBs may result in infection,chronic pain,structural injury,granuloma,and psychological distress,especially with late presentation （more than 1 week from the time of injury）.展开更多
Traditionally performed by a small group of highly trained specialists,bedside sonographic procedures involving the musculoskeletal system are often delayed despite the critical need for timely diagnosis and treatment...Traditionally performed by a small group of highly trained specialists,bedside sonographic procedures involving the musculoskeletal system are often delayed despite the critical need for timely diagnosis and treatment.Due to this limitation,a need evolved for more portability and accessibility to allow performance of emergent musculoskeletal procedures by adequately trained non-radiology personnel.The emergence of ultrasound-assisted bedside techniques and increased availability of portable sonography provided such an opportunity in select clinical scenarios.This review summarizes the current literature describing common ultrasound-based musculoskeletal procedures.In-depth discussion of each ultrasound procedure including pertinent technical details,indications and contraindications is provided.Despite the limited amount of prospective,randomized data in this area,a substantial body of observational and retrospective evidence suggests potential benefits from the use of musculoskeletal bedside sonography.展开更多
Screw metal implants (3S, Israel) with rough or smooth polished surface were introduced in a tibial proximal condyle of not purebred rabbits. The condition of surrounding tissues in 2 and 6 months after implantation w...Screw metal implants (3S, Israel) with rough or smooth polished surface were introduced in a tibial proximal condyle of not purebred rabbits. The condition of surrounding tissues in 2 and 6 months after implantation was compared by light microscopy and X-ray methods. Within 6 months after operation the considerable distinctions of radiological and morphological data were revealed not. 2 months later after introduction of implants with a rough surface the effort enclosed for its twisting is, much more, than for removal of the polished product. However, stability of fixing of implants was practically made even at 6 months. On remote rough implants there is a set of tissue scraps whereas on products with a smooth surface the tissue remains were much less. Surrounding tissues strongly join a rough surface, grow into cavities, and during removal of such products there is a considerable trauma of tissues round an implantation place. Smooth implants have the smaller area of contact with organism tissues, they are fixed due to bicortical implantation, during removal easily get out and don’t break off surrounding tissues. The signs of inflammation and formation of merged multinuclear macrophages were not found at all cases, which give evidence to the inertness of material of the mentioned articles for living organism. In some observations however and by implantation of the rough article and by introduction of polished implants, metal particles were found, but after use of the foreign body with grit-blasted treatment of surface metal was found more frequently, and its fragments had larger volume.展开更多
文摘BACKGROUND The majority of published reports on foreign bodies(FBs)involve the rectum and applied a transanal retrieval.Usually,patients with FB above the rectum are subjected to laparotomy for removal.Here,we illustrate the case of a man with an FB that had migrated into the descending colon,and its successful removal via a laparoscopic approach.CASE SUMMARY A 43-year-old man,who had the habit of FB insertion into his anus to aid defe-cation,presented upon experience of such an FB slipping through and migrating upward to the distal colon.Plain abdominal radiograph revealed a bottle-shaped FB,positioned in the left iliac fossa region.The FB was successfully removed via a laparoscopic-assisted procedure in which we combined diagnostic laparoscopic and endoscopic techniques during surgery.The patient was monitored for 2 d postoperatively and subsequently discharged home.CONCLUSION A minimally invasive approach should be adopted to aid extraction of colorectal FB as it is effective and safe.
文摘Rectal foreign bodies are man-made injury that occurs occasionally.The management depends on its depth and the consequence it caused.We here report a case of rectal foreign body(a glass bottle measuring about 38 mm×75 mm)which was located 13-15 cm from the anus.The patient had no sign of perforation,and we managed to remove it using endoscopy with gastrolith forceps.
文摘BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical problems.Methods to handle such problems continue to evolve offering advantages,such as the avoidance of surgery,reduced cost,improved visualization,reduced morbidity,and high removal success rate.However,to date,no studies have evaluated the endoscopic management of FBs in Japan.AIM To elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.METHODS A total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018.Data were collected from medical charts,and endoscopic details were collected from an endoscopic reporting system.Procedures performed with a flexible gastrointestinal endoscope were only taken into account.Patients who underwent a technique involving FB or FBI from the digestive tract were only included.Data on patient sex,patient age,outpatient,inpatient,FB type,FB location,procedure time,procedure type,removal device type,success,and technical complications were reviewed and analyzed retrospectively.RESULTS Among the 215 procedures,136(63.3%)were performed in old adults(≥60 years),180(83.7%)procedures were performed in outpatients.The most common type of FBs were press-through-pack(PTP)medications[72(33.5%)cases],FBI[47(21.9%)],Anisakis parasite(AP)[41(19.1%)cases].Most FBs were located in the esophagus[130(60.5%)cases]followed by the stomach[68(31.6%)cases].AP was commonly found in the stomach[39(57.4%)cases],and it was removed using biopsy forceps in 97.5%of the cases.The most common FBs according to anatomical location were PTP medications(40%)and dental prostheses(DP)(40%)in the laryngopharynx,PTP(48.5%)in the esophagus,AP(57.4%)in the stomach,DP(37.5%)in the small intestine and video capsule endoscopy device(75%)in the colon.A transparent cap with grasping forceps was the most commonly used device[82(38.1%)cases].The success rate of the procedure was 100%,and complication were observed in only one case(0.5%).CONCLUSION Endoscopic management of FBs and FBI in our Hospital is extremely safe and effective.
文摘BACKGROUND Fishbone migration from the esophagus to the neck is relatively uncommon in clinical practice.Several complications secondary to esophageal perforation after ingestion of a fishbone have been described in the literature.Typically,a fishbone is detected and diagnosed by imaging examination and is usually removed by a neck incision.CASE SUMMARY Herein,we report a case of a 76-year-old patient with a fishbone in the neck that had migrated from the esophagus and that was in close proximity to the common carotid artery,and the patient experienced dysphagia.An endoscopically-guided neck incision was made over the insertion point in the esophagus,but the surgery failed due to having a blurred image at the insertion site during the operation.After injection of normal saline laterally to the fishbone in the neck under ultrasound guidance,the purulent fluid outflowed to the piriform recess along the sinus tract.With endoscopic guidance,the position of the fish bone was precisely located along the direction of liquid outflow,the sinus tract was separated,and the fish bone was removed.To the best of our knowledge,this is the first case report describing bedside ultrasound-guided water injection positioning combined with endoscopy in the treatment of a cervical esophageal perforation with an abscess.CONCLUSION In conclusion,the fishbone could be located by the water injection method under the guidance of ultrasound and could be accurately located along the outflow direction of the purulent fluid of the sinus by the endoscope and was removed by incising the sinus.This method can be a nonoperative treatment option for foreign body-induced esophageal perforation.
文摘Purpose:To describe a technique for removing deep corneal plant foreign bodies. Methods:Twelve patients (7 males and 5 females, aged 5 to 56 years).with plant foreign bodies embedded in the deep cornea were treated between July 2011 and December 2012. The course of disease ranged from 1 to 11 d. Four of the patients had wooden foreign bodies, 3 had bamboo foreign bodies, and 5 had flower thorns; all underwent surgical removal. During the surgery,a novel suture needle was used to remove the foreign bodies.For injuries with a deep tunnel caused by the foreign bodies,the tunnel was cut open with a keratome. The foreign bodies were then removed and necrotic tissue was thoroughly debrided.Incisions were closed with interrupted sutures. The corneal foreign bodies were collected postoperatively for fungus and bacterial culture and appropriatemedical treatment was provided. Results: Bacteria were identified in 3 cases, fungus in 3 cases, and no bacteria or fungus in 6 cases.All corneal foreign bodies were embedded deep in the corneal stroma without incidence of full-thickness corneal penetration or intraocular infection. Conclusion:Plant foreign bodies embedded in the deep cornea should be removed immediately. During the surgery, the foreign bodies and surrounding necrotic corneal stroma should be completely removed. The injured cornea should be cut open to eliminate necrotic tissues when necessary. (Eye Science 2013; 28:30-33)
文摘Background: There were 800 individual case reports of urogenital foreign bodies in the English literature from 1755 to 1999. The use of urogenital foreign bodies for sexual pleasure is a common occurrence in today’s population. The aim of this discussion is the management of scrotal injury caused by magnetic urogenital foreign bodies. Case Presentation: 56-year-old male with scrotal tissue entrapped between two opposed magnet rings. Self-reported attempts at removal were unsuccessful and caused for presentation to the emergency department. Additional attempts at removal by medical staff unsuccessful in emergency department and therefore the patient proceeded to the operating room. Intraoperatively the use of two cardiac magnets allowed for removal without a need for invasive surgical procedure. Conclusion: Cardiac magnets are preferred means of removal for entrapped skin between magnetic foreign bodies that could be utilized at the bedside.
文摘A number of techniques have been described to remove rectal foreign bodies. In this report, a novel endoscopic technique using a pneumatic dilatation balloon normally used in achalasia patients is presented. In addition, a systematic review of the literature was performed for non-operative methods to remove foreign bodies from the rectum. These results are summarised, presented as a practical at-a- glance overview and a flow chart is offered to guide the clinician in treatment decisions. The design of the flow chart was based on the aims to treat the patient preferably on an outpatient basis with minimally invasive techniques and if possible under conscious sedation rather than general anaesthesia.
文摘A 52-year-old female presented to our clinic after accidentallyingesting a push-through pack(PTP). After determining that the PTP was present in the stomach, we successfully and safely removed it endoscopically by using a handmade endoscopic hood fashioned from a cut endotracheal tube. Foreign body ingestion is a common clinical problem, and most ingested foreign bodies pass spontaneously. However, the ingestion of sharp objects, such as PTPs, increases the risk of complications, and urgent endoscopy is recommended to remove such objects. Previous studies have reported the use of other devices, both commercial and handmade, for the safe endoscopic removal of foreign bodies. The novel design of our handmade hood for the removal of the PTP, which was fashioned from a cut endotracheal tube, was beneficial in terms of maintaining a wide visual field, patient safety and tolerance, and easy preparation compared to previously reported commercial and handmade devices. It may be a viable and safe device for the retrieval of PTPs and other sharp foreign bodies.
文摘Foreign body （FB） removal represents a large part of the work in surgical practice.[1] However,FB removal may often be a surgical challenge because of the nonpalpated and close anatomical relationship of the FB to vital structures or due to patients with cicatricial diathesis.[2] Retained FBs may result in infection,chronic pain,structural injury,granuloma,and psychological distress,especially with late presentation （more than 1 week from the time of injury）.
文摘Traditionally performed by a small group of highly trained specialists,bedside sonographic procedures involving the musculoskeletal system are often delayed despite the critical need for timely diagnosis and treatment.Due to this limitation,a need evolved for more portability and accessibility to allow performance of emergent musculoskeletal procedures by adequately trained non-radiology personnel.The emergence of ultrasound-assisted bedside techniques and increased availability of portable sonography provided such an opportunity in select clinical scenarios.This review summarizes the current literature describing common ultrasound-based musculoskeletal procedures.In-depth discussion of each ultrasound procedure including pertinent technical details,indications and contraindications is provided.Despite the limited amount of prospective,randomized data in this area,a substantial body of observational and retrospective evidence suggests potential benefits from the use of musculoskeletal bedside sonography.
文摘Screw metal implants (3S, Israel) with rough or smooth polished surface were introduced in a tibial proximal condyle of not purebred rabbits. The condition of surrounding tissues in 2 and 6 months after implantation was compared by light microscopy and X-ray methods. Within 6 months after operation the considerable distinctions of radiological and morphological data were revealed not. 2 months later after introduction of implants with a rough surface the effort enclosed for its twisting is, much more, than for removal of the polished product. However, stability of fixing of implants was practically made even at 6 months. On remote rough implants there is a set of tissue scraps whereas on products with a smooth surface the tissue remains were much less. Surrounding tissues strongly join a rough surface, grow into cavities, and during removal of such products there is a considerable trauma of tissues round an implantation place. Smooth implants have the smaller area of contact with organism tissues, they are fixed due to bicortical implantation, during removal easily get out and don’t break off surrounding tissues. The signs of inflammation and formation of merged multinuclear macrophages were not found at all cases, which give evidence to the inertness of material of the mentioned articles for living organism. In some observations however and by implantation of the rough article and by introduction of polished implants, metal particles were found, but after use of the foreign body with grit-blasted treatment of surface metal was found more frequently, and its fragments had larger volume.
