1/11. Retained digital foreign body after a pellet gun injury.A symptomatic foreign body embedded in the human body can be a frustrating problem for physician and patient alike. A unique case of a retained foreign object resulting from a pellet gun injury has been presented. Although the course of treatment in this case was uncomplicated, it is important to understand the complexities of the human body's response to foreign bodies.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/11. Urethrocutaneous fistula due to a retained ring of condom.Hidden foreign bodies have been described as a rare cause of both strangulation of the glans penis and urethrocutaneous fistula. We present the case of a 30-year-old man who developed a urethrocutaneous fistula and penile shaft necrosis after a condom broke during intercourse. Neither the patient nor several physicians could identify the retained ring of condom, which had been buried under newly epithelialized skin. He underwent removal of the foreign body under general anesthesia, followed 5 months later by a formal urethrocutaneous fistula repair.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/11. Cactus thorn arthritis: case report and review of the literature.synovitis secondary to penetrating plant thorn injuries is an infrequently reported event. Despite its wide geographic distribution, thorns from the prickly pear cactus (Optunia ficusindica) are a rare source of this type of inflammatory arthritis. We hereby present an unusual case of an individual who developed an acute monoarthritis of the knee shortly after sustaining a penetrating cactus thorn injury. The clinical and pathophysiologic features of cactus thorn arthritis are reviewed and the unusual features present in this individual are highlighted. Treatment options, with an emphasis on rapid diagnosis and therapeutic interventions, are discussed. Increased physician awareness and recognition of this unusual but not rare entity are essential as a means of improving clinical outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/11. Pediatric eye injury due to Avena fatua (wild oats).OBJECTIVE: We report on florid and unusual ophthalmic physical signs in three children where the trauma was caused by seeds from Avena fatua, a grass common in western north america. DESIGN: Case series and literature review. SETTING: Three local emergency departments (ED) during the fall of 1998. patients OR PARTICIPANTS: Three children reporting to an ED with an acutely painful eye from which the foreign body was identified botanically as Avena fatua. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Symptoms, interventions, duration of problem. RESULTS: Three male children (6, 10, 14 years) presented separately following incidents in which they had sustained direct eye injury. Each child immediately experienced severe pain and profuse watering of the eye. Severe localized edema of the conjunctiva and inflammation was evident with conjunctival vessel injection leading to bleeding, reminiscent of a chemical "burn." Initially, two children appeared to have an eyelash caught behind the lower lid. In both instances, the emergency physicians initially dismissed the possibility of there being a significant foreign body, but because of the severity of the pain, conjunctival vessel injection, and edema, they attempted to remove the "lash." Removal of the foreign body proved difficult in all three cases, requiring far greater traction than anticipated. Intact seedpods had become embedded in the subconjunctival space. Ophthalmic analgesia relieved the pain immediately, but in one child who was treated with topical antibiotic alone, significant pain was experienced for 18 hours, until steroid-antibiotic therapy was instituted. All injuries occurred in late summer when the grass propagates. CONCLUSIONS: The physical signs of scleral vasculitis and conjunctival edema can be mistaken for chemical injury or allergic chemosis, but where a foreign body resembling a hair or eyelash is visible, the presence of a seed-pod retained in the subconjunctival space must be considered, particularly if the patient reports exposure to wild grass. Application of local analgesia, foreign body removal, and steroid-antibiotic treatment is recommended.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/11. An unusual way of tracheal stoma cleaning could end up with foreign body aspiration in a laryngectomized patient.We report a case of a laryngectomized patient who accidentally aspirated a wooden stick through his tracheal stoma in highly unusual circumstances. He was in a habit of cleaning secretions of upper airway with a wooden stick covered with cotton on the tip soaked in olive oil, via tracheostomy. After applying topical aerolized lidocaine spray through the tracheostomy stoma a flexible video-brochoscopy was performed and a tree twig over 11 cm in length was removed. The patient's symptoms were resolved by a bronchoscopy. With experience and availability of accessories, the removal of the foreign body using flexible bronchoscope under local anesthesia can be performed safely and successfully. This case suggests that the physicians and otolaryngologists should educate their laryngectomized patients about stomal care and discuss any potential life-threatening situation they might encounter.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/11. hip ulcer secondary to foreign body reaction and vacuum-assisted closure therapy: report of a case.patients who have a foreign body reaction are at risk of developing chronic ulcers secondary to necrosis, due to the inflammation present in the affected tissues or trauma, worsened by alterations in the vascular perfusion. These ulcers represent a therapeutic challenge for both physicians and patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/11. Wooden foreign bodies in the foot.Wooden foreign body injuries are difficult to diagnose and treat. Three patients who had a common wooden toothpick in the foot are presented. Two patients could recall a puncture injury and one patient could not. Roentgenography and numerous visits to several physicians did not detect the wood, which was only found during careful surgical exploration. Removal of the foreign body is required to treat the inflammatory reaction it produces.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/11. Complications of fiber implantation for baldness.Several methods of fiber implantation have been used to reduce pattern baldness, and similar results have been reported: fiber breakage, foreign-body reaction, infection and scarring. Since one method or another tends to predominate in different geographic areas, the physician often is unable to compare the results of the various methods. The two patients described in this article underwent different methods of fiber implantation; serious complications occurred in both. Fiber implantation is an unsafe technique and must be discouraged.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/11. hand injuries from sea urchin spines.Sea urchin spine injury is usually a benign process that rarely comes to the attention of a physician. Aside from the transient episode of excruciating pain which responds dramatically to hot water soaks, there is usually no residual disability. As in any puncture wound, tetanus prophylaxis and observation for latent infection is advised. Complications arise, however, when spines are embedded over bony prominences, within joints, or in contact with nerves. Cases are reported herein of the latter two problems occurring in the hand. A case of a neuropathy associated with sea urchin injuries has not been previously reported in the literature. When such injuries necessitate exploration, aseptic surgical technique is required.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/11. esophageal perforation caused by coin ingestion.esophageal perforation and acquired tracheoesophageal fistulae (ATEF) are rare sequelae of foreign body ingestion in the pediatric population. Here we discuss the cases of two patients with esophageal perforation caused by prolonged impaction of a coin; in one case, a tracheoesophageal fistula developed. The presence of aerodigestive symptoms and signs in infants and small children should prompt physicians to consider foreign body ingestion and the presence of an ATEF. Clinical presentation, diagnostic modalities, and technical considerations for surgical management are outlined.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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