1/53. Unusual presentation of a ring injury in a psychiatric patient.1. A ring embedded in the digits may result in erosion of the skin, tendons, and bones. 2. This type of injury may be prevented by removing the ring at the time of the injury. 3. All constricting bands should be carefully monitered and, if necessary, removed from fingers to prevent chronic erosion especially in people with a physical or mental disability.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/53. Imperforate anus: an unusual presentation of a common disease.Imperforate anus is a common problem facing the pediatric surgeon. Most cases of imperforate anus are discovered at birth during the initial physical examination and are corrected early. The pediatric population also accounts for 80% of all cases of ingested foreign bodies. Most of these pass through spontaneously and the treatment is observation. In this article, we present the case of a seven-month-old child in whom failure to pass a swallowed coin led to the diagnosis of imperforate anus. This case illustrates an uncommon presentation of a common disorder and emphasizes the importance of vigilance and careful physical examination in the newborn.- - - - - - - - - - ranking = 20.563998619867keywords = physical examination, physical (Clic here for more details about this article) |
3/53. Tracheobronchial foreign body management in an acutely ill neonate.Pediatric foreign body management has become refined in recent years, both from a diagnostic and therapeutic standpoint. history, physical examination, and radiographic evaluation performed in a timely manner can lead to safe and successful foreign body retrieval. Advancement in videoendoscopic instrumentation and anesthetic techniques enable the airway surgeon to achieve simultaneous airway stabilization and foreign body removal. In the emergency setting, the surgeon may not have access to such instrumentation. We present a case of an acutely ill, extremely low birthweight infant who incurred foreign body aspiration. Basic tools of expediency and control of the airway remind us once again that technique must precede technology.- - - - - - - - - - ranking = 10.281999309934keywords = physical examination, physical (Clic here for more details about this article) |
4/53. Pediatric coin ingestion: an unusual presentation.A 35-month-old child presented to the Emergency Department with a suspected coin ingestion. A physical examination and radiographic examination revealed no evidence of the coin, and the child was prepared for discharge. When the child continued to refuse to drink, digital examination of the hard palate revealed the coin lodged behind the upper incisors. It was only possible to visualize when the patient's neck was fully extended. This case represents an unusual presentation of coin ingestion. It points out the importance of a meticulous physical examination and the need for reevaluation when findings are contradictory.- - - - - - - - - - ranking = 20.563998619867keywords = physical examination, physical (Clic here for more details about this article) |
5/53. Syringe needle located deep in the brain: image-guided removal.BACKGROUND: Removal of a thin but long foreign body lodged in the deep brain tissue may need special technique to remove it without causing major injury. We report a special technique for the safe, elective removal of such objects. CASE DESCRIPTION: A 5-year-old boy presented following mild head trauma; he was asymptomatic and physical examination revealed an intact scalp and no neurological deficit. The incidental presence of a 3.4 cm-long syringe needle in the right frontal region was noted on the skull radiographs. Cranial computed tomography (CT) scan showed the deeper end of the needle in the right caudate head and the superficial end at a depth of 3.5 cm from the cortical surface. Burr hole surgery was performed under general anesthesia employing a Fisher stereotactic frame and continuous biplanar guidance from the image intensifiers. The superficial end of the needle was clasped with an endoscopy biopsy forceps, allowing removal of the needle via the least traumatic route. The child had an uneventful recovery. Follow-up magnetic resonance imaging at 6 months did not reveal any abnormality. CONCLUSIONS: The two-dimensional biplanar image-guided stereotactic technique allowed safe removal of a long foreign body from a deep brain location with minimal trauma to the brain.- - - - - - - - - - ranking = 10.281999309934keywords = physical examination, physical (Clic here for more details about this article) |
6/53. Facio-cervical transfixion by a metallic rod: a case report.foreign bodies penetrating into the neck may cause extensive neurovascular and aerodigestive tract injuries. Facio-cervical transfixion by a metallic rod without such injuries is very rare. The patient presented in this article reported to our center 5 hours after the road traffic accident with impacted hollow metallic rod traversing through the tongue, pharynx, and neck after causing fracture to maxilla. Exploration under general anesthesia after tracheostomy resulted in an uneventful extraction of the metallic rod. Postoperatively, the patient recovered completely and had no neurologic deficits. [editorial comment: This case report demonstrates an approach to an extremely difficult and potentially dangerous clinical problem. The authors decision to forego angiography is based on physical examination with evidence of palpable flow in the superficial temporal artery.]- - - - - - - - - - ranking = 10.281999309934keywords = physical examination, physical (Clic here for more details about this article) |
7/53. Injury caused by deeply penetrating knife blade lodged in infratemporal fossa.Knife-inflicted, deeply penetrating head and neck trauma is an uncommon life-threatening injury and a challenging problem. An examination of the neurovascular and systemic physical status is a first requirement and the decision as to which approach to adopt for the removal of the blade is of critical importance. Here we report a rare case of a pre-auricular stab wound with the knife blade deeply lodged in the extracranial infratemporal fossa. Radiological investigations showed that the knife blade had entered from the temporomandibular joint and become lodged through the anterior margin of foremen magnum below the petrosal bone. Minimal left vocal cord paresis, left palatal weakness and a slight deviation of the tongue towards the left side were observed. The other neurological and systemic physical evaluations were normal. Simple withdrawal of the blade in the operating room did not cause serious neurovascular injury. Here we discuss and compare the expanded exposure of anatomical structures for blade removal and simple withdrawal in similar injuries.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
8/53. Unique presentation of a bronchial foreign body in an asymptomatic child.A child who aspirates a foreign body may present in many ways. We present the case of an 8-year-old boy whose initial presentation consisted only of his preoccupation with his lost toy and his gesturing toward his oral cavity. There was no witnessed coughing or choking episode, and there were no initial physical examination findings of note, and no abnormalities on appropriate radiographic studies. The patient was transferred to our institution for further evaluation and management. Our careful examination revealed a slight wheeze at the left upper lobe. endoscopy was immediately performed, and bronchoscopy revealed a yellow, tubular, plastic foreign body in the left main bronchus through which the patient was breathing freely. This was removed without incident by means of optical graspers. The physical characteristics of this foreign body, including its small size, relatively inert material, and large lumen, allowed this patient to present relatively asymptomatically. This case demonstrates the need for a high index of suspicion in the evaluation and management of foreign bodies in the aerodigestive tract.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
9/53. An accidental death caused by an unexploded 40-mm grenade.Unexploded grenades are potentially dangerous materials. Numerous grenades have been found to be unexploded after wars have ended. We present an interesting case of an unexploded grenade that was found accidentally in a soldier's skull. On physical examination, the entrance wound of an unusual penetrating object was noted. This unusual physical finding led us to undertake radiographic examination. A 40-mm unexploded grenade was noticed on the radiograph of the soldier's skull.- - - - - - - - - - ranking = 11.281999309934keywords = physical examination, physical (Clic here for more details about this article) |
10/53. Swallowed ocular prostheses: report of three cases in children with retinoblastoma.PURPOSE: To report 3 instances of 2 children who swallowed their ocular prostheses. methods: A 30-month-old boy whose eye had been enucleated for retinoblastoma swallowed his ocular prosthesis on 2 different occasions, and a 32-month-old boy whose eye had also been enucleated for retinoblastoma swallowed his ocular prosthesis once. RESULTS: In the second child, an abdominal radiograph was obtained, but the swallowed prosthesis was not apparent, and radiographic imaging of the recovered prosthesis failed to demonstrate an identifiable object. In each case, the prosthesis was recovered in the child's stool without incident several weeks later. Neither child had physical complications as a result of the swallowing events. CONCLUSIONS: We report 3 instances in which a child fitted for an ocular prosthesis after enucleation swallowed his prosthesis and had no untoward effects. The failure of imaging to detect the prostheses in the second child is attributed to the radiolucent nature of materials used in the manufacture of the prosthesis. Each of the children was having life stresses in addition to his medical treatment that may have accounted for his behavior.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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