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Management of a large intraorbital wooden foreign body: Case report.

ABSTRACT: Background: Intraorbital foreign bodies are a global injury and occur with a frequency of one in six orbital injuries; however, intraorbital wooden foreign bodies are uncommon. Intraorbital wooden foreign bodies predominantly affect the male population with a mean age ranging from 21 to 22 years. The diagnosis of intraorbital wooden foreign bodies depending on their size can be challenging on imaging and if not removed early the risk of infection is high.Case Description: A 23-year-old motorcyclist presented to the ER following a collision with a donkey cart carrying wood 3 h before presentation. Examination revealed an acutely ill-looking man in painful distress with a right supraorbital laceration associated with ipsilateral ptosis and periorbital edema. There was a retained intraorbital wooden foreign body. Computed tomography scan showed evidence of both an intraorbital bone fragment and a wooden foreign body. Surgery was done 3rd day of admission before which vision has declined with only perception to light. Only the wooden foreign body was removed. Evolution was favorable with recovery of vision and improvement of the ptosis.Conclusion: The management of intraorbital wooden foreign bodies demands a multidisciplinary approach after a thorough history, examination, and imaging. Treatment of choice is timely and meticulous removal of the foreign body to avoid infection and other associated complications.

SUBMITTER: Jabang JN

PROVIDER: S-EPMC7332514 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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An extremely rare case: Transorbital penetrating intracranial injury by wooden foreign body. Case report.

Project description:Introduction and importanceTransorbital Penetrating Intracranial Injury (TOPI) is a rare case, but those caused by Wooden Foreign Body are even challenging that may pose unusual diagnostic and surgical challenges.Case presentationwe presented a TOPI following a wood penetrated to the left temporal fossa region via orbital roof due to struck the tree branches while got a motor vehicle accident. The patient was fully conscious with decreased visual acuity in the left eye and left ophthalmoplegia. Non-contrast CT scan showed the linear-shaped foreign body, air mimicking that penetrated medial orbit plane to the left temporal fossa.Clinical discussionThe surgery was performed with a temporobasal approach and revealed good results with only mild ophthalmologic complications without long-term fatal complications (1-year followed-up).Conclusionearly removal of wooden foreign body that penetrates to the intracranial via transorbital is mandatory and should be involved multidisciplinary approach to get the optimal result and avoid the fatal complication both neurologically or ophthalmologically.

| S-EPMC8528685 | biostudies-literature

Management of unusual missed diagnosis of a Intra-orbital wooden foreign body: A case report and review of literature.

Project description:IntroductionAlthough intra-orbital foreign bodies (IOrFBs) are commonly seen in daily ophthalmology practice, rarely, they can have very unusual clinical presentations, especially nonmetallic FBs.Presentation of caseA 33-year-old male presented with sudden onset right lower lid swelling and tearing. He was initially tolerating the symptoms, however, it got progressively worse, so he came two weeks after the initiation of symptoms. His eye vitals were within normal limit, including the visual acuity of 6/6 OU. Additionally, slit lamp and fundus examinations were benign. Concern was for infectious etiology with unclear source. After a lengthy conversation, he recalled falling on the ground with face down about 16 months ago. However, he stated that he had remained asymptomatic and never went for treatment after the incident. Non-contrast CT of head and orbit showed hyperdense tract in medial aspect of right eye adjacent to the globe, piercing across the bilateral ethmoidal sinuses. Thus, a diagnosis of retained IOrbFB was made. He underwent surgery where a 5cm rotten wood was extracted. Post-surgical course was uncomplicated. Not all penetrating intra-orbital foreign bodies present immediately after the incident. In our case the patient remained asymptomatic for 16 months.ConclusionTherefore, when dealing with an ocular infection of unclear source, clinicians should ask about distant histories of ocular or facial injuries to assess intraocular foreign bodies.

| S-EPMC9289385 | biostudies-literature

An unusual case of intra orbital foreign body; diagnosis, management, and outcome: a case report.

Project description:BACKGROUND:An orbitocranial injury with a penetrating Intraorbital Foreign Body (IOFB) is listed as a rare cause of penetrating trauma. Since this type of trauma is considered a surgical emergency, taking a thorough history along with careful examination to find out the mechanism and cause of the trauma is crucial towards correct diagnosis and management of the disease. CASE PRESENTATION:A 35-year-old male patient was presented to the ER with an occupational craniofacial injury because of an IOFB. The patient underwent an extra-dural orbitocranial craniotomy procedure to remove the foreign body. Interestingly, a plastic foreign body (a piece of a plastic pipe) was removed from the orbital cavity, which was suspected to be a fractured orbital bone, at first place. CONCLUSION:In this study, we demonstrated that plastics could mimic bone structure in a Computerized Tomography (CT) scan leading to possible initial misdiagnosis. Hence high clinical suspicion is necessary for the correct diagnosis of such cases. However, despite the prompt intervention, our patient ended up with permanent vision loss in his injured eye.

| S-EPMC6611006 | biostudies-literature

[An unusual intraurethral foreign body: a case report].

Project description:In medical literature there are several case reports of foreign bodies introduced into the urethra. Foreign bodies are usually inserted as result of erotic activities, psychiatric disorders and, rarely, in an attempt to evacuate the urine. Diagnosis is based on clinical examination and imaging tests. Endoscopic management is the treatment of choice but, in some cases, open surgery may be necessary. The therapeutic approach should be systematically complemented by a psychiatric assessment of the patient. We report the case a 64-year old man with a personal history of behavioral disorders who introduced an electric wire in his urethra. The patient underwent endoscopic extraction under regional anesthesia. The patient at the time of discharge was referred to a psychiatrist.

| S-EPMC5554675 | biostudies-other

A subglottic foreign body mimicking croup: A case report.

Project description:IntroductionForeign body (FB) aspiration is one of the causes of respiratory distress in infants is an extremely dangerous and potentially life-threatening event. The diagnosis of FB aspiration is difficult because the signs and symptoms vary according to the degree of airway blockage or location of the FB.Patient concernsAn 11-month-old female infant visited a hospital because of a sudden onset cough. She was relatively healthy without fever, rhinorrhea cyanosis, or poor feeding. On physical examination, auscultation revealed inspiratory stridor without wheezing and crackles.DiagnosisCroup was suspected when considering the history, physical examination, and imaging. However, she did not respond to a 4-day course of treatment for croup. Flexible laryngoscopic examination was performed, and we identified a thin, flat, and sharp FB embedded in the subglottic region.InterventionsEmergency surgery was performed to remove the FB. Short-term intravenous corticosteroids and antibiotics were used to prevent laryngeal swelling and aspiration pneumonia.OutcomesOne week after the procedure, the laryngeal mucosa had completely healed.ConclusionFB aspiration should be considered in an infant with an impression of croup. In particular, if there is no response to medical or conservative treatment for croup, further evaluation is needed.

| S-EPMC8284713 | biostudies-literature

Rectal foreign body causing perforation: Case report and literature review.

Project description:Background:Clinicians must maintain an index of suspicion to diagnose an anorectal foreign body (FB). The patient may not be forthcoming with information secondary to embarrassment or possibly psychiatric issues. Providers must express empathy and compassion while maintaining nonjudgmental composure. Despite accounts of anal FB insertion, this pathology is lacking level one evidence-based surgical algorithms. Case presentation:A 46-year-old male psychiatric patient presented in septic shock, complaining of lower abdominal/pelvic pain starting 1 week prior. His past medical history was significant for schizophrenia, bipolar disorder, and noncompliance with medications. CT of the abdomen/pelvis revealed a rectal perforation with free air and a FB which appeared to be a screwdriver. Fluid resuscitation and broad-spectrum antibiotics were administered. In the operating room, after unsuccessful transrectal removal, an exploratory laparotomy was performed. The metallic end of the screwdriver had perforated the rectosigmoid. Resection of the perforated rectum with removal of the screwdriver, incision and drainage of a large right buttock abscess and colostomy was performed. The patient recovered and was discharged to behavioral health. At 2 weeks follow-up the patient was doing well with a functioning colostomy and reversal was planned for later this year. Conclusion:This case highlights the importance of maintaining a high index of suspicion when encountering psychiatric patients with nonspecific lower abdominal or anorectal pain with inconsistent presentations. Controversy exists regarding the type of surgical treatment in case of anorectal perforation. More research is needed to provide surgeons with evidence-based standardized methods for dealing with these rare pathologies.

| S-EPMC6804320 | biostudies-literature

The largest esophageal foreign body in adults: A case report.

Project description:Introduction:The swallowing of foreign bodies can be accidental or intentional. The majority of the cases of accidental foreign body ingestion are observed in children. In adults, foreign body ingestion can be accidental, related to specific pathological changes of the digestive tract, or deliberate, as observed in patients with psychiatric diseases or in those released from the prison. Case presentation:A 42-year-old male was admitted to the emergency department with symptoms including choking, drooling from the mouth, holding his neck, and aphonia. He had a history of psychiatric illness with suicidal ingestion of a foreign body. After stabilization, he was sent for chest radiograph, which revealed a significant radiopaque shadow the shape of a spanner, occupying the whole length of the esophagus. Emergency rigid esophagoscopy was performed to save the patient's life. Discussion:The patient swallowed the largest hard foreign body to harm himself or his family, to get the attention of his family, or as a suicide attempt. Such patients require urgent intervention by rigid esophagoscopy to reduce the risk of complications and to save the patients' lives. Further follow-up is essential due to the possibility of repeated foreign body ingestion. Conclusion:While taking care of psychiatric patients, close observation by family members is mandatory to prevent them from harming themselves and to prevent suicide attempts by swallowing sharp, hard, large, and dangerous foreign bodies such as the size 17 wrench spanner observed in the present case.

| S-EPMC7210472 | biostudies-literature

A foreign body in the cephalic vein: A case report.

Project description:RationaleForeign bodies in the vasculature usually cause numerous problems for clinical physicians. Physician experience with diagnosing and treating non-iatrogenic foreign body migration in the venous system is insufficient.Patient concernsHere, we reported a 41-year-old male who had a foreign body in his left forearm following a work-related injury.DiagnosesX-ray films indicated a 3-mm high-density shadow in the superficial soft tissue of the left forearm. During the operation, the foreign body was imaged by a C-arm fluoroscope to provide a more accurate location.InterventionsThe foreign body was removed completely following a microsuture of the cephalic vein.OutcomesThe procedure was uneventful, and the patient remained asymptomatic after 6 months of clinical follow-up.LessonsThis case indicated that the foreign body in the superficial tissue needed to be accurately diagnosed and located. X-ray and C-arm fluoroscope imaging should be combined with the patient's medical history to ensure sufficient preoperative preparation.

| S-EPMC6023701 | biostudies-literature

METALLIC FOREIGN BODY IN LEFT MAIN BRONCHUS (A Case Report).

Project description:A child with accidental inhalation of a metallic foreign body into left main bronchus is reported. The foreign body was removed by rigid bronchoscopy. The problems in management are discussed and current literature reviewed.

| S-EPMC5529707 | biostudies-other

Foreign body associated non-ST elevation myocardial infarction: a case report.

Project description:The incidence of guiding catheter tip fracture, is quite rare during percutaneous coronary interventions (PCI). Retained broken catheter tip in coronary artery and circulation can result in serious complications such as thrombosis, embolism, acute occlusion and myocardial infarction, arrhythmias and sepsis. It is mandatory to remove the fractured catheter as soon as possible to avoid these complications. Transcatheter removal is the treatment of choice. If percutaneous removal is failed, surgical intervention is advised.

| S-EPMC5787336 | biostudies-literature

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