MyMedR

Fulltext When the symptoms remain, the diagnosis may need a change: a missed foreign body

Vengatesh Rao, Irfan Mohamad

Archives of Orofacial Sciences, 2016;11(1):15-17.

MyJurnal

The unilateral nasal symptom should trigger a treating physician to a certain diagnosis. The differential
diagnosis includes foreign body, rhinolith and tumour. The chronicity of symptom helps a lot with the diagnosis.
Foreign body for example, tends to present with positive history of insertion, mainly by children or the acute
symptom of local infection. In the presence of prolonged symptom, rhinolith should be suspected especially when
the patient presents with pathognomonic nasal obstruction with foul smelly discharge. A referral should be made
for a nasoendoscopy evaluation whenever a rhinitis-like symptoms remain after a period of medical treatment for
allergy. We share a case of a missed diagnosis of a rhinolith after six years of symptoms.

Matched MeSH terms: Foreign Bodies

Use of capnography delaying the diagnosis of tracheal intubation

Chan YK, Zuraidah S, Tan PS

Anaesthesia, 1998 Dec;53(12):1207-8.

PMID: 10193227

There was a delay in making the correct diagnosis of tracheal intubation in a parturient who developed severe bronchospasm after intubation because we relied on the capnogram.

Matched MeSH terms: Foreign Bodies/diagnosis*

Fulltext Ureterovaginal fistula: A complication of a vaginal foreign body

Lo TS, Jaili SB, Ibrahim R, Kao CC, Uy-Patrimonio MC

Taiwan J Obstet Gynecol, 2018 Feb;57(1):150-152.

PMID: 29458888 DOI: 10.1016/j.tjog.2017.12.026

OBJECTIVE: To know the diagnostic tools and proper management of ureterovaginal fistula following neglected vaginal foreign body in order to achieve optimal outcome.

CASE REPORT: A case of ureterovaginal fistula associated with a neglected vaginal foreign body. The patient was complaining of a foul-smelling vaginal discharge and lower abdominal pain. On vaginal examination, a hard and large foreign body was found. Examination under anesthesia was performed, and an aerosol cap was removed from her vagina. The patient developed urinary incontinence after removal of the foreign body. Subsequent work-up demonstrated the presence of a right ureterovaginal fistula. The patient underwent an abdominal ureteroneocystostomy. At one year follow up, the patient had fully recovered.

CONCLUSION: Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications.

Matched MeSH terms: Foreign Bodies/complications*; Foreign Bodies/surgery

Unusual foreign body in the rectum

Lal M

Med J Malaysia, 1975 Jun;29(4):309-10.

PMID: 1196180

Matched MeSH terms: Foreign Bodies*

Fulltext Unilateral foul smelly nasal discharge in an adult

Irfan M, Hasme Zam H, Mohd Khairi M

Malays Fam Physician, 2012;7(1):28-30.

PMID: 25606242 MyJurnal

The incidence of rhinolith is by far very low compared to the nasal foreign bodies, especially in adult. Foreign body (FB) in the nostril will lead to unilateral nasal symptom which can start with nasal obstruction or discomfort. In younger children, they may miss to report the problem to the parents but, later on, the FB will manifest itself with unilateral nasal discharge, which at most of the time fouls smells. We report a case of a healthy adult female who presented with unilateral foul smelly nasal discharge which later was diagnosed as rhinolith, with rubber-tip pencil eraser as the nidus of calcification.

Matched MeSH terms: Foreign Bodies

Fulltext Undiagnosed chicken meat aspiration as a cause of difficult-to-ventilate in a boy with traumatic brain injury

Mohd Ariff NA, Mazlan MZ, Mat Hassan ME, Seevaunnamtum PA, Wan Muhd Shukeri WF, Nik Mohamad NA, et al.

Respir Med Case Rep, 2018;23:93-95.

PMID: 29387523 DOI: 10.1016/j.rmcr.2018.01.001

Introduction: Bronchoscopy is a commonly used procedure in the context of aspiration in the Intensive Care Unit setting. Despite its ability to remove mucus plug and undigested gastric contents, aspiration of gastric content into the trachea is one of the most feared complications among anesthesiologist.

Discussion: The scenario is made worst if the aspiration causes acute hypoxemic respiratory failure immediately post intubation. However, in the event of desaturation, the quick decision to proceed with bronchoscopy is a challenging task to the anesthesiologist without knowing the causes.

Case presentation: We present a case of a 12-year-old boy who had a difficult-to-ventilate scenario post transferring and immediately connected to ventilator in operation theatre (OT) from portable ventilator from the emergency department. She was successfully managed by bronchoscopy.

Conclusion: Special attention should be given to the difficult-to-ventilate scenario post intubation of traumatic brain injury patient prior to operation. Prompt diagnosis and bronchoscope-assisted removal of foreign body was found to be a successful to reduce morbidity and mortality.

Matched MeSH terms: Foreign Bodies

Fulltext Traumatic transnasal penetrating injury with cerebral spinal fluid leak

Teng TS, Ishak NL, Subha ST, Bakar SA

EXCLI J, 2019;18:223-228.

PMID: 31217785 DOI: 10.17179/excli2018-1971

CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.

Matched MeSH terms: Foreign Bodies

Fulltext Transoral surgical resection of bilateral styloid processes elongation (eagle's syndrome)

Baharudin A, Rohaida I, Khairudin A

Acta Inform Med, 2012 Jun;20(2):133-5.

PMID: 23322967 DOI: 10.5455/aim.2012.20.133-135

Eagle's syndrome represents a symptomatic styloid process elongation or calcification of stylohyoid or stylomandibular ligament. The symptoms include the throat pain radiating to ipsilateral ear or foreign body sensation in the pharynx causing odynophagia and dysphagia. It is commonly unilateral and bilateral cases are rare. We report a case of bilateral elongation of styloid processes treated surgically by transoral approach.

Matched MeSH terms: Foreign Bodies

Fulltext Tracheotomy: an alternative for tracheobronchial foreign body removal

Tang CL, Lee SC, Mohamad Lal A, Thomas RA, Ngui LX, Lim LY

Med J Malaysia, 2014 Oct;69(5):241-3.

PMID: 25638243 MyJurnal

A 6 years old girl accidentally aspirated a plastic whistle while playing. Computed Tomography of thorax showed foreign body at carina level. Rigid bronchoscope under general anesthesia was attempted but unable to extract the whistle through vocal cord. Tracheostomy was later performed and foreign body was removed.

Matched MeSH terms: Foreign Bodies

Tracheobronchial foreign bodies in relation to feeding practices in young children

Indudharan R, Ram SP, Sidek DS

J Accid Emerg Med, 1997 Sep;14(5):341-3.

PMID: 9315945

Tracheobronchial foreign bodies, which are common in children, are a leading cause of accidental deaths in children under four years of age. Three cases of tracheobronchial foreign bodies in children less than two years old are described. One of the foreign bodies was unsuspected; the other two were probably related to food habits. All three cases improved without sequelae following prompt bronchoscopic intervention. Young children should not be given food containing bones or hard chitinous shells.

Matched MeSH terms: Foreign Bodies/etiology*; Foreign Bodies/radiography; Foreign Bodies/therapy

The precarious use of charm needles susuk in treatment of low back pain by traditional medicine practitioners and its possible risk to patient safety

Rampal S, Tan EK, Gendeh HS, Prahaspathiji LJ, Zainal S, Amir S

Med J Malaysia, 2020 01;75(1):80-82.

PMID: 32008027

A 68-year-old female presented with a 1-month history of lower back pain with right-sided radiculopathy and numbness. She was diagnosed with lumbar spondylosis and treated conservatively with analgesia and physiotherapy. Imaging showed multiple susuk, a metal alloy, in the lower back region and other regions of the body. The patient had undergone traditional medicine consultation 10 years earlier when the susuk was inserted in the lower back as talisman. The practice of the insertion of susuk is popular in rural East Malaysia and Indonesia. These foreign bodies act as possible causes of chronic inflammation and granuloma formation. In addition, the localised heighten peril upon imaging. This report suggests that the insertion of multiple susuk as talisman carries risk to safety of patients when imaging, and this practice complicates the management of musculoskeletal disorders.

Matched MeSH terms: Foreign Bodies/complications*

Fulltext The incidence of inhaled foreign body in West Malaysia

Shanmugham MS

Singapore Med J, 1984 Feb;25(1):52-3.

PMID: 6463665

In this paper the incidence of inhaled foreign body in the tracheobronchial tree at the University Hospital Kuala Lumpur, West Malaysia, is reviewed. Children are the usual victims. Food·related substance (peanut) is the most common foreign body, Successful removal of foreign body by bronchoscopy is achieved in the great majority of cases (86%), Prevention can be achieved by educating the parents not to give nuts to children below the age of 3 years.

Matched MeSH terms: Foreign Bodies/epidemiology*; Foreign Bodies/therapy

Fulltext The hazards of impacted alkaline battery in the nose

Ramasamy V, Nadarajah S

J Family Med Prim Care, 2019 1 2;7(5):1083-1085.

PMID: 30598962 DOI: 10.4103/jfmpc.jfmpc_47_18

A foreign body in the nose is a common referral dealt by the otolaryngologist on daily basis. Here we report a case of a 5-year-old girl who was referred from a primary care center with complaints of left nasal blockage and epistaxis along with foul smelling brownish discharge for 1-day duration. Nasal endoscopic examination of the left side of the nose revealed an impacted button battery at the cartilaginous portion of the nasal septum.

Matched MeSH terms: Foreign Bodies

Fulltext The eyes do not see what the mind does not know: an underreported feature in mature cystic teratoma of the ovary

Wong, Y.P., Tan, G.C.

Medicine & Health, 2018;13(2):223-228.

MyJurnal

Mature cystic teratoma is the commonest ovarian germ cell tumour which accounts for 70% of all benign ovarian neoplasms in the reproductive age groups. Being a pluripotent germ cell tumour, mature cystic teratoma has at least two out of three mature embryonic germ cell components: ectoderm, mesoderm and endoderm. The presence of multiple cystic spaces within the tumour wall, also known as pneumatosis cystoides-like appearance is rarely described but a characteristic feature in cystic teratoma of the ovary. Currently, there is little information concerning the mechanism of its formation. Herein, we described an unusual case of ovarian mature cystic teratoma in a 31-year-old pregnant female with multiple sieve-like areas resembling pneumatosis cystoides of the intestine. Macroscopic and histological examination of the ovary revealed features diagnostic of mature cystic teratoma. Intriguingly, multiple cystic spaces of variable sizes were found within the cyst wall histologically. They were lined partially or completely by foamy histiocytes and foreign body type multinucleated giant cells, exhibiting strong CD68 immunoreactivity. Vascular endothelial markers (CD31 and CD34) and epithelial marker (cytokeratin AE1/AE3) were negative. A diagnosis of mature cystic teratoma with pneumatosis cystoides-like feature was rendered. The patient was discharged well with no signs and symptoms of early labour. The etiopathogenesis of this intriguing histological feature is briefly discussed in this article.

Matched MeSH terms: Foreign Bodies

The epidemiology of Open Globe Injuries presenting to a tertiary referral eye hospital in Australia

Beshay N, Keay L, Dunn H, Kamalden TA, Hoskin AK, Watson SL

Injury, 2017 Jul;48(7):1348-1354.

PMID: 28438416 DOI: 10.1016/j.injury.2017.04.035

BACKGROUND: Open globe injuries (OGIs) account for 44% of the cost of ocular trauma within Australia. It is estimated that 90% of ocular trauma is preventable. However, there have been few epidemiological studies within Australia that have identified groups at risk of OGIs specifically. The aim of our study was to review the epidemiology of OGIs presenting to a tertiary referral eye hospital in Australia.

METHODS: The Birmingham Eye Trauma Terminology (BETT) system was used to classify injuries as globe ruptures, penetrating eye injuries (PEIs), intraocular foreign bodies (IOFBs) or perforating injuries. Demographic data, past ocular history, mechanism of trauma, ocular injuries, and best-corrected visual acuity (BCVA) before and after treatment were recorded.

RESULTS: The 205 OGIs included 80 globe ruptures, 71 PEIs, 48 IOFBs and six perforating injuries. Falls predominated in older age groups compared to the other mechanisms of injury (p<0.0001). A fall was responsible for 33 globe ruptures and 82% of these had a history of previous intraocular surgery. Globe rupture and perforating injuries had poorer visual outcomes (p<0.05), consistent with previous studies. Alcohol was implicated in 20 cases of OGI, with 11 of these due to assault. PEIs and IOFBs commonly occurred while working with metal. BCVA was significantly worse following removal of an intraocular foreign body. We found presenting BCVA to be a good predictor of BCVA at the time of discharge.

CONCLUSIONS: The causes of OGI varied in association with age, with older people mostly incurring their OGI through falls and younger adults through assault and working with metal. Globe ruptures occurring after a fall often had a history of intraocular surgery. The initial BCVA is useful for non-ophthalmologists who are unfamiliar with the ocular trauma score to help predict the BCVA following treatment.

Matched MeSH terms: Eye Foreign Bodies/epidemiology*; Eye Foreign Bodies/physiopathology

Fulltext Tell tale of tablets in bronchus

Shimpi T, Chawla A, Shikhare S

Med J Malaysia, 2015 Feb;70(1):36-7.

PMID: 26032528

Foreign body (FB) aspiration is an emergency of concern at all ages. However, in adults, it can present with atypical symptoms such as shortness of breath, wheezing or rarely cyanosis. Aspiration of oral medications is seen in the elderly population with impairment of protective airway mechanism. Treatment of choice is endoscopic removal of the foreign body. We report such a case of foreign body aspiration (potassium chloride tablet), diagnosed on imaging and subsequently developed bronchostenosis. There are a very few reported cases of oral potassium supplement aspiration and associated complications in the literature.

Matched MeSH terms: Foreign Bodies

Susuks: charm needles in facial soft tissues

Shanmuhasuntharam P, Ghani SH

Br Dent J, 1991 Apr 20;170(8):309-11.

PMID: 2036281

Susuks or charm needles are a form of talisman inserted and worn subcutaneously, in the face and other parts of the body, in the belief that they will enhance or preserve the wearer's beauty, youth, charisma, strength or health, or bring success in business. This mystic practice is found among some south-east Asian people, especially Malayan and Muslim females. Most susuk wearers are secretive about their hidden talismans, but these gold or silver needles are being discovered with increasing frequency now that radiographs are used more widely. An understanding of this practice and an awareness of its existence is important to avoid misdiagnosis and mismanagement of these patients. The practice of susuk wearing and its relevance to dentistry is discussed. Nine cases of facial susuk wearers are presented and previous reports are reviewed.

Matched MeSH terms: Foreign Bodies/complications*

Fulltext Surgical Techniques for Correction of Penile Paraffinoma

Salauddin SA, Ghazali H

Malays J Med Sci, 2019 Nov;26(6):137-142.

PMID: 31908595 MyJurnal DOI: 10.21315/mjms2019.26.6.14

Background: Penile augmentation using injection of a foreign body into penile skin was mainly performed by non-medical personnel. Majority of these patients end up with complication of an abnormal mass formation known as penile paraffinoma.

Methods: We described three different surgical techniques for correction of penile paraffinoma based on our single-centre experience. Informed consents were obtained from patients whose photographs were taken during the operation step.

Results: In general, three patients had simple excision biopsy with primary suturing, four patients underwent single stage excision of circumferential granuloma with bilateral scrotal skin flap reconstruction and one patient experienced dual stage procedure. Three of them were injected with paraffin, one with silicone and the remaining four were unable to identify the substance used. All patients successfully underwent the surgical procedure and four of them had minor post-operative surgical site infection and wound gapping.

Conclusion: All patients recovered well and the mean International Index of Erectile Function (IIEF-5) score obtained was 24.25. In our experience, excision biopsy was adequate for focal mass and reconstructive surgery using bilateral scrotal flap was suitable for circumferential mass.

Matched MeSH terms: Foreign Bodies

Fulltext Superglue accidentally used as ear drops

Anusha B, Purushotman R, Lina LC, Avatar S

Med J Malaysia, 2012 Apr;67(2):212-3.

PMID: 22822647 MyJurnal

Superglue in the ear as a foreign body is an uncommon presentation. We report the case of a lady who accidentally instilled superglue directly onto her tympanic membrane and presented five days later. We successfully removed the glue with acetone and managed to preserve the integrity of the tympanic membrane.

Matched MeSH terms: Foreign Bodies/therapy*

Fulltext Strengthening of RC Beams Using Externally Bonded Reinforcement Combined with Near-Surface Mounted Technique

Darain KMU, Jumaat MZ, Shukri AA, Obaydullah M, Huda MN, Hosen MA, et al.

Polymers (Basel), 2016 Jul 19;8(7).

PMID: 30974542 DOI: 10.3390/polym8070261

This study investigates the flexural behaviour of reinforced concrete (RC) beams strengthened through the combined externally bonded and near-surface mounted (CEBNSM) technique. The externally bonded reinforcement (EBR) and near-surface mounted (NSM) techniques are popular strengthening solutions, although these methods often demonstrate premature debonding failure. The proposed CEBNSM technique increases the bond area of the concrete⁻carbon fibre reinforced polymer (CFRP) interface, which can delay the debonding failure. This technique is appropriate when any structure has a narrow cross-sectional width or is in need of additional flexural capacity that an individual technique or material cannot attain. An experimental test matrix was designed with one control and five strengthened RC beams to verify the performance of the proposed technique. The strengthening materials were CFRP bar as NSM reinforcement combined with CFRP fabric as EBR material. The test variables were the diameter of the NSM bars (8 and 10 mm), the thickness of the CFRP fabrics (one and two layers) and the U-wrap anchorage. The strengthened beams showed enhancement of ultimate load capacity, stiffness, cracking behaviour, and strain compatibility. The ultimate capacity of the CEBNSM-strengthened beams increased from 71% to 105% compared to that of the control beam. A simulation method based on the moment-rotation approach was also presented to predict the behaviour of CEBNSM-strengthened RC beams.

Matched MeSH terms: Foreign Bodies

Displaying publications 1 - 20 of 152 in total