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Open in new tab Download slide OBJECTIVES The goal of this histological study was to assess the biocompatibility of vascular patches used in the repair of congenital heart defects. METHODS We examined tissue-engineered bovine (n = 7) and equine (n = 7) patches and autologous human pericardium (n = 7), all explanted due to functional issues or follow-up procedures. Techniques like Movat-Verhoeff, von Kossa and immunohistochemical staining were used to analyse tissue composition, detect calcifications and identify immune cells. A semi-quantitative scoring system was implemented to evaluate the biocompatibility aspects, thrombus formation, extent of pannus, inflammation of pannus, cellular response to patch material, patch degradation, calcification and neoadventitial inflammation. RESULTS We observed distinct material degradation patterns among types of patches. Bovine patches showed collagen disintegration and exudate accumulation, whereas equine patches displayed edematous swelling and material dissolution. Biocompatibility scores were lower in terms of cellular response, degradation and overall score for human autologous pericardial patches compared to tissue-engineered types. The extent of pannus formation was not influenced by the type of patch. Bovine patches had notable calcifications causing tissue hardening, and foreign body giant cells were more frequently seen in equine patches. Plasma cells were frequently detected in the neointimal tissue of engineered patches. CONCLUSIONS Our results confirm the superior biocompatibility of human autologous patches and highlight discernible variations in the changes of patch material and the cellular response to patch material between bovine and equine patches. Our approach implements the semi-quantitative scoring of various aspects of biocompatibility, facilitating a comparative quantitative analysis across all types of patches, despite their inherent differences. [ABSTRACT FROM AUTHOR]

Purpose: To improve awareness of delayed onset uveitis in patients with a history of intraocular tattoo ink injection.Results: A 47-year-old man underwent a scleral tattoo procedure during which there was inadvertent intraocular injection of tattoo ink into his right eye. He subsequently developed endophthalmitis, retinal detachment, and retinal necrosis. He was treated with intravitreal and oral antibiotics and underwent vitreoretinal surgical intervention. A vitreous specimen was obtained and demonstrated significantly elevated levels of several heavy metals. One month later, he developed an acute granulomatous anterior uveitis in the same eye that was managed with a combination of topical and perioperative intravitreal, intravenous, and oral corticosteroids.Conclusion: This case highlights the importance of monitoring patients with a history of intraocular tattoo ink injection for delayed onset uveitis in addition to retinal toxicity.

This paper attempts to deal with a specific kind of pathological identification—"raw object identification"—which tends to appear as concrete physiological phenomena, trying to escape meaning and integration. These somatic manifestations stem from early traumatic experiences with a meaningful object and entrap—as revealed through analysis—specific significant qualities of that object. A massive splitting ensues between body and mind, self and object, relation and identification. Certain properties of the object are then experienced as a foreign body in the subject and are defensively identified with. Thus, raw object identification is often manifested in stubborn bodily symptoms. [ABSTRACT FROM AUTHOR]

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Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Choking is a relevant public health problem. Data in medical literature are scarce and fatal events are dramatically under-reported.The aim of this manuscript is to give a real estimation of this problem and to raise awareness about this topic.Materials and methods. All deaths caused by choking reported by Italian Mass Media over a two years period were collected. Suspected sudden infant death syndrome was an exclusion criteria.Results. 76 deaths due to foreign body airway obstruction were identified, 51% during 2018 and 49% in 2019, without identifiable time clusters. Choking affected every age, including pre-scholar children (25%), children 6 to 18 years old (3%), adults (38%), and elderly patients (34%). Witnessed cases were 61 (80%) but in almost half 26 cases (42%) the fatal event occurred before or without first aid maneuvers being performed.Conclusion. On the Italian territory, during a 2 years period, three cases per month of fatal choking due to foreign-body airway obstruction occurred, many of them in adult patients (38%). Italian people seem not to be educated to provide first aid in these settings.

Background: Foreign bodies adherent to the hard palate often mimic oral lesions. Case report: A 10-month-old female infant presented with the sudden development of a hard palate lesion. With photography and visualization, the "lesion" was a false nail, which belonged to the child's caregiver. Discussion/conclusion: The differential diagnosis of palatal lesions in infants should include foreign bodies, and if identified as such, evaluation under anesthesia may be avoided. [ABSTRACT FROM AUTHOR]

Foreign body-induced granuloma is an uncommon yet clinically significant cause of hypercalcemia. The molecular mechanisms are uncertain, although extrarenal calcitriol production has been proposed. We describe severe hypercalcemia associated with increased levels of plasma calcitriol in a patient with HIV and local granulomatous reaction 5 years after injection of polymethylmethacrylate (PMMA) as dermal filler for cosmetic body sculpting. Extensive evaluation revealed no identifiable cause of increased calcitriol levels. Nuclear imaging was remarkable for diffuse uptake in the subcutaneous tissues of the buttocks. Subsequent muscle biopsy and immunohistochemical staining showed strong local expression of CYP27B1 within histiocytes surrounding globules of PMMA. This case highlights an unfortunate complication of dermal fillers and shows that inflammatory cells can express high levels of CYP27B1 even without frank granulomas. The growing trend of body contour enhancement using injectable fillers should raise suspicion for this cause of hypercalcemia in clinical practice. Patients with HIV who receive this treatment for lipodystrophy or other cosmetic purposes may have increased susceptibility to hypercalcemia in the setting of underlying chronic inflammation. This may be a concern when changing anti-retroviral therapy, since alterations in levels of HIV viremia may initiate or contribute to worsening hypercalcemia.

Background The result of illicit polymer injection is chronic inflammation with foreign-body granuloma (FBG) formation. Treatment can be divided into medical and surgical. Some patients develop severe complications with need surgical treatment. This study aims to describe patients who underwent surgical removal of the FBGs and autoimmune/inflammatory syndrome induced by adjuvants (ASIA); additionally, we evaluated the quality of life after surgery. Methods In this retrospective single-center study, the authors examined data of patients who underwent surgical removal of FBG caused by illicit polymer injection for cosmetic purposes and confirmed ASIA from 2015 to 2020 by three different surgical approaches. Descriptive summary statistics were reported on patient demographics, presenting symptoms and clinical examination features, treatment strategies, histopathology reports and quality of life. Results The cohort included 11 female patients with FBGs and ASIA. The most affected anatomical zones were the combination of gluteal region, thighs and legs (40%); and thighs with legs (20%). Main presentation was: skin hyperpigmentation (90.9%), skin induration (63.6%), chronic fatigue (63.6%), and ulcers (36.4%). Surgical modalities consisted of: ultrasonic-assisted liposuction in four patients (36.4%); open en bloc excision and primary closure in four patients (36.4%); and open en bloc excision and microsurgical reconstruction in three patients (27.2%). The postoperative quality of life visual analog scale score was 83.9. Conclusions ASIA treatment represents a challenge for the plastic surgeon. Adequate surgical treatment emphasizing, when possible, the total or near-total resection of the FBG must be performed to improve ASIA evolution. [ABSTRACT FROM AUTHOR]

Gossypiboma is a rare, preventable and under-reported pseudo-tumour complication following surgery. It has serious medicolegal consequences. It poses a diagnostic dilemma due to non-specific clinical and radiologic features. We therefore report a case of gossypiboma in a 31-year old woman following a midnight emergency caesarean operation, to highlight the risk in our environment, the implications and the need for a high index of suspicion in postsurgical patients. [ABSTRACT FROM AUTHOR]

Penetrating wounds from sea urchin spines are marine injuries that may cause morbidity in humans. Seasonal fishing for abalone in Dhofar is associated with an increase in the number of these injuries, as divers may strike their extremities, especially the dorsum of hands and fingers, on the rocks where Echinoderms and juvenile abalone (Haliotis mariae) are anchored. The immediate effect of injuries includes pain, edema, bleeding, erythema, and rarely systemic complications. There can be a delayed effect in the form of chronic granulomatous skin disease, which is a slow developing reaction to retained spine fragments in the wound that may take several months to develop. We report a case of sea urchin granulomas in a 45-year-old male who injured his hands by the spines of sea urchin while harvesting Haliotis mariae. Clinical manifestations, histological patterns, and treatment modalities are discussed here, to enhance the knowledge about these injuries and the available therapies.

An eleven month old male, juvenile lion brought for rehabilitation at the Olusegun Obasanjo Presidential Library (OOPL) Wildlife Park was diagnosed with gastrointestinal foreign body and intussusception based on the history of persistent vomiting following ingestion of a cotton towel, and radiographic findings of a radiopaque gastric foreign body extending from the fundus to the pylorus and a cylindrical soft tissue mid-abdominal mass. The lion was premedicated with an intramuscular injections of ketamine (5 mg.kg−1) and midazolam (0.25 mg.kg−1), while anaesthesia was induced with an intravenous injection of propofol (2 mg.kg−1). A celiotomy followed by gastrotomy and subsequent intestinal resection and anastomosis was performed to remove the gastrointestinal foreign bodies and correct the intussus ception. The lion recovered well without any complication and was gradually introduced back into the group housing three weeks later following successful alimentation process. This report is probably the first case of intussusception in a lion that was associated with a gastrointestinal foreign body.

• The majority of ingested foreign bodies pass through the gastrointestinal tract harmlessly. • Ingested foreign bodies can cause significant complications like bowel obstruction, bleeding, abscess formation, migration to other organs, and perforation. • In selected cases, endoscopic management is more cost-effective, minimally invasive, has less post-operative complications, and leads to a more expeditious recovery. Ingested foreign bodies (IFB) can uncommonly cause perforation of the gastrointestinal tract. The traditional management is surgical exploration via laparotomy or laparoscopy, although endoscopic options are now gaining prominence. We present two patients with almost identical clinical presentations of post-prandial abdominal pain and anorexia. On examination they were haemodynamically stable with localised epigastric tenderness. Both patients underwent CT scan of the abdomen, with one scan revealing a foreign body in the stomach penetrating the full thickness of the gastric wall with the tip lying extraluminally. They subsequently underwent endoscopy where a chicken bone was found perforating the wall of the stomach. This was removed via snare and endoscopic clips were used to close the site of perforation. The majority of ingested foreign bodies pass through the gastrointestinal tract harmlessly. However some IFBs can cause significant complications like bowel obstruction, bleeding, abscess formation, migration to other organs, and in our case perforation. The diagnosis may be delayed due to an insidious clinical presentation especially if the patient does not recall ingesting anything untoward. Our patients managed to avoid surgery by undergoing successful endoscopic therapy. In selected cases, endoscopic management is more cost-effective, minimally invasive, has less post-operative complications, and leads to a more expeditious recovery. Therefore, the role of therapeutic endoscopy for gastric perforations secondary to foreign bodies should always be considered. [ABSTRACT FROM AUTHOR]

Penetrating wounds from sea urchin spines are marine injuries that may cause morbidity in humans. Seasonal ishing for abalone in Dhofar is associated with an increase in the number of these injuries, as divers may strike their extremities, especially the dorsum of hands and ingers, on the rocks where Echinoderms and juvenile abalone (Haliotis mariae) are anchored. he immediate efect of injuries includes pain, edema, bleeding, erythema, and rarely systemic complications. here can be a delayed efect in the form of chronic granulomatous skin disease, which is a slow developing reaction to retained spine fragments in the wound that may take several months to develop. We report a case of sea urchin granulomas in a 45-year-old male who injured his hands by the spines of sea urchin while harvesting Haliotis mariae. Clinical manifestations, histological patterns, and treatment modalities are discussed here, to enhance the knowledge about these injuries and the available therapies. [ABSTRACT FROM AUTHOR]

Background Pneumothorax is one of the respiratory toxic effects of cocaine inhalation. The literature counts several cases, some associated to other respiratory conditions such as pneumomediastinum, haemoptysis and others not requiring surgical treatment. Aim We present a series of nonHIV cocaine-inhaler subjects who underwent video-assisted thoracoscopic surgery (VATS) for isolated spontaneous pneumothorax. Design Nine subjects, with a mean age of 24 ± 4 years, admitting cocaine inhalation, developed spontaneous pneumothorax and underwent 10 surgical treatments by means of VATS, at our Institution. Results Previous pneumothorax occurred in six cases episodes ranged from 0 to 5 (mean 1.6 ± 1.6). Chest computed tomography (CT) scan showed abnormalities in seven cases. All subjects underwent lung apicectomy, apical pleurectomy and mechanical pleurodesis. Seven subjects had also bullectomy. In all cases the visceral pleura was partially covered by fibrinous exudate. Histology of the lung showed small foreign body granulomatous inflammation in fibrotic and/or emphysematous pulmonary parenchyma. Relapse of pneumothorax occurred in one subject at 60 days and it was surgically treated. Mean follow-up was 150 ± 38 months (range 120–239). All subjects are now well, with no evidence of pneumothorax. Conclusions Spontaneous pneumothorax in cocaine-inhaler subjects is a reality of which physicians need to be aware. Chest CT scan might not reveal abnormalities. Macroscopically the lung might presents bullae and/or peculiar visceral pleura. Foreign body granulomas observed in the specimens suggest that the particulate component of inhaled substances can injure the lung. Surgical treatment of the bullous disease and mechanical pleurodesis can provide a long-term follow-up without relapse of pneumothorax. [ABSTRACT FROM AUTHOR]

• Foreign body granulomas may be associated with silicone prostheses. • Foreign body granulomas can be mistaken for malignant neoplasms. • Diagnosis of foreign body granuloma needs clinical, imaging and histological analysis. This study aimed to report the case of a foreign body granuloma in a 34-year-old woman, presenting clinical and imaging characteristics, as well as to discuss the association of using alloplastic material for the lesion in question. Female patient seeking dental care for a routine treatment. The panoramic radiograph showed the presence of asymptomatic, radiolucent, and multiloculated lesion between teeth 31 and 34. Among the hypotheses diagnosed, central giant cell granuloma and osteosarcoma were suggested. When questioned, the patient denied any health changes or recent local procedures. After performing a histopathological examination and insisting on anamnesis, the case was diagnosed more accurately as "foreign body reaction" and the adequate therapy was determined. The use of alloplastic material has been reported as an etiological factor of foreign body lesions, and dentists, either clinicians, radiologists or pathologists, should be aware of this because of the great increase of such procedures and the difficulties related to their diagnosis. The foreign body granuloma associated with silicone prosthesis, based on its clinical and imaging characteristics, may be mistaken for neoplastic processes. [ABSTRACT FROM AUTHOR]

A three year old Boerboel bitch was presented to the Veterinary Teaching Hospital, FUNAAB with complaint of lethargy and inappetence. Clinical signs observed included abdominal tenderness, watery bloody stool and palpable intestinal mass. Blood sample was obtained for complete blood counts, while transcutaneous abdominal ultrasound and lateral abdominal radiograph were also performed. Result of complete blood count showed severe neutrophilic leukocytosis. Transcutaneous abdominal ultrasound revealed dilated bowel loop containing a hyperechoic structure in the lumen, while radiographic contrast examination of the intestine revealed distended bowel loop and a radiopaque foreign body in the jejunum. Based on the findings, a tentative diagnosis of intestinal obstruction was made and an exploratory laparotomy was scheduled. After pre-anaesthetic medications with 3mg/kg intramuscular injection of 5% tramadol, 0.04mg/kg intramuscular injection of 0.1% atropine and 0.5mg/kg intramuscular injection of 2% Xylazine, anaesthesia was induced with a loading dose of 4mg/kg intravenous injection of 1% propofol and maintained with constant infusion of propofol at the rate of 0.12mg/kg/min. During laparotomy, the obstructed region was identified and enterotomy revealed the foreign body to be an ingested plastic bottle cap. Following removal of the foreign body, moderate inflammation of the segment of the intestine around the obstruction site was observed, necessitating the need for resection of the intestine to be performed and anastomosis using an end to end technique. The dog recovered without any complications after one week of postoperative antibiotic therapy and fluid administration. Prompt diagnosis of intestinal foreign body in dogs followed by appropriate selection of anaesthetic protocol and surgical technique with adequate intensive post-operative follow-up is essential for successful management. [ABSTRACT FROM AUTHOR]

Objective It has been reported previously that granulomas can occur around nonabsorbable sutures, but that granuloma formation around the staple line is very rare. However, the increased use of thoracoscopic surgery is creating more opportunities to use automatic mechanical suturing equipment for pulmonary surgery, and it is expected that the incidence of granuloma around the staple line will increase. Methods We retrospectively investigated the clinical records of 6 patients who developed nontuberculous mycobacterial granuloma on the staple line after pulmonary resection. We investigated their clinical characteristics and compared them with data in 16 cases of cancer recurrence. Results Fluorodeoxyglucose uptake was detected in all 6 patients. Laboratory data including white blood cell counts and C-reactive protein levels were within normal ranges in all patients. There was no evident tendency in terms of age, sex, maximal standardized uptake value, or radiological findings. However, compared to cancer recurrence, mycobacterial granuloma around the staple line appeared after a longer period of time, and the proportion of patients who had a segmentectomy as the initial surgery was significantly higher. Conclusion When growing shadows are observed near the staple line, it is difficult to differentiate between cancer recurrence and nontuberculous mycobacterial granuloma from computed tomography and laboratory findings. However, if a mass shadow around the staple line appears 2, 3, or more years after segmentectomy, it could be considered likely to be a granuloma. “Post-segmentectomy” and “late occurrence” are important attributes for distinguishing staple line granuloma from cancer recurrence. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the diagnostic value of integrated 18F-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) for suspected recurrence of epithelial ovarian cancer (EOC) with non-disseminated lesions. Methods: We retrospectively reviewed the medical records of recurrent EOC patients who underwent secondary cytoreduction from January 2000 to December 2013. A total of 134 patients underwent secondary cytoreduction after imaging with either 18F-FDG-PET/CT or contrast-enhanced computed tomography (CECT). Results: In a patient-based analysis of 134 patients, 124 (92.5%) were confirmed to be positive for malignancy. Among 72 patients with suspected non-disseminated recurrence on 18F-FDG-PET/CT, 65 (89.0%) were confirmed to have recurrence, giving 98.5% sensitivity, 87.7% accuracy, and 88.9% positive predictive value (PPV). In the 65 patients with recurrence, residual tumor remained in 14 patients, giving an accuracy of patient selection for secondary cytoreduction of 69.4% (50/72) and it is higher than that of CECT (64.0%). In 169 lesions removed from patients who underwent preoperative 18F-FDG-PET/CT, 135 (79.9%) were confirmed to be positive for malignancy and 124 were accurately detected by 18F-FDG-PET/ CT, giving 91.9% sensitivity, 81.1% accuracy, and 85.5% PPV. Foreign body granuloma was found in 33.3% of 21 lesions with false-positive 18F-FDG-PET/CT findings (7/21). The mean preoperative cancer antigen 125 (CA-125) level in false-positive patients was 28.8 U/mL. Conclusion: Compared with CECT, 18F-FDG-PET/CT shows higher sensitivity in lesion-based analysis and better accuracy of patient selection for secondary cytoreduction. However, there is still a need for integration of the results of 18F-FDG-PET/CT, CECT, and CA-125 levels to aid treatment planning. [ABSTRACT FROM AUTHOR]

Purpose: To report the clinicopathologic features of a case of conjunctival synthetic fiber granuloma. Case Report: A 6-year-old girl presented with a slow-growing red nodule in the right inferior conjunctival sac with no history of surgery or trauma. Histopathological examination revealed foreign body type granulomatous inflammation around birefringent fibers of variable colors consistent with synthetic fiber granuloma. Conclusion: This is the first case report of synthetic fiber (teddy bear) conjunctival granuloma from Iran. Despite its scarcity, ophthalmologists should consider this type of granuloma in the differential diagnoses of childhood conjunctival lesions especially when the lesion is unilateral and inferior.

Foreign body granulomas can develop after the injection of various cosmetic filling materials into the facial area to flatten wrinkles. Clinically, reactive lesions are easily mistaken for soft-tissue neoplasms or cysts. This report presents a case of foreign body granuloma in a 52-year-old female patient complaining of a painless swelling in the nasolabial region. Both clinical and histological features are described, underscoring the diagnostic role of magnetic resonance imaging findings. [ABSTRACT FROM AUTHOR]

Silicone granulomas (siliconomas) represent a chronic and natural inflammatory response of the host to restrain a foreign substance, in this case, silicone. They are related to one of the possible complications after the rupture or leak of the silicone gel from breast implants. This increasingly important problem was triggered by the Poly Implant Prothèse® (PIP) silicone gel breast implants. PIP breast implants were found to have higher break frequency compared with other breast prosthesis manufactures, affecting more than 300,000 women in 65 different countries. We report the case of a 50 year-old woman with a history of breast augmentation with silicone gel implants brand PIP, who was admitted with breast ptosis, localized lipodystrophies and an axillary mass. Histopathological findings along with clinical information led to a diagnosis of siliconoma as result of the migration of silicone from the PIP implant and extracapsular rupture. [ABSTRACT FROM AUTHOR]

We report a patient with a wooden foreign body granuloma in the intervertebral disc space being symptomatic 17 years after a paraspinal penetrant trauma. According to the our result of the search for wooden foreign body granulomas, this is the first case suffered from a wooden foreign body granuloma in the intervertebral disc space that reported in the literature. In this report, we emphasized the importance of rigorous examination and follow up in paraspinal wooden penetrant traumas. [ABSTRACT FROM AUTHOR]

Introduction and Aim: Retained intracorporeal textile products (gossypiboma-textiloma) are undesired and accidental surgical results for both patients and surgeons, which are underreported because of medicolegal remifications. Fourteen textiloma cases, who had been treated or whose treatment procedures had been followed-up personally by two general surgeons in a period of 27 years almost during their whole professional lives were presented to describe and define the clinical and pathological characteristics. Material and Methods: Patient characteristics including gender and age, areas of location within the body, time intervals until diagnosis, clinical presentations and complaints, treatment modalities, complications, causative surgical interventions, and diagnostic approaches were retrospectively evaluated. Results: Nine female and five male patients with a mean age of 43.07 ± 15.23 (median: 45) years at diagnosis were enrolled in the study. Cesarean section in three, inguinal hernioraphy in four, explorative laparotomy because of acute abdomen in one, sigmoid colon resection in one, appendectomy and right salpingoophorectomy in one, etrangulated incisional hernia after a previous surgical intervention because of an ovarian mass in one, thyroidectomy in one, epigastric hernioraphy in one, and bilateral segmental mastectomy with bilateral axillary sentinal lymph node dissection in one were the causative surgical interventions. Locations of textilomas were the abdominal cavity in seven, inguinal surgical wound in four, epigastric surgical wound in one, thyroidectomy lodge in one, and bilateral axillary cavities in one patient. The mean time interval until diagnosis was 14.48 (median: 5.5) months. Dıscussıon: Earlier recognition of foreign bodies can provide a better outcome. Conclusion: Gossypibomas are preventable iatrogenic faults which create severe problems. Strict adherence to the rules of the operation room is a must to keep the tip of the iceberg shut in the Pandora’s box.

Dermal fillers are generally accepted as safe and well-tolerable cosmetic tools. However, adverse reactions have been reported in the literature. Here, we present a case of atypical facial filler granuloma and compare its histologic features with those of the classic paraffinoma. [ABSTRACT FROM AUTHOR]

Intracranial foreign body granulomas are rarely reported. Clinical symptoms caused by foreign body granulomas can be noticed from months to many years after surgical procedure. The most common reported etiology is suture material. A 45-year-old woman was presented with grand mal epilepsy. She was operated for brain tumor 19 years ago. In CT scan, a round radio-dense mass resembling a tumor at anterior fossa was seen. She underwent craniotomy and resected a granuloma with cotton fibers surrounded by yellow capsule without residual or recurrent tumor. Granuloma can mimic intracranial meningioma and special attention should be paid not to leave cotton pledgets during operations.

Introduction: The soft palate corresponds to about one third of the posterior portion of the palate, it is composed of glands of mucous and salivary secretion. It has only muscle fibers and aids in speech and swallowing. During development, children go through the oral phase, in which their first contact with the outside world is by placing objects in their mouths. Objectives: To report the case of an infant who ingested the tomato paste packaging lid and it stuck to the soft palate, causing infection, and to highlight the importance of frequent evaluation of the child's oral cavity. Resumed report: Male patient, 1 year and 2 months old, accompanied by his mother, sought hospital due to suspected seizure and momentary loss of consciousness after the mother had left the child alone in a bathtub with water. After neurological screening and imaging tests were all normal, he was discharged from the neurology department. During oroscopy, a foreign body was observed firmly adhered to the soft palate with presence of granuloma, hyperemia and purulent secretion in adjacent skin. The mother reports that she had not noticed the object. Antibiotic therapy was started and the object was manually removed in the operating room. Conclusion: Infants get to know the world by bringing objects to their mouths. Thus, it is important to carry out frequent evaluation of children's oral cavity and to perform a thorough otorhinolaryngological examination, avoiding bronchoaspiration and palatal perforation. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Rigid bronchoscopy (RB) is the principal method used for the extraction of a tracheo-bronchial foreign body (FB), but its use as a diagnostic tool implies a certain rate of negative exams, exposing the child to the risk of procedure and anesthesia-related complications. Technological progress has improved the accuracy and availability of non-invasive modalities, such as CT scan and fluoroscopy. Our aim is to review our experience in the routine use of bronchoscopy for a suspected FB aspiration, and evaluate the adequacy of our current attitude in light of these alternatives. Methods: We performed a retrospective review of cases where bronchoscopy was used in the management of a suspected airway FB, and analysis of the correlation between the clinical and radiological data and the bronchoscopy''s results. In addition we reviewed the literature concerning the use of RB and alternative means of diagnosis such as CT scan, fluoroscopy and flexible bronchoscopy. Results: Thirty-two patients underwent bronchoscopy to rule out a FB aspiration under general anesthesia. No FB was found in 8 cases (25%). Cough and a history of choking were the most sensitive parameters (sensitivity 100% and 80% respectively), but had a low specificity. Stridor was the most specific sign (88% specificity), but was not sensitive. Chest radiography had 25% sensitivity, and 62.5% specificity. Flexible bronchoscopy changed the management in 22% of cases, sparing RB. Conclusions: Basing the decision to perform RB solely on the clinical findings and chest radiography entails a 25% rate or more of negative exams. CT scan appears to be the most accurate non-invasive tool for ruling out the presence of a FB but its use cannot be systematic due to its complexity and the risks of exposure to radiation. Digital substraction fluoroscopy is a safe and simple mean to confirm the presence of air trapping generated by a bronchial obstruction, but it is not sensitive enough to definitively rule out a FB. We propose a stepwise approach using fluoroscopy or possibly flexible bronchoscopy under sedation, in order to reduce the number of negative RBs while restricting the use of the CT scan. [Copyright &y& Elsevier]

The purpose of this article was to describe the clinical and microscopic features of a foreign-body granuloma in submental region that resulted from a fish bone embedded in the floor of mouth. A 45-year-old female patient complained of a hard mass in submental region. Clinical examination showed a non-compressible, firm, fixed lump, painless on palpation. Ultrasound examination showed an internally uneven, uncircumscribed, hypoechoic mass with a steaky hyperechoic spot of 1.1 cm length in the center. A microscopic examination showed newly-formed granuloma, composed of lympocytes and epithelioid cells, and some microabscess with neurophiles. The final diagnosis was a foreign-body granuloma with fish bone. Even though foreign-body granulomas in submental region are rare lesions, surgeon should be familiar with their features and include them in the differential diagnosis of tissue masses. [ABSTRACT FROM AUTHOR]

Gossypiboma is used to describe unintentionally retained surgical item in the body after an operation. A 52-year-old man presented with palpable abdominal mass fifteen years after cholecysctectomy operation. It was diagnosed as hydatid cyst preoperatively and as gastrointestinal stromal tumor intraoperatively. Gossypiboma should be in the differential diagnosis of any postoperative patient who presents with palpable mass. [ABSTRACT FROM AUTHOR]

Paciente do sexo masculino, branco, 43 anos, apresentava há dois anos lesão única, localizada no joelho direito, além de descamação nas regiões plantares. O exame micológico direto das lesões plantares mostrava filamentos de dermatófitos, mas foi negativo na lesão do joelho. Porém o exame histopatológico dessa área demonstrou presença de granuloma de corpo estranho com hifas de dermatófitos, confirmando o diagnóstico de granuloma de Majocchi.Caucasian male patient, 43 years old, presented two years ago with one single lesion in the right knee, in addition to desquamation in the plantar region. Direct mycological exam of the plantar damage showed filaments of dermatophytes, but it was negative for the knee injury. However, histopathology of the area showed presence of foreign body granuloma with hyphae of dermatophytes, confirming the diagnosis of Majocchi's granuloma.

The paradoxical movement of the mediastinum, in relation to the respiratory cycle, is a valuable fluoroscopie sign in the evaluation of partial obstruction of air-flow through the trachea or larynx. Its recognition in the presence of the normal chest radiograms together with the clinical history of aspiration, is of importance in the diagnosis of a foregin body located above the tracheal bifurcation. The pathophysiology and the radiographic manifestations of this phenomenon are described. Various etiologies are discussed in which this sign is also seen. The experience with 18 pediatric patients is presented and 3 cases are outlined in details. [ABSTRACT FROM AUTHOR]

Foreign-bodies in the aero-digestive tract are a frequent occurrence in ENT practice. The diagnosis and management are based on clinico-radiological findings. We report a case of a 50 paise coin impacted in the adult larynx where the patient came to us 3 days later with the symptom of change of voice and pain in the throat but, surprisingly no dyspnoea or stridor. [ABSTRACT FROM AUTHOR]