Diagnostic Imaging of Non-Accidental Injury and Percutaneous Foreign Bodies: A Case Report from Zambia (original) (raw)
Related papers
Scandinavian Journal of Surgery, 2017
Introduction: Foreign body injuries are common in children. Most of them are not serious but they can be fatal. A suspected foreign body injury in a child results in a high rate of hospitalizations, exposure to radiation, and need for intervention. This study aimed to analyze the current epidemiology of in-hospital or out of hospital treated foreign object injuries and suspected foreign body injuries in children. Material and Methods: All children <16 years of age (N = 152) who suffered or were suspected to suffer (N = 63) from a foreign body injury and were treated in a pediatric trauma unit of Oulu University Hospital, Oulu, Finland, over a 6-year study period (2008-2013) were included. A comprehensive chart review was completed in order to evaluate injury history, age at the time of trauma, treatment and characteristics of the foreign objects. Results: The majority (57.9%, N = 88) of the injuries were found in children <3 years of age. There was a male predominance (60.5%, N = 92). The most common anatomical site where the foreign body was found was the nose (28.9%, N = 44), followed by the esophagus (20.4%, N = 31) and the eye (11.2%, N = 17). Foreign objects were also found in the lower airways (10.5%, N = 16), ear (10.5%, N = 16), bowel (9.9%, N = 15), throat (3.9%, N = 6), stomach (3.9%, N = 6), and urethra (0.7%, N = 1). Various household items were the most common foreign bodies (33.6%, N = 51). Toys in particular caused 22.4% (N = 34) of the injuries. In-hospital intervention was necessary for 38.5% of the patients (N = 58). Intervention was needed in 39.7% (N = 25/63) of the patients who were suspected to suffer from foreign body but did not. There were no fatalities. Conclusion: Foreign body injuries treated at the pediatric trauma unit were most common in the youngest children (<3 years of age). Majority (61.8%, N = 94) of the patients were treated non-operatively, without any in-hospital intervention.
Imaging foreign bodies in head and neck trauma: a pictorial review
Insights into Imaging, 2021
Open injuries bear the risk of foreign body contamination. Commonly encountered materials include gravel debris, glass fragments, wooden splinters or metal particles. While foreign body incorporation is obvious in some injury patterns, other injuries may not display hints of being contaminated with foreign body materials. Foreign objects that have not been detected and removed bear the risk of leading to severe wound infections and chronic wound healing disorders. Besides these severe health issues, medicolegal consequences should be considered. While an accurate clinical examination is the first step for the detection of foreign body materials, choosing the appropriate radiological imaging is decisive for the detection or non-detection of the foreign material. Especially in cases of impaired wound healing over time, the existence of an undetected foreign object needs to be considered.Here, we would like to give a practical radiological guide for the assessment of foreign objects in...
Multiple Foreign Bodies in a 5-Year Old: Non-Accidental Trauma
Annals of African Surgery, 2020
Foreign bodies, a significant proportion of which are a result of non-accidental trauma, are common but under-reported. Pediatric foreign body injuries can be inconsequential, severe or even fatal, and cause long-lasting morbidity and the need for treatment and hospitalization. Evaluation of injury or death requires elements of detection, pattern recognition, interpretation and comparison, all based on clinical, radiological and forensic experience with normal and abnormal findings. We report an unusual and strange case of non-accidental trauma in a young child who presented to our surgical services with 44 sewing needles and wires in his body. The patient had specific characteristics or risks for abuse. His injuries were evaluated, recognized, documented and reported. He was treated for peritonitis and malnutrition and the foreign bodies removed using staged operations under image guidance. Patient’s recovery was uneventful. Keywords: Multiple foreign bodies, Trauma
Foreign bodies in a pediatric emergency department in South Africa
Pediatric Emergency Care, 2012
Objectives: Foreign bodyYrelated pediatric trauma has a high incidence, but studies with large data sets are rare and typically stem from Western settings. The aim of this study was to identify characteristics of foreign bodyYrelated trauma in children treated at our trauma unit in South Africa. Methods: In this retrospective study, we analyzed all foreign bodyrelated trauma admissions from 1991 to 2009. We collected detailed data including age, sex, type of foreign body, injury severity, and anatomical location of the foreign body. Results: We analysed 8149 cases. Marginally more boys (54.9%) than girls were involved. The overall median age was 3 years (interquartile range, 2-6 years); 78.8% were younger than 7 years. The predominant anatomical sites were the respiratory tract and the gastrointestinal tract (39.1%); ears (23.9%); nose (19.4%); and extremities (8.8%). The commonest objects were coins (20.8 %), (parts of) jewelry (9.5%), and food (8.7%). Three quarters (74.5%) of patients presented between 1 and 2 hours after the injury (median, 1 hour). A total of 164 cases (2.0%) were marked as possible child abuse; 17 cases were filed as confirmed child abuse. Conclusions: Preventive parent education programs targeting foreign bodyYrelated injury should mainly focus on both sexes younger than 7 years. Parents should be taught to keep small objects out of reach of young children, especially coins, because these most often result in a trauma unit visit.
Journal of Radiography and Radiation Sciences
Objectives: To assess the knowledge and practice of Non-accidental injuries (NAI) among radiographers practising within Maiduguri Metropolis. Methods: A cross-sectional study was conducted using a questionnaire to elicit information on knowledge and practice of imaging children with Non-accidental injuries. The information elicited from the questionnaire related to the following themes: Demographic characteristics, knowledge and practice of imaging children with NAI. Informed consent was sought from participants. Descriptive statistics (mean, frequencies) were used to analyze the data. Results: A total of 45 questionnaires were distributed to radiographers, and 36 (100%) were completed and returned. A total of 23 (63.9%) were males and 13 (36.1%) were females. The majority 34 (94.4%) of the respondents had good knowledge of NAI. Skeletal survey was the examination commonly requested in children with NAI as reported by 23 (63.9%) respondents, and the majority of the participants 31 (...
Introduction: Retained foreign bodies are the external objects lying within the body, which are placed with voluntary or involuntary intentions. The involuntarily or accidentally, and complicated cases with the retained foreign body may come to the emergency services, which may require rapid and adequate imaging assessment. Materials and methods: We share our experience with six different cases with retained foreign bodies, who visited emergency radiological services with acute presentation of symptoms. The choice of radiological investigation considered based on the clinical presentation of the subjects with a retained foreign body. Conclusion: Patients with the retained foreign body may present acute symptoms to the emergency medical or surgical services, radiologists play a central role in rapid imaging evaluation. Radiological investigation plays a crucial role in identification, localization, characterization, and reporting the complication of the retained foreign bodies, and in many scenarios, radiological investigations may expose the unsuspected or concealed foreign bodies in the human body. Ultimately radiological services are useful rapid assessment tools that aid in triage and guide in the medical or surgical management of patients with a retained foreign body. Keywords: Imaging of foreign body; Retained foreign body; Emergency radiology; Trichobezoar with intussusception; Scalpel in pleura; Handle shower in rectum; Gun shot injury; Air way foreign body Arch Clin Med Case Rep 2020; 4 (5): 952-968
Foreign body injuries in children: a review
Acta Otorhinolaryngologica Italica, 2015
SUMMARY The aim of this paper was to overview existing knowledge on foreign body (FB) injuries in children, with particular focus on FB types and anatomical locations, clinical presentation and complications. FB injuries represent a severe public health problem in childhood. The fact that the highest prevalence of FB injuries is reported for children between 0 and 3 years of age depends primarily on the fact that they explore objects using their mouth and are also not able to distinguish edible objects from non-edible ones. Types of FB causing injuries depend on the symptoms related to FB ingestion/inhalation/insertion (providing an early diagnosis of FB injuries) and complications related to the FB characteristics (type, shape, dimensions). The analysis of the Susy Safe database showed that in 10,564 cases, in which the object type was available, 74% of objects were inorganic and were mostly represented by pearls and balls, followed by coins. The main concerning about FB injuries i...
Musculoskeletal Regeneration
Common organic materials like thorns, wood and sand constitute routine accident scene flora and comprise a large percentage of foreign bodies. These low radiopaque foreign bodies present a diagnostic challenge and are routinely missed. In musculoskeletal injuries, failure to detect these foreign bodies may lead to infection, morbidity and patient dissatisfaction. A universal investigation protocol for foreign body detection is lacking. This study was initiated to compare the effectiveness of Digital radiography, CT, MRI and Hi-Frequency ultrasound for foreign body detection in In-vitro (goat thigh specimens) and to formulate a foreign body detection protocol which is universal and practical to use especially for setups in country like ours. Eight materials selected were wood, plastic, sand, metal (steel), glass, stone, teeth and fiber plastic. Foreign bodies placed into the muscle and bone-muscle interface. Digital radiography, Ultrasonography, CT and MRI imaging methods performed. Conventional radiography is established screening modality for radiopaque foreign bodies, which were visualized with all 4 modalities. USG is a useful tool for superficial and deep (within 3 cms) low radiopaque foreign bodies (Wood, sand, fiber plastic). CT provides accurate information regarding dimensions and orientation of deeper foreign bodies. MRI has high intra-observer variations, is an expensive tool which might not be available at all the centers and time. Radiography as a primary tool teamed up by Ultrasonography can detect almost all routine foreign bodies. CT/MRI may follow if intervention is planned or information regarding size, orientation and location is desired based on availability. Successful detection requires detailed patient's information and suspected nature of foreign body or accident site. Our protocol should guide to successful management of a patient with retained foreign body.
Foreign Body Accidents in a Pediatric Emergency Department
International Archives of Otorhinolaryngology
Introduction Foreign body accidents (FBAs) are frequent in children and can be severe, being a common cause of morbidity and mortality and a public health problem. As these accidents are multifactorial, their cause can only be determined by analyzing the clinical details and characteristics of the object. Knowing the associated mechanisms and factors is essential to determine a risk profile and have a preventive, therapeutic, and diagnostic purpose. Objective The present study aimed to describe the incidence of FBAs in otorhinolaryngology according to their anatomical location, focusing on the aerodigestive system. Methods This is a retrospective study performed by reviewing the medical records of 668 cases seen in the emergency department of a tertiary pediatric hospital in São Paulo, state of São Paulo, Brazil, between 2014 and 2017. Results Foreign bodies (FBs) were found in the digestive system (238/668), in the nasal cavities (206/668), in the ears (182/668), in the oropharynx ...