June 4, 2015 Ramanuj Sinha, MS; Utpal Jana, MS; Soumya Ghatak, MS; Gautam Biswas, MS; Jayanta Saha, MS; Indranil Sen, MS
Ingested foreign bodies that migrate extraluminally are rare. In such cases, exploration of the neck via an external approach is the recommended procedure to remove the object. However, locating such a foreign body can be a difficult task. We report what we believe is the first adult case of fluoroscopically guided localization of an accidentally ingested foreign body that had migrated into the soft tissues of the neck. We also review the other methods used to locate a migrating foreign body.
Foreign-body ingestion is a common cause of esophageal perforation, which can lead to a fatal posterior mediastinal abscess. Routine treatments include the drainage of pus through the esophageal perforation, thoracotomy, and videothoracoscopic drainage. We present 2 cases of posterior mediastinal abscess caused by esophageal perforation. Both patients-a 44-year-old woman and an 80-year-old man-were successfully treated with a novel, minimally invasive approach that involved draining pus through the retropharyngeal space; drainage was supplemented by the administration of broad-spectrum antibiotics and nasal feeding.
January 19, 2015 Parth Shah, MD; Angela Han, BA; Rishin Patel, MD; Paul Howlett, MD; Scott Akers, MD; Mitchell Margolis, MD; Sunil Singhal, MD
A 58-year-old man with a remote history of choking on a chicken bone 5 years earlier presented with chronic cough but had no remarkable clinical examination findings. He was being followed for recurrent pneumonias complicated by a resistant empyema, for which he had undergone thoracotomy and decortication. Imaging studies initially missed a foreign body (the chicken bone), which was found on follow-up studies and was removed with a flexible bronchoscope despite the fact that 5 years had passed since the aspiration.
September 17, 2014 Yu-Hsuan Lin, MD; Ming-Yee Lin, MD, PhD
Physicians should not rush indiscriminately into action without a careful otoscopic examination and a detailed history, to discern whether a patient has abnormal anatomy and is at risk for complications.
May 7, 2014 Parker A. Velargo, MD; Jennifer D. McLevy, MD
While cases of large, completely obstructing foreign bodies in the subglottis would lead to sudden respiratory distress, the initial presentation of smaller foreign bodies in the subglottis can be quite similar to croup, presenting with biphasic stridor, cough, and/or the steeple sign.