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2.
Rev. cuba. pediatr ; 93(3): e1510, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1347545

ABSTRACT

La ingestión de un cuerpo extraño es un tipo de lesión no intencionada muy frecuente en la infancia, particularmente en lactantes mayores de 6 meses y preescolares. El propósito deseado con la publicación de esta guía es contar con herramientas actualizadas en el diagnóstico y tratamiento de esta afección que permitan sistematizar la conducta y mejorar la calidad de la asistencia médica. Dentro de los cuerpos extraños más frecuentes tenemos: monedas, imanes, baterías, juguetes pequeños, plásticos, joyas, botones, huesos e impactaciones alimentarias en los niños mayores. La sintomatología varía según la naturaleza del cuerpo extraño, el lugar donde se impacte, que casi siempre es en las estrecheces anatómicas o adquiridas del tubo digestivo o por la presencia de complicaciones. Para confirmar el diagnóstico son necesarios diferentes estudios imagenológicos y endoscópicos, estos últimos con un valor terapéutico. El tratamiento depende de factores como la edad, el tiempo de ingerido, la localización, la presencia de complicaciones, la naturaleza del cuerpo extraño, su número y el potencial lacerante, tóxico o corrosivo. En la mayoría de los casos los cuerpos extraños son expulsados de forma espontánea y tienen un pronóstico favorable, pero queda un grupo de pacientes donde es necesario un tratamiento quirúrgico. Después de realizar una búsqueda de revisiones sistemáticas de calidad y tomando en cuenta la experiencia del Servicio de Cirugía Pediátrica de Matanzas en el tratamiento de estos pacientes se elaboró esta guía que fue discutida y aprobada en el IV Simposio Nacional de Cirugía Pediátrica. La publicación de esta guía permitiría a los servicios de Cirugía Pediátrica emplearla como referencia y aplicarla en sus propias instituciones con el consecuente beneficio para los pacientes(AU)


Ingestion of a foreign body is a very common type of unintentional injury in childhood, particularly in infants older than 6 months and preschoolers. The desired purpose with the publication of this guideline is to have up-to-date tools in the diagnosis and treatment of this condition that allow to systematize the behavior and improve the quality of medical care. Within the most frequent foreign bodies we have: coins, magnets, batteries, small toys, plastics, jewelry, buttons, bones and food impactations in older children. Symptomatology varies depending on the nature of the foreign body, the place where it impacted, which is almost always in anatomical or acquired narrowness of the digestive tract, or by the presence of complications. To confirm the diagnosis, different imaging and endoscopic studies are necessary, the latter with a therapeutic value. Treatment depends on factors such as age, ingestion time, location, presence of complications, the nature of the foreign body, the amount and the lacerating, toxic or corrosive potential. In most cases foreign bodies are expelled spontaneously and have a favorable prognosis, but there is a group of patients left for whom surgical treatment is necessary. After conducting a search for quality systematic reviews and taking into account the experience of Matanzas province's Pediatric Surgery Service in the treatment of these patients, this guideline was created and it was discussed and approved at the IV National Symposium of Pediatric Surgery. The publication of this guideline would allow Pediatric Surgery services to use it as a reference and apply it in their own institutions with the consequent benefit for patients(AU)


Subject(s)
Humans , Infant , Child, Preschool , Diagnostic Imaging/methods , Practice Guideline , Gastrointestinal Tract/injuries , Foreign Bodies/therapy , Medical Care
3.
Medisur ; 19(3): 524-529, 2021. graf
Article in Spanish | LILACS | ID: biblio-1287334

ABSTRACT

RESUMEN: La ingestión intencional de cuerpos extraños es frecuente entre prisioneros. Es un fenómeno asociado a un aumento de la morbimortalidad y los costos. Generalmente no requiere de intervención específica, aunque pueden aparecer complicaciones severas, que requieren, en ocasiones, tratamiento quirúrgico urgente. Se presenta un paciente masculino, de 24 años de edad, sin antecedentes relevantes, recluido en la prisión de máxima seguridad de la provincia Camagüey. Se introdujo por la boca un alambre de 40 cm de longitud, con un gancho en su punta. Presentó sialorrea y molestias retroesternales. Al examen físico se encontró normalidad de sus parámetros vitales, sin alteraciones en el examen del tórax, con abdomen doloroso a la palpación profunda del cuadrante inferior derecho. Se realizaron radiografías simples de tórax posteroanterior, lateral, y de abdomen simple, se encontraron un cuerpo extraño desde la boca hasta el tercio inferior del esófago torácico y otro cuerpo extraño ubicado en la pelvis, que refirió haber ingerido intencionalmente hace un año. Se realizó laparotomía urgente y extracción de ambos cuerpos extraños. El paciente evolucionó satisfactoriamente sin desarrollar complicaciones. La ingestión intencional de cuerpos extraños en la población penal es un problema de salud complejo. La prevención es uno de los pilares fundamentales de su tratamiento. Es importante un alto índice de sospecha sobre la ingestión de múltiples objetos, en este grupo de pacientes la cirugía es frecuentemente requerida.


ABSTRACT The conscious ingestion of foreign bodies is frequent among prisoners. It is a phenomenon associated with an increase in morbidity - mortality and costs. Generally, it does not require specific intervention, although severe complications may appear, which sometimes require urgent surgical treatment.to present the case of a prisoner with recurrent intentional ingestion of multiple foreign bodies, one of them not previously diagnosed. Case presentation: A 24-years-old male patient, with no relevant history, held in the Camagüey province maximum security prison. The wire was introduced through the mouth 40 cm long, with a hook at its tip. Referring to hypersalivation and retrosternal discomfort. The physical examination found normality of his vital parameters, without alterations in the chest examination, with a painful abdomen on deep palpation of the right lower quadrant. A posteroanterior and lateral chest X-ray was performed, finding a foreign body from the mouth to the lower third of the thoracic esophagus, an abdominal X-ray where another foreign body was located in the pelvis, which he reported having intentionally ingested a year ago. An urgent laparotomy was performed and both foreign bodies were removed. The patient evolves satisfactorily without developing complications. The intentional ingestion of foreign bodies in the prison population is a complex health problem. Prevention is one of the fundamental pillars of its treatment. A high index of suspicion on the ingestion of multiple objects is important; in this group of patients surgery is frequently required.


Subject(s)
Humans , Male , Adult , Prisoners/psychology , X-Rays , Costs and Cost Analysis , Foreign Bodies/complications , Physical Examination , Indicators of Morbidity and Mortality , Foreign Bodies/therapy
4.
Rev. cir. (Impr.) ; 71(6): 518-522, dic. 2019. tab, graf, ilus
Article in Spanish | LILACS | ID: biblio-1058312

ABSTRACT

Resumen Introducción: El cuerpo extraño rectal (CER) es un problema de difícil manejo para el cirujano general. La vía anal es la puerta de entrada más habitual seguido de la oral. La sospecha clínica es fundamental para el diagnóstico, pudiendo apoyarse de imágenes. El tratamiento es su extracción por vía transanal o por vía anterior. Objetivos: Caracterizar, describir y presentar el tratamiento de los pacientes con CER que consultaron en urgencia del Hospital el Pino (HEP) entre los años 2011 y 2016. Material y Método: Estudio serie de casos. Se realiza revisión de fichas clínicas de pacientes con CER en un periodo de 5 años en el Servicio de Urgencia del HEP. Se identificó a los pacientes tratados en box y a aquellos tratados en pabellón. Se caracterizó según variables demográficas, tratamiento, complicaciones y días de hospitalización. Resultados: Se identificaron 18 pacientes, 13 hombres y 5 mujeres de 45 años (± 36-51) y 34 años (± 23-64) respectivamente. En 1 de ellos fue posible extracción manual transanal en box sin anestesia y en 17 se requirió tratamiento en pabellón, donde 12 fue por vía transanal y 5 por abordaje abdominal. En ningún caso se identificó lesión intestinal. Evolución postoperatoria adecuada. Días de hospitalización promedio 1,8 días. Conclusión: Este es un problema infrecuente y de difícil manejo. Existe mayor frecuencia en hombres de edades media siendo la puerta de entrada la vía anal en todos los casos. En la mayoría se requirió extracción en pabellón bajo anestesia siendo el abordaje transanal el más utilizado y con buenos resultados.


Introduction: The rectal forcing body (RFB) is a problem which involves a difficult management for surgeons. Anal via is the most frequent entrance area, followed by the oral via. Clinical suspicion is fundamental for diagnosis and it is possible to support it using imaging. Treatment considers extraction through transanal or frontal via. Aim: To describe and present the treatment of patients with rectal foreing body in the Urgency Service of El Pino Hospital during years 2011 to 2016. Materials and Method: Case studies. Clinical records revision of patients with rectal foreing body in the Urgency Service of El Pino Hospital considering a 5-year period. Patients are identified as those treated in the box and in a surgical pavilion. Patients were classified according to demographic variables, received treatment, associated complications and hospitalization time. Results: 18 patients are identified, 13 men and 5 women, 45 (± 36-51) and 34 (± 23-64) years respectively. It was possible to manually extract via trans-anal at box, in one of these cases; 17 of them required treatment at surgical pavilion, where 12 were via trans-anal and 5 via abdominal. None of these cases had intestinal injury. Post-surgery evolution was adequate. Average hospitalization was 1.8 days. Conclusion: RFB is a non-frequent problem which requires high diagnose suspicious to be able to carry out proper treatments. It is more frequent in middle age men, with transanal input. In most cases, the extraction was done in surgical pavilion and required anesthesia and were done via trans anal with good results.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Rectum/injuries , Rectum/diagnostic imaging , Foreign Bodies/complications , Foreign Bodies/therapy , Foreign Bodies/diagnostic imaging , Chile , Device Removal , Lacerations/etiology , Mental Disorders/complications
5.
Int. braz. j. urol ; 45(2): 384-391, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002212

ABSTRACT

ABSTRACT Purpose: To study the effect of penile constriction devices used on a large series of patients who presented at our emergency facility. We explored treatment options to prevent a wide range of vascular and mechanical injuries occurring due to penile entrapment. Materials and Methods: Between January 2001 and March 2016, 26 patients with penile entrapment were admitted to our facility and prospectively evaluated. Results: The time that elapsed from penile constrictor application to hospital admission varied from 10 hours to 6 weeks (mean: 22.8 hours). Non-metallic devices were used by 18 patients (66.6%) while the other nine (33.4%) had used metallic objects. Acute urinary retention was present in six (23%) patients, of whom four (66.6%) underwent percutaneous surgical cystotomy and two (33.4%) underwent simple bladder catheterization. The main reason for penile constrictor placement was erectile dysfunction, accounting for 15 (55.5%) cases. Autoerotic intention, psychiatric disorders, and sexual violence were responsible in five (18.5%), five (18.5%), and two (7.4%) cases, respectively. The mean hospital stay was 18 hours (range, 6 hours to 3 weeks). Conclusion: Penile strangulation treatment must be immediate through the extraction of the foreign body, avoiding vascular impairments that can lead to serious complications. Most patients present with low-grade injuries and use penile constrictors due to erectile dysfunction. Removal of constrictor device can be challenging. The use of specific tools for achieving penile release from constrictors is a fast, safe and effective method. Patients with urinary retention may require urinary diversion.


Subject(s)
Humans , Male , Adolescent , Adult , Aged , Young Adult , Penile Diseases/etiology , Penis/injuries , Self-Injurious Behavior/therapy , Foreign Bodies/therapy , Penile Diseases/pathology , Penis/surgery , Penis/pathology , Sexual Behavior , Self-Injurious Behavior/surgery , Self-Injurious Behavior/complications , Constriction, Pathologic , Foreign Bodies/complications , Amputation , Middle Aged
6.
Int. arch. otorhinolaryngol. (Impr.) ; 23(1): 110-115, Jan.-Mar. 2019. graf
Article in English | LILACS | ID: biblio-1002174

ABSTRACT

Abstract Introduction Fish bone foreign body (FFB) impaction in the upper aerodigestive tract is a common cause for emergency department referral. Its management varies in both diagnosis and treatment paradigms. Fish bone foreign bodies are more commonly found in the oropharynx in cases of patients < 40 years old, and in the esophagus in cases of patients > 40 years old. Symptoms are typically non-indicative for the location of the FFB, with the exception of foreign body sensation at/superior to the cervical esophagus. A lack of findings during the physical examination is routinely followed by imaging, with computed tomography (CT) being the preferred modality. In practice, many patients undergo unnecessary imaging studies, including CT scans. Objectives To identify patients with suspected fish bone impaction who do not require CT imaging and can be safely discharged. Data Synthesis We have searched the PubMed database for the following medical subject headings (MeSH) terms: fish bone, fish foreign body AND oropharynx, hypopharynx, esophagus, flexible esophagoscopy, and rigid esophagoscopy. Our search in the English language yielded 32 papers. Case reports were included, since they highlighted rare and serious complications. Conclusion In patients > 40 years old suspected of fish bone impaction, noncontrast CT is recommended and should be urgently performed, even in the presence of ambiguous symptoms. However, in patients < 40 years old presenting within 24 hours from ingestion, imaging has little diagnostic value due to the low probability of esophageal fish bones. For this specific subgroup, in the absence of clinical findings, discharge without imaging studies may be considered safe. (AU)


Subject(s)
Humans , Child, Preschool , Adult , Middle Aged , Bone and Bones/diagnostic imaging , Pharyngeal Diseases/diagnostic imaging , Esophageal Diseases/diagnostic imaging , Fishes , Foreign Bodies/diagnostic imaging , Tomography, X-Ray Computed , Prevalence , Esophagoscopy/methods , Foreign Bodies/complications , Foreign Bodies/physiopathology , Foreign Bodies/therapy , Foreign Bodies/epidemiology
9.
Arch. argent. pediatr ; 116(4): 256-261, ago. 2018. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-950040

ABSTRACT

Introducción: La ingestión de un cuerpo extraño (CE) es un accidente frecuente en el hogar en la edad pediátrica; su manejo oportuno por especialistas puede evitar complicaciones a corto y largo plazo. Objetivo: Describir características y complicaciones de los CE en el tubo digestivo en población pediátrica. Material y métodos: Estudio transversal, retrospectivo y prospectivo. Se incluyeron pacientes con diagnóstico de ingestión de un CE desde enero de 1971 a diciembre de 2016. Se recabaron características generales de los pacientes, tipo de objeto, métodos de extracción y complicaciones. Se realizó análisis descriptivo. Resultados: Durante 45 años, se extrajeron 2637 CE localizados en faringe (n= 118), esófago (n= 2410), estómago (n= 103) e intestino (n= 6). Predominaron en el sexo masculino (50,9%); 74% fueron en menores de 5 años. El 57% llegó en las primeras 24 horas; sialorrea, disfagia y vómito fueron los principales síntomas y un 16% estaba asintomático. La radiografía permitió localizar el CE en el 93%; el más ingerido fue la moneda (78%); la localización más común fue el tercio superior del esófago (79%); el 86% se extrajo con endoscopio rígido y las complicaciones se presentaron en el 7,8% de los casos. Conclusiones: La ingestión de un CE predomina en menores de 5 años, y los metales son los más frecuentes. La radiografía simple es el estudio de elección, que permite realizar el diagnóstico y la extracción es por vía endoscópica con endoscopio rígido o flexible según la experiencia del endoscopista.


Introduction: Foreign body (FB) ingestion is a common home accident during childhood; a timely management by the specialists may help prevent complications in the short and long term. Objective: To describe the characteristics and complications of FB ingestion located in the gastrointestinal tract in the pediatric population. Material and methods: Two phases, retrospective, and prospective study. Patients diagnosed with FB ingestion between January 1971 and December 2016 were included. The general characteristics of patients, FB type, removal method, and complications were registered. A descriptive analysis was performed. Results: Over 45 years, 2637 FBs were removed from the pharynx (n= 118), the esophagus (n= 2410), the stomach (n= 103), and the intestines (n= 6). Male patients predominated (50.9%); 74% were younger than 5 years. Besides, 57% arrived within the first 24 hours; ptyalism, dysphagia, and vomiting were the main symptoms; 16% of patients had no symptoms. It was possible to locate the FB using an X-ray in 93% of cases; the most common FBs were coins (78%); the most frequent location was the upper third of the esophagus (79%); 86% of FBs were removed using a rigid endoscope, and complications were observed in 7.8% of patients. Conclusions: FB ingestion predominated among children younger than 5 years; metal objects were the most common ones. A plain X-ray is the test of choice for diagnosis; removal is usually done with a rigid or flexible endoscope, depending on the endoscopist's experience.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Bronchoscopy , Esophagoscopy , Foreign Bodies/diagnosis , Turkey/epidemiology , Child, Hospitalized , Retrospective Studies , Statistics, Nonparametric , Foreign Bodies/therapy , Foreign Bodies/epidemiology
10.
Neumol. pediátr. (En línea) ; 13(1): 21-23, ene. 2018. ilus
Article in Spanish | LILACS | ID: biblio-999232

ABSTRACT

Foreign body aspiration in children is a frequent cause of consultation in the pediatric emergency department and can be a life-threatening event. It occurs mainly during the first 4 years of life and is more frequent in males. It is possible to find the clinical triad of cough, localized wheezing and decrease of respiratory noises in 50 percent of cases. The diagnosis is based on an adequate clinical history to detect an asphyxiation event. Chest radiography is an important diagnostic tool although it is possible to find normal results in 12 to 25 percent of cases. Several studies have reported the usefulness of flexible bronchoscopy in extracting foreign bodies; however, rigid bronchoscopy remains the best choice for foreign body aspiration


La aspiración de cuerpo extraño en niños es una causa frecuente de consulta en el departamento de urgencias pediátricas y puede ser un evento potencialmente mortal. Se presenta principalmente durante los primeros 4 años de vida y es mas frecuente en el género masculino. Clínicamente es posible encontrar en un 50 por ciento de los casos la triada clínica de tos, sibilancias localizadas y disminución de ruidos respiratorios. El diagnóstico se basa en una historia clínica adecuada en la cual se busca intencionadamente el antecedente de un evento de asfixia. La radiografía de tórax es una herramienta importante para el diagnóstico aunque es posible encontrarla normal del 12 al 25 por ciento de los casos. Diversos estudios reportan la utilidad de la broncoscopia flexible en la extracción de cuerpos extraños, sin embargo la broncoscopia rígida continua siendo el estándar de oro para el manejo de la aspiración de cuerpo extraño


Subject(s)
Humans , Child , Bronchoscopy , Respiratory Aspiration/diagnosis , Respiratory Aspiration/therapy , Foreign Bodies/diagnosis , Foreign Bodies/therapy
12.
Health sci. dis ; 19(2): 61-64, 2018. ilus
Article in French | AIM, AIM | ID: biblio-1262797

ABSTRACT

Introduction. La survenue d'un corps étranger (CE) est un motif fréquent de consultation en ORL. Le but de notre étude était d'analyser les données épidémiologiques, cliniques et thérapeutiques des sujets porteurs de corps étrangers à l'Hôpital National Ignace Deen (CHU de Conakry). Matériels et méthodes. Il s'agit d'une étude prospective de type descriptif, étalée de Janvier ­à décembre 2015 (un an), portant sur tous les cas de corps étrangers des conduits auditifs externes et des voies aérodigestives supérieures colligés au service d'ORL de l'Hôpital National Ignace Deen. Nos variables d'intérêt étaient les données épidémiologiques, cliniques et thérapeutiques Résultats. Durant la période d'étude, 192 cas de CE ont été colligés parmi les 2177 consultations, soit une fréquence de 8,82%. L'âge des patients variait de 2 à 60 ans avec une prédominance des enfants de moins de 10 ans (42,71%). Le sex-ratio homme/femme était de deux. Le délai moyen d'admission était de 48h avec des extrêmes de 0 à 30 jours. Les circonstances de survenue des CE étaient représentées par les jeux dans 54,17 % des cas. Le conduit auditif externe était la localisation la plus fréquente (64,58%). La nature des CE était inorganique dans 76,56 % des cas et organique dans 23,44 % des cas. Tous les CE ont été extraits par la voie d'introduction, le plus souvent au fauteuil de consultation (90,10 % des cas). L'évolution a été favorable chez tous les patients. Conclusion. Les corps étrangers ORL constituent un motif fréquent de consultation et affectent surtout les enfants de sexe masculin.ils sont habituellement inorganiques et affectent surtout le conduit auditif externe. L'évolution est en règle favorable après extraction


Subject(s)
Ear Canal , Foreign Bodies/diagnosis , Foreign Bodies/epidemiology , Foreign Bodies/therapy , Guinea , Otolaryngology
13.
Article in French | AIM, AIM | ID: biblio-1264029

ABSTRACT

Introduction : La perforation pharyngo-œsophagienne par ingestion de corps étranger (CE) est une complication rare et grave. De ce fait, sa prise en charge n'est pas standardisée. Le but de ce travail est d'étudier les caractéristiques épidémiologiques et diagnostiques de ces complications et de discuter les modalités thérapeutiques. Patients et méthodes :Sur une période 17 ans (1998 - 2014), nous avons colligé 573 patients ayant ingéré des CE pharyngo-œsophagiens et qui ont bénéficié d'une extraction endoscopique au tube rigide. Onze patients (1,9%) se sont compliqués d'une perforation. Résultats : Il s'agissait de 3 enfants et 8 adultes. Les corps étrangers étaient dominés par les fragments d'os (55% des cas). Les perforations étaient jugées liées aux manœuvres d'extraction dans 54,5% et au CE dans 45,5%. Le diagnostic a été posé dans un délai maximal de 2 jours après extraction. La chirurgie a été réalisée d'emblée dans 2 cas devant la migration extra-viscérale du CE et devant la présence d'une abcédation péri-œsophagienne, respectivement. Le geste opératoire consistait, respectivement, en l'ablation du CE avec suture de l'œsophage et un simple drainage de l'abcès. Dans un autre cas, la chirurgie a été pratiquée en seconde intention après échec du traitement médical et devant l'apparition d'une pleurésie purulente. Le geste opératoire était une suture renforcée par un lambeau intercostal. Un traitement conservateur était instauré dans 8 cas (72,7%).L'évolution était favorable dans 10 cas (soit 90,9%) et fatale dans un seul cas, soit une mortalité de 9,1%. Conclusion : Le pronostic dépend essentiellement de la précocité diagnostique des perforations œsophagiennes par CE. Le traitement conservateur serait suffisant et efficace en dehors d'un syndrome infectieux sévère


Subject(s)
Esophageal Perforation , Foreign Bodies/complications , Foreign Bodies/epidemiology , Foreign Bodies/therapy , Hypopharynx
14.
Neumol. pediátr. (En línea) ; 10(3): 106-110, jul. 2015. tab, ilus
Article in Spanish | LILACS | ID: lil-774010

ABSTRACT

It is a frequent pediatric event and a common cause of morbidity and mortality in children, requiring accurate diagnosis and proper treatment. Diagnosis is usually based on clinical manifestations such as cough, dyspnea. stridor, respiratory distress and asymmetric decreased air entry or unilateral wheeze. Choking crisis may be absent or minimized. Chest X-ray may have no abnormalities or show signs such as asymmetrical hyperinflation, massive, fixed or changing atelectasis. Occasionally, hyperinflation or obstructive emphysema with atelectasis can be present in the same hemithorax. Inspiratory and expiratory chest X-rays show ipsilateral mediastinum movements. Most foreign bodies are not visible to chest X-ray exploration. Acute suffocation must be treated with Heimlich procedure. In later stages, diagnosis and treatment require rigid bronchoscopy. Prognosis is fairly positive with an early and complete foreign-body extraction.


La aspiración de un cuerpo extraño (CE) a la vía aérea en pediatría es un accidente frecuente, presenta importante morbimortalidad, por lo que requiere un diagnóstico y tratamiento oportuno. El diagnóstico usualmente se establece mediante hallazgos clínicos, siendo los más frecuentes tos, síndrome de penetración, y con menor frecuencia dificultad respiratoria, estridor, sibilancias unilaterales. La radiografía de tórax puede ser normal o alterada, mostrando hiperinsuflación unilateral, atelectasia u otros signos. La mayoría de los CE son radiotransparentes. Durante la fase aguda debe practicarse la maniobra de Heimlich, en cambio en la fase crónica el diagnóstico y tratamiento definitivo se hace mediante broncoscopía. La prevención es fundamental evitando que niños menores manipulen objetos pequeños, advertir el riesgo de asfixia por aspiración en los envases de alimentos riesgosos y de juguetes de pequeño tamaño. El pronóstico es bueno si la extracción del cuerpo extraño es precoz y completa.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Foreign Bodies/diagnosis , Foreign Bodies/therapy , Respiratory Aspiration/etiology , Foreign Bodies/etiology , Heimlich Maneuver , Airway Obstruction/etiology , Prognosis , Risk Factors
15.
Article in English | IMSEAR | ID: sea-159431

ABSTRACT

The fracture of endodontic instruments is a common procedural error created during a root canal therapy. Starting from the hand files and up to the use of rotary systems, the root canal therapy is sometimes associated with the fracture of the instruments inside the root canal. The purpose of this work was to report a clinical case of removal of a fractured endodontic instrument in the root canal of a maxillary premolar, when part of this fragment extended through the apical foramen. In this case, a simple and a feasible chairside technique was used for the retrieval of the separated file tip.


Subject(s)
Adult , Dental Instruments/adverse effects , Dental Instruments/instrumentation , Endodontics/adverse effects , Endodontics/instrumentation , Equipment Failure , Female , Foreign Bodies/therapy , Humans , Root Canal Therapy/adverse effects , Root Canal Therapy/instrumentation , Rotation , Ultrasonics/instrumentation
16.
Braz. dent. j ; 26(1): 79-85, Jan-Feb/2015. graf
Article in English | LILACS | ID: lil-735842

ABSTRACT

This paper describes two cases of instrument fragment removal from the apical thirds of root canals using a customized extractor and a modified needle technique, respectively. In case 1, a customized extractor was manufactured to remove a bur fragment located in the apical root canal of a maxillary central incisor. The use of this extractor enabled successful and conservative removal of the instrument fragment. In case 2, a modified injection needle was used as a trepan to gain access around an instrument fragment located in the curved apical portion of the mesiobuccal canal of a mandibular molar. A segment of steel wire was inserted into the needle lumen to engage the metallic fragment, enabling its removal with counter-clockwise rotation and a simultaneous pull-out motion. Alternative and creative methods are useful for the management of intracanal metallic fragments during root canal treatment.


Este relato descreve dois casos de remoção de fragmentos de instrumentos de terços apicais de canais radiculares utilizando um extrator personalizado e técnica da agulha modificada, respectivamente. No Caso 1, um extrator foi fabricado para remover fragmento de broca localizado no terço apical do canal radicular de um incisivo central superior. O uso deste extrator permitiu a remoção bem sucedida e conservadora do fragmento de instrumento. No Caso 2, uma agulha para anestesia modificada foi utilizada como um trépano para ganhar acesso ao redor de um fragmento de instrumento localizado na porção apical curva do canal mésio-vestibular de um molar inferior. Um segmento de fio de aço foi inserido no lúmen da agulha para envolver o fragmento metálico, permitindo sua remoção com rotação no sentido anti-horário e simultâneo movimento de retração. Métodos alternativos e criativos são úteis para a remoção intracanal de fragmentos metálicos durante o tratamento endodôntico.


Subject(s)
Humans , Female , Child , Middle Aged , Foreign Bodies/therapy , Root Canal Therapy/instrumentation , Brazil , Dental Instruments , Equipment Design , Equipment Failure , Incisor , Molar , Needles
17.
J. of med. and surg. res ; 1(4): 114-117, 2015.
Article in English | AIM, AIM | ID: biblio-1263676

ABSTRACT

Introduction: A missed or neglected foreign body (NFB) is not infrequent in surgical practice. It constitutes a common reason for consultation later; location and removal of foreign bodies can be difficult because of possible inflammation; induration; granulated tissue and fibrous scar. This paper describes a simple method for the quick localization and surgical removal of NFB using two 25 gauge needles. Materials and Methods: In this paper we report the experience of department of plastic and reconstructive surgery in Ibn Sina Teaching Hospital in Rabat; conducted on ten patients in terms of the use of two 25-gauge needles was used in 12 NFB in soft tissue in order to achieve proper localization and fixation of foreign bodies during surgery.Results: Results were satisfactory in most of our Patients; surgical removal was successful in 11 of 12 NFB.Conclusion: Needle guided technique allows the successful surgical removal of NFB using minimal soft tissue exploration and dissection via proper localization; fixation; and propulsion of the foreign body toward the surface of the skin


Subject(s)
Foreign Bodies/surgery , Foreign Bodies/therapy , Needles
18.
Rev. chil. pediatr ; 85(6): 682-689, dic. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-734809

ABSTRACT

Gastrointestinal foreign bodies (FB) are frequent complaints in the emergency departments, with esophageal foreign bodies as the most frequent cases. Symptoms are varied and depend on the location of the FB, with several techniques available for removal. Objective: To describe the FB removed by endoscopy in children as well as the consulting population characteristics. Patients and Method: Patient chart reviews of those who, during the last six years, underwent gastrointestinal endoscopy were performed. Descriptive statistics were used to analyze the data. Results: 51 patients, 28 males and 23 females, with average age of four years old, underwent endoscopy due to FB intake. The most common symptoms were drooling (45%) and dysphagia (35%); the FBs were extracted mostly under general anesthesia. Coins were the most common foreign bodies found (57%) and they were mainly located in the esophagus (91%). All bodies were extracted by direct endoscopy or endoscopically assisted extraction; lesions that corresponded to erosions were found in 19 (37%) patients and ulcers in 4 (8%). There were no complications. Conclusions: Endoscopic removal of gastrointestinal FBs is a safe procedure. Given the risk of serious injury, especially in foreign bodies in the esophagus, performing endoscopy within a reasonable time must always be considered. Management protocols are necessary to unify the standards of those working in emergency rooms, having in mind that the most important strategy is prevention.


Los cuerpos extraños (CE) gastrointestinales son motivo de consulta frecuente en los servicios de urgencia, siendo los esofágicos los de mayor riesgo Los síntomas de presentación son variados y dependen de la ubicación del CE, existiendo diversas técnicas para su extracción. Objetivo: Describir las características de la población consultante y de los CE retirados por endoscopia en niños. Pacientes y Método: Se realizó una revisión de los últimos 6 años, de las fichas de los pacientes a los que se le indicó una endoscopía digestiva por CE gastrointestinal. Se utilizó estadística descriptiva para el análisis de los datos. Resultados: 51 pacientes, 28 hombres y 23 mujeres, con un promedio de edad de 4 años, fueron sometidos a endoscopía digestiva por ingesta de CE. Los síntomas de presentación más frecuentes fueron la sialorrea (45%) y la disfagia (35%), siendo extraídos los CE en su mayoría con anestesia general. Los CE más frecuentemente fueron monedas (57%) y se ubicaron principalmente en esófago (91%). Todos se extrajeron mediante endoscopía directa o con asistencia endoscópica y las lesiones encontradas fueron erosiones en 19 (37%) pacientes y úlceras en 4 (8%). No hubo complicaciones. Conclusiones: La extracción endoscópica de CE gastrointestinales es un procedimiento seguro. Dado el riesgo de lesiones graves, especialmente en los CE de ubicación esofágica, debe considerarse siempre la realización de la endoscopía dentro de un plazo prudente. Los protocolos de manejo son necesarios para unificar los criterios de las personas que trabajan en los servicios de urgencia teniendo presente que la estrategia más importante es la prevención.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Deglutition Disorders/etiology , Endoscopy, Gastrointestinal/methods , Foreign Bodies/therapy , Sialorrhea/etiology , Emergency Service, Hospital , Esophagus , Foreign Bodies/diagnosis , Gastrointestinal Tract , Numismatics
19.
Int. j. odontostomatol. (Print) ; 7(3): 475-481, Dec. 2013. ilus
Article in English | LILACS | ID: lil-696581

ABSTRACT

The purpose of this study was to investigate whether the Electrochemical Dissolution (DE) facilitates the retrieval of fractured files, from Endo-Training block with an artificial root canal, by using ultrasonic techniques (US). Twenty Endo-Training block with an artificial single canal with working length 16 mm and twenty nickel-titanium (NiTi) Protaper Universal rotary files were used. 10 Shaping S1 files and 10 Shaping S2 files, were sectioned transversally within the conduit, to 5mm of the apical tip. Twenty samples were divided into four groups: Group1 and 3 received the action of DE and US, and groups 2 and 4 received the action of US. To remove the fragments we used Staging Platform and Dental Microscope. Outcome was analyzed statistically by Student t test. Statistical Analysis showed a significant difference in retrieval time of the fragments and weight loss mass of Endo training block ultrasonic tips were used, between groups that applied Ultrasonic with electrochemical dissolution and the group using only ultrasonic. It can be concluded that there was weight loss mass of separated fragment by electrochemical action, however, it was not sufficient and its use alone was inconclusive to retrieve the fragments. The procedure needs to be complemented with the use of the staging platform, ultrasonic tips and Dental Microscope.


Este estudio tiene como propósito determinar si la Disolución Electroquímica (DE) favorece el retiro de fragmentos de limas fracturadas, insertos en bloc endodónticos de entrenamiento de resina, con un conducto radicular simulado, mediante el uso de ultrasonido (US). Se utilizaron 20 bloc y 20 limas rotatorias usadas ProTaper Universal de NiTi Shaping Files, 10 S1, 10 S2, que fueron fracturadas dentro del conducto, a 5 mm desde la punta apical y divididos en Grupo1 y 3 que recibieron la acción de la DE y US; y Grupo 2 y 4 sólo utilizó US. Para retirar los fragmentos se utilizó Plataforma de Trabajo y Microscopio Dental. Los datos fueron analizados con la prueba T de Student. Los resultados indican que existen diferencias estadísticamente significativas en el tiempo de retiro de los fragmentos y en la pérdida de masa del bloc de entrenamiento por el uso del ultrasonido, en los grupos que se aplicó Disolución Electroquímica más Ultrasonido. Se puede concluir que la acción electroquímica permite que exista pérdida de masa del fragmento fracturado, sin embargo, no es suficiente y su sola utilización no es concluyente para retirar los fragmentos, es necesario complementar el procedimiento con la utilización de la Plataforma de Trabajo, puntas de ultrasonido y el Microscopio Dental.


Subject(s)
Humans , Dental Alloys/chemistry , Foreign Bodies/therapy , Root Canal Preparation/methods , Device Removal/methods , Electrochemical Techniques/instrumentation , Electrolysis/methods , Microscopy , Nickel , Solubility , Titanium , Ultrasonics
20.
Rev. chil. pediatr ; 84(5): 505-512, oct. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-698671

ABSTRACT

Introducción: La ingestión de cuerpo extraño (CE) es frecuente en la infancia, requiriendo en el 10-20 por ciento de los casos extracción endoscópica. El objetivo de este trabajo fue analizar las características demográficas, clínicas y endoscópicas de los pacientes con ingesta de CE que requieren manejo endoscópico. Pacientes y Método: Estudio de cohorte prospectivo. Se incluyen los pacientes derivados al servicio de urgencia de Clínica Alemana de Santiago para extracción de cuerpo extraño entre noviembre de 2007-noviembre de 2011. Se registran variables demográficas, clínicas y endoscópicas, clasificando la sintomatología en respiratoria, digestiva y otros. Se evaluaron factores de riesgo y complicaciones. Resultados: 170 pacientes, 52,4 por ciento varones, edad promedio de 4 años y 3 meses. En 78,5 por ciento la ingestión de CE ocurrió en el hogar, el 82,1por ciento consultó en las primeras 2 h. Los síntomas más comunes post ingestión fueron digestivos, respiratorios y dolor local. La localización del CE fue con radiografía simple en 87,6 por ciento. En el 91,8 por ciento se extrajo el CE. Localización: 1,3 por ciento retrofaríngeo, 69,3 por ciento esófago, 23 por ciento estómago, 1,9 por ciento duodeno, 3,8 por ciento distal a duodeno. Los CE más frecuentes fueron los redondos (56,4 por ciento) y dentro de ellos las monedas, punzantes (24,1 por ciento), pilas (14,7 por ciento), imanes (2,9 por ciento) y otros de gran tamaño (1,8 por ciento). Se encontró lesión de mucosa en el 53,5 por ciento, requiriendo hospitalización el 9,8 por ciento de los niños. Conclusiones: La ingestión de CE ocurre en el hogar y es más frecuente en pre escolares. El CE más frecuentes fue la moneda. La localización del CE fue con radiografía simple y no hubo fracaso ni complicaciones en la extracción endoscópica.


Introduction: The ingestion of a foreign body (FB) is very common in childhood, 10 to 20 percent of the cases require endoscopic removal. The aim of this study is to analyze the demographic, clinical and endoscopic characteristic of patients with FB ingestion requiring endoscopic management. Patients and Methods: The design corresponded to a Prospective Cohort Study. It included patients referred to the Clinica Alemana ER in Santiago in order to remove foreign bodies from their digestive systems between November 2007 and November 2011. Demographic, clinical and endoscopic characteristics were recorded, classifying the symptoms as respiratory, digestive and other manifestations. Risk factors and complications were evaluated. Results: 170 patients, 52.4 percent male with average age of four years and three months old. In 78.5 percent of the cases, the FB ingestion occurred at home, 82.1percent sought medical attention within two hours from the ingestion. Digestive, respiratory and local pain were among the most common symptoms. The location of the FB took place using simple x-ray in 87.6 percent of the cases. 91.8 percent of the FBs were extracted. Location: retropharyngeal 1.3 percent, 69.3 percent esophagus, stomach 23 percent duodenum 1.9 percent and 3.8 percent distal duodenum. Round FB were the most frequent (56.4 percent) like coins, sharp objects (24.1 percent), batteries (14.7 percent), magnets (2.9 percent) and other large items (1.8 percent). Mucosal lesion was found in 53.5 percent of the cases and 9.8 percent required hospitalization Conclusions: The ingestion of FB occurred at home, and it is most frequent in preschool children. The most common FB was a coin. The location of the FB was through x-ray and no failure or complications were described during the endoscopic removal.


Subject(s)
Humans , Male , Adolescent , Female , Infant , Child, Preschool , Child , Accidents , Foreign Bodies/therapy , Endoscopy, Digestive System , Emergency Medical Services/statistics & numerical data , Postoperative Complications , Foreign Bodies/epidemiology , Prospective Studies , Risk Factors
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