Foreign body

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Foreign body
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An endoscopy image of the stomach, showing a foreign body in the form of a toothbrush.
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A foreign body (FB) is any object originating outside the body of an organism. In machinery, it can mean any unwanted intruding object.

Contents

Most references to foreign bodies involve propulsion through natural orifices into hollow organs.

Foreign bodies can be inert or irritating. If they irritate they will cause inflammation and scarring. They can bring infection into the body or acquire infectious agents and protect them from the body's immune defenses. They can obstruct passageways either by their size or by the scarring they cause. Some can be toxic or generate toxic chemicals from reactions with chemicals produced by the body, as is the case with many examples of ingested metal objects.

With sufficient force (as in firing of bullets), a foreign body can become lodged into nearly any tissue.

Gastrointestinal tract

One of the most common locations for a foreign body is the alimentary tract.

It is possible for foreign bodies to enter the tract from the mouth or rectum.

Both children and adults experience problems caused by foreign objects becoming lodged within their bodies. Young children, in particular, are naturally curious and may intentionally put shiny objects, such as coins or button batteries, into their mouths. They also like to insert objects into their ear canals and nostrils. [1] The severity of a foreign body can range from unconcerning to a life-threatening emergency. For example, a coin causes local pressure on the tissue but generally is not a medical emergency to remove. A button battery, which can be a very similar size to a coin, generates hydroxide ions at the anode and causes a chemical burn in two hours. [2] An ingested button battery that is stuck in the esophagus is a medical emergency. In 2009, Avolio Luigi and Martucciello Giuseppe showed that although ingested nonmagnetic foreign bodies are likely to be passed spontaneously without consequence, ingested magnets (magnetic toys) may attract each other through children's intestinal walls and cause severe damage, such as pressure necrosis, perforation, intestinal fistulas, volvulus, and obstruction. [3]

Pancreas

Sometimes foreign bodies can pass spontaneously through the gastrointestinal tract and perforate or penetrate the wall of stomach and duodenum and migrate into the pancreas. The laparoscopic approach before open surgery could be performed safely for the removal of foreign bodies embedded in the pancreas. [4]

Airways

It is possible for a foreign body to enter the airways and cause choking. [5] A choking case can require the fast usage of basic anti-choking techniques to clear the airway.

In one study, peanuts were the most common obstruction. [6] In addition to peanuts, hot dogs, grapes, and latex balloons are also serious choking hazards in children that can result in death. A latex balloon will conform to the shape of the trachea, blocking the airway and making it difficult to expel with basic anti-choking techniques. [7]

Eyes

Airborne particles can lodge in the eyes of people at any age. These foreign bodies often result in allergies which are either temporary or even turn into a chronic allergy. This is especially evident in the case of dust particles.

It is also possible for larger objects to lodge in the eye. The most common cause of intraocular foreign bodies is hammering. [8] Corneal foreign bodies are often encountered due to occupational exposure and can be prevented by instituting safety eye-wear at work place. [9]

Foreign bodies in the eye affect about 2 per 1,000 people per year. [10]

Skin

Surgical suture. H&E stain. Suture micrograph.jpg
Surgical suture. H&E stain.

Splinters are common foreign bodies in skin. Staphylococcus aureus infection often causes boils to form around them. [11]

Tetanus prophylaxis may be appropriate. [12]

Peritoneum

Foreign bodies in the peritoneum can include retained surgical instruments after abdominal surgery. Rarely, an intrauterine device can perforate the uterine wall and enter the peritoneum.

Foreign bodies in the peritoneum eventually become contained in a foreign body granuloma. In the extremely rare case of retained ectopic pregnancy, this forms a lithopedion, which involves the fetus being too large to be reabsorbed, and is calcified [13] as a means of shielding the surrounding tissue from infection.

Other

Foreign material in a blood vessel due to an embolization procedure. Embolization kidney.jpg
Foreign material in a blood vessel due to an embolization procedure.
Talcosis of the lung due to intravenous drug use. H&E stain. Pulmonary talcosis low mag cropped.jpg
Talcosis of the lung due to intravenous drug use. H&E stain.

Foreign bodies can also become lodged in other locations:

Other animals

Foreign bodies are common in animals, especially young dogs and cats. Dogs will readily eat toys, bones, and any object that either has food on it or retains the odor of food. Unlike humans, dogs are susceptible to gastrointestinal obstruction due to their ability to swallow relatively large objects and pass them through the esophagus. Foreign bodies most commonly become lodged in the stomach because of the inability to pass through the pyloric sphincter into the jejunum. Symptoms of gastrointestinal obstruction include vomiting, abdominal pain often characterized by aggression, acute infection, and depression due to dehydration. [22] Treatment of a foreign body is determined by its severity. The amount of time a foreign body is present, location of the object, degree of obstruction, previous health status of the animal and the type of material from which the foreign body is made can all determine the severity of the condition. Peritonitis results if either the stomach or intestine has ruptured. Foreign bodies in the stomach can sometimes be removed by endoscopic retrieval or if necessary by gastrotomy. [22] Very often, a simple instrument to remove foreign bodies without operation endoscopy is the Hartmann alligator forceps. The instrument is manufactured from 8 cm to 1 m length. Foreign bodies in the jejunum are removed by enterotomy.

Certain foreign bodies in animals are especially problematic. Bones or objects with sharp edges may cause tearing of the wall of the esophagus, stomach, or small intestine and lead to peritonitis. Pennies swallowed in large numbers may cause zinc poisoning, which in dogs leads to severe gastroenteritis and hemolytic anemia. Linear foreign bodies can especially be dangerous. A linear foreign body is usually a length of string or yarn with a larger object or clump of material at either end. One end is usually lodged in the stomach or proximal small intestine and the other end continues to travel through the intestines. The material becomes tightly stretched and the intestines may "accordion up" on themselves or be lacerated by it. This is especially common in cats who may enjoy playing with a ball of string or yarn. Sometimes the linear foreign body anchors in the mouth by catching under the tongue. [23] Pantyhose is a common linear foreign body in dogs.

See also

Related Research Articles

<span class="mw-page-title-main">Gastroenterology</span> Branch of medicine focused on the digestive system and its disorders

Gastroenterology is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometimes referred to as the GI tract, which includes the esophagus, stomach, small intestine and large intestine as well as the accessory organs of digestion which include the pancreas, gallbladder, and liver.

<span class="mw-page-title-main">Stomach</span> Digestive organ

The stomach is a muscular, hollow organ in the upper gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach is involved in the gastric phase of digestion, following the cephalic phase in which the sight and smell of food and the act of chewing are stimuli. In the stomach a chemical breakdown of food takes place by means of secreted digestive enzymes and gastric acid.

<span class="mw-page-title-main">Gastrointestinal tract</span> Organ system within humans and other animals

The gastrointestinal tract is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as faeces. Gastrointestinal is an adjective meaning of or pertaining to the stomach and intestines.

<span class="mw-page-title-main">Peristalsis</span> Radially symmetrical contraction and relaxation of muscles

Peristalsis is a type of intestinal motility, characterized by radially symmetrical contraction and relaxation of muscles that propagate in a wave down a tube, in an anterograde direction. Peristalsis is progression of coordinated contraction of involuntary circular muscles, which is preceded by a simultaneous contraction of the longitudinal muscle and relaxation of the circular muscle in the lining of the gut.

<span class="mw-page-title-main">Choking</span> Mechanical obstruction of the flow of air from the environment into the lungs

Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen deprivation. Although oxygen stored in the blood and lungs can keep a person alive for several minutes after breathing stops, choking often leads to death.

<span class="mw-page-title-main">Esophagus</span> Vertebrate organ through which food passes to the stomach

The esophagus, oesophagus, or œsophagus all ; pl.: ( e)(œ)sophagi or (œ)sophaguses), colloquially known also as the food pipe, food tube, or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the stomach. The esophagus is a fibromuscular tube, about 25 cm (10 in) long in adults, that travels behind the trachea and heart, passes through the diaphragm, and empties into the uppermost region of the stomach. During swallowing, the epiglottis tilts backwards to prevent food from going down the larynx and lungs. The word oesophagus is from Ancient Greek οἰσοφάγος (oisophágos), from οἴσω (oísō), future form of φέρω + ἔφαγον.

<span class="mw-page-title-main">Pulmonary aspiration</span> Entry of materials into the larynx (voice box) and lower respiratory tract

Pulmonary aspiration is the entry of material such as pharyngeal secretions, food or drink, or stomach contents from the oropharynx or gastrointestinal tract, into the larynx and lower respiratory tract, the portions of the respiratory system from the trachea (windpipe) to the lungs. A person may inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe".

<span class="mw-page-title-main">Upper gastrointestinal series</span> Radiographs used to examine abnormalities of the digestive system excluding the colon

An upper gastrointestinal series, also called a barium swallow, barium study, or barium meal, is a series of radiographs used to examine the gastrointestinal tract for abnormalities. A contrast medium, usually a radiocontrast agent such as barium sulfate mixed with water, is ingested or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of the regions of interest. The barium enhances the visibility of the relevant parts of the gastrointestinal tract by coating the inside wall of the tract and appearing white on the film. This in combination with other plain radiographs allows for the imaging of parts of the upper gastrointestinal tract such as the pharynx, larynx, esophagus, stomach, and small intestine such that the inside wall lining, size, shape, contour, and patency are visible to the examiner. With fluoroscopy, it is also possible to visualize the functional movement of examined organs such as swallowing, peristalsis, or sphincter closure. Depending on the organs to be examined, barium radiographs can be classified into "barium swallow", "barium meal", "barium follow-through", and "enteroclysis". To further enhance the quality of images, air or gas is sometimes introduced into the gastrointestinal tract in addition to barium, and this procedure is called double-contrast imaging. In this case the gas is referred to as the negative contrast medium. Traditionally the images produced with barium contrast are made with plain-film radiography, but computed tomography is also used in combination with barium contrast, in which case the procedure is called "CT enterography".

Ingestion is the consumption of a substance by an organism. In animals, it normally is accomplished by taking in a substance through the mouth into the gastrointestinal tract, such as through eating or drinking. In single-celled organisms, ingestion takes place by absorbing a substance through the cell membrane.

<span class="mw-page-title-main">Gastrointestinal disease</span> Illnesses of the digestive system

Gastrointestinal diseases refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum; and the accessory organs of digestion, the liver, gallbladder, and pancreas.

Gastrointestinal cancer refers to malignant conditions of the gastrointestinal tract and accessory organs of digestion, including the esophagus, stomach, biliary system, pancreas, small intestine, large intestine, rectum and anus. The symptoms relate to the organ affected and can include obstruction, abnormal bleeding or other associated problems. The diagnosis often requires endoscopy, followed by biopsy of suspicious tissue. The treatment depends on the location of the tumor, as well as the type of cancer cell and whether it has invaded other tissues or spread elsewhere. These factors also determine the prognosis.

<span class="mw-page-title-main">Foregut</span> Anterior part of the gastrointestinal tract

The foregut in humans is the anterior part of the alimentary canal, from the distal esophagus to the first half of the duodenum, at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. The foregut arises from the endoderm, developing from the folding primitive gut, and is developmentally distinct from the midgut and hindgut. Although the term “foregut” is typically used in reference to the anterior section of the primitive gut, components of the adult gut can also be described with this designation. Pain in the epigastric region, just below the intersection of the ribs, typically refers to structures in the adult foregut.

<span class="mw-page-title-main">Veterinary surgery</span> Surgery performed on non-human animals

Veterinary surgery is surgery performed on non-human animals by veterinarians, whereby the procedures fall into three broad categories: orthopaedics, soft tissue surgery, and neurosurgery. Advanced surgical procedures such as joint replacement, fracture repair, stabilization of cranial cruciate ligament deficiency, oncologic (cancer) surgery, herniated disc treatment, complicated gastrointestinal or urogenital procedures, kidney transplant, skin grafts, complicated wound management, and minimally invasive procedures are performed by veterinary surgeons. Most general practice veterinarians perform routine surgeries such as neuters and minor mass excisions; some also perform additional procedures.

<span class="mw-page-title-main">Schatzki ring</span> Narrowing of the lower esophagus due to mucosal or muscular tissue

A Schatzki ring or Schatzki–Gary ring is a narrowing of the lower esophagus that can cause difficulty swallowing (dysphagia). The narrowing is caused by a ring of mucosal tissue or muscular tissue. A Schatzki ring is a specific type of "esophageal ring", and Schatzki rings are further subdivided into those above the esophagus/stomach junction, and those found at the squamocolumnar junction in the lower esophagus.

<span class="mw-page-title-main">Endoscopic foreign body retrieval</span>

Endoscopic foreign body retrieval refers to the removal of ingested objects from the esophagus, stomach and duodenum by endoscopic techniques. It does not involve surgery, but rather encompasses a variety of techniques employed through the gastroscope for grasping foreign bodies, manipulating them, and removing them while protecting the esophagus and trachea. It is of particular importance with children, people with mental illness, and prison inmates as these groups have a high rate of foreign body ingestion.

<span class="mw-page-title-main">Esophageal food bolus obstruction</span> Blockage of the esophagus by an ingested foreign body

An esophageal food bolus obstruction is a medical emergency caused by the obstruction of the esophagus by an ingested foreign body.

<span class="mw-page-title-main">Foreign body in alimentary tract</span> Medical condition

One of the most common locations for a foreign body is the alimentary tract. It is possible for foreign bodies to enter the tract either from the mouth, or from the rectum.

<span class="mw-page-title-main">Foreign body aspiration</span> Medical condition

Foreign body aspiration occurs when a foreign body enters the airway which can cause difficulty breathing or choking. Objects may reach the respiratory tract and the digestive tract from the mouth and nose, but when an object enters the respiratory tract it is termed aspiration. The foreign body can then become lodged in the trachea or further down the respiratory tract such as in a bronchus. Regardless of the type of object, any aspiration can be a life-threatening situation and requires timely recognition and action to minimize risk of complications. While advances have been made in management of this condition leading to significantly improved clinical outcomes, there were still 2,700 deaths resulting from foreign body aspiration in 2018. Approximately one child dies every five days due to choking on food in the United States, highlighting the need for improvements in education and prevention.

<span class="mw-page-title-main">Gastrointestinal wall</span> Digestive system structure

The gastrointestinal wall of the gastrointestinal tract is made up of four layers of specialised tissue. From the inner cavity of the gut outwards, these are the mucosa, the submucosa, the muscular layer and the serosa or adventitia.

<span class="mw-page-title-main">Human digestive system</span> Digestive system in humans

The human digestive system consists of the gastrointestinal tract plus the accessory organs of digestion. Digestion involves the breakdown of food into smaller and smaller components, until they can be absorbed and assimilated into the body. The process of digestion has three stages: the cephalic phase, the gastric phase, and the intestinal phase.

References

  1. ↑ "Foreign Bodies: Nose and Paranasal Sinus Disorders: Merck Manual Professional". Archived from the original on 2012-08-26. Retrieved 2008-12-16.
  2. ↑ Litovitz, Toby. "Swallowed a Button Battery?". National Capital Poison Center. Archived from the original on 17 August 2012. Retrieved 11 June 2011.
  3. ↑ Avolio, Luigi; Martucciello, Giuseppe (25 June 2009). "Ingested Magnets". New England Journal of Medicine. 360 (26): 2770. doi:10.1056/NEJMicm0801917. PMID   19553650.
  4. ↑ Mulita, Francesk; Papadopoulos, George; Tsochatzis, Stelios; Kehagias, Ioannis (2020). "Laparoscopic removal of an ingested fish bone from the head of the pancreas: case report and review of literature". Pan African Medical Journal. 36: 123. doi: 10.11604/pamj.2020.36.123.23948 . PMC   7422735 . PMID   32849978.
  5. ↑ "Foreign Body Aspiration: Overview - eMedicine". Archived from the original on 2008-12-27. Retrieved 2008-12-16.
  6. ↑ Yadav SP, Singh J, Aggarwal N, Goel A (September 2007). "Airway foreign bodies in children: experience of 132 cases" (PDF). Singapore Med J. 48 (9): 850–3. PMID   17728968. Archived (PDF) from the original on 2008-12-01.
  7. ↑ Muntz, Harlan (2009). Pediatric Otolaryngology for the Clinician: Foreign Body Management. Humana Press. pp. 215–222. ISBN   978-1-58829-542-2.
  8. ↑ "Foreign Body, Intraocular: Overview - eMedicine". Archived from the original on 2008-12-24. Retrieved 2008-12-16.
  9. ↑ Onkar, Abhishek (2020). "Commentary: Tackling the corneal foreign body". Indian Journal of Ophthalmology. 68 (1): 57–58. doi: 10.4103/ijo.IJO_1625_19 . PMC   6951207 . PMID   31856467.
  10. ↑ Ahmed, Faheem; House, Robert James; Feldman, Brad Hal (1 September 2015). "Corneal Abrasions and Corneal Foreign Bodies". Primary Care. 42 (3): 363–375. doi:10.1016/j.pop.2015.05.004. ISSN   1558-299X. PMID   26319343.
  11. ↑ Fisher, Bruce; Harvey, Richard P.; Champe, Pamela C. (2007). Lippincott's Illustrated Reviews: Microbiology (Lippincott's Illustrated Reviews Series). Hagerstown, MD: Lippincott Williams & Wilkins. ISBN   978-0-7817-8215-9.
  12. ↑ Halaas GW (September 2007). "Management of foreign bodies in the skin". Am Fam Physician. 76 (5): 683–8. PMID   17894138.
  13. ↑ Gedam, B.S.; Shah, Yunus; Deshmukh, Shahaji; Bansod, Prasad Y. (2014-12-12). "Skeletal remains of mummified foetus for 36 years in mother's abdomen". International Journal of Surgery Case Reports. 7: 109–111. doi:10.1016/j.ijscr.2014.10.074. ISSN   2210-2612. PMC   4336399 . PMID   25647606.
  14. ↑ "First Aid & Emergencies: Rectal Foreign Object Treatment". WebMD. Archived from the original on May 18, 2015. Retrieved May 9, 2015.
  15. ↑ "Foreign Body Retrieval". RadiologyInfo.org. Archived from the original on 2015-04-13.
  16. ↑ Thompson SK, Wein RO, Dutcher PO (November 2003). "External auditory canal foreign body removal: management practices and outcomes". Laryngoscope. 113 (11): 1912–5. doi:10.1097/00005537-200311000-00010. PMID   14603046. S2CID   21136867.
  17. ↑ "Foreign Body, Nose". Archived from the original on 2008-12-20. Retrieved 2008-12-16.
  18. ↑ LUCAS RB (1952). "Foreign body reactions in the oral tissues - PubMed". Https. 45 (4): 209–215. PMC   1987454 . PMID   14930039.
  19. ↑ Plascencia, H.; Cruz, A.; Solís, R.; Díaz, M.; Vázquez, J. (2014). "Iatrogenic Displacement of a Foreign Body into the Periapical Tissues". Https. 2014: 698538. doi: 10.1155/2014/698538 . PMC   4244928 . PMID   25478244.
  20. ↑ Rahman, N. U.; Elliott, S. P.; McAninch, J. W. (2004). "Self-inflicted male urethral foreign body insertion: endoscopic management and complications". BJU International. 94 (7): 1051–1053. doi:10.1111/j.1464-410X.2004.05103.x. PMID   15541127. S2CID   38657876.
  21. ↑ "Foreign Body, Vagina". Archived from the original on 2008-12-17. Retrieved 2008-12-16.
  22. 1 2 "Gastrointestinal Obstruction in Small Animals - Digestive System - Merck Veterinary Manual". Merck Veterinary Manual. Retrieved 2017-12-05.
  23. ↑ Glossary Term: Linear Foreign Body Archived 2008-05-17 at the Wayback Machine
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