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Dec 2022 DOI 10.14302/issn.2641-5518.jcci-22-4374
Intrathoracic foreign bodies secondary to penetrating wounds are rare in children. We report the observation of a 10-year-old patient who presented an intrapulmonary metallic foreign body following a playful accident. Its migratory aspect, highlighted by imaging, required urgent extraction which was performed by thoracotomy, with good clinical outcome. The interest of the question lies in the circumstances of the incident, the type of foreign body and the terrain.
Feb 2026 DOI 10.14302/issn.2641-5518.jcci-26-5982
Introduction A retained surgical towel in the abdomen is a serious postoperative complication and the most avoidable. Known as “gossypiboma”, it may migrate into adjoining cavities like the stomach, small bowel, colon, vagina, urinary bladder, pericardium, and urethra. Case Report A 32-year-old male presented with complaints of abdominal pain, 4 months after a laparotomy for complicated appendicitis. Initial history and presentation gave an impression of a lower urinary tract obstruction. However, symptoms progressed with signs of bowel obstruction and investigations pointed to a possible retained foreign body. This was confirmed on laparotomy with indications of a transmural migration during the period of evaluation. The report discusses the pathophysiology and manifestations of a migratory surgical gossypiboma. Conclusions A rare case of gossypiboma displaying transmural migration is reported. This showed an initially peritoneally placed sponge that migrated into the intestinal lumen with the sudden presentation of obstructive symptoms. Routine practice of the World Health Organization Surgical Safety Checklist can significantly prevent these incidents.
Apr 2021 DOI 10.14302/issn.2470-0436.jos-21-3710
Introduction Large impaled object in the orbital region causes severe visual impact and requires specialized care within the shortest time possible. Objectives In this case report, we discussed the approach and management of a patient that presented with a penetrating orbitocranial injury, from management at the emergency unit, diagnostic imaging, referral to other subspecialty, surgical and medical intervention, and post-operative care. Discussion A 36-year old male had an impaled toilet brush on the supero-nasal aspect of the right orbit, with visual acuity of 6/60 and lacerated upper eyelid. The globe had minimal movement on all gazes, but pupil was reactive to light with no afferent defect. On plain cranial and orbital CT-scan, the foreign body entered the anterior and medial aspects of the right orbit penetrating the right superior orbital wall, right medial lamina papyracea, and the lateral and inferior border of the right frontal sinus with its distal tip at the intracranial region at the right frontal lobe compressing the medial rectus along its tract. Two hours after injury, patient underwent wound exploration, removal of foreign body, repair of eyelid laceration, right craniotomy, frontal contussectomy, duraplasty, and JP-drain insertion under general anesthesia. Intraoperatively, there was note of transected canaliculus and avulsed conjunctiva. The medial rectus was intact and attached. The frontal lobe was contused with embedded fragments of right posterior orbital bone with 3cm opening on the dura. Post-operatively, Fluconazole was added to the medications after culture results of the toilet brush tip tested positive for fungal elements. Patient was discharged after 21 days with visual acuity of 6/6 on both eyes and improved ocular movement. Conclusion These types of injury warrants thorough and systematic history taking and physical examination, acquiring pertinent imaging modalities to better visualize the extent of injury, and execute surgical and medical intervention that is multidisciplinary.
Mar 2020 DOI 10.14302/issn.2575-1212.jvhc-20-3225
Objective To evaluate/ determine the risk factors for dogs presented with Gastric Dilation- Volvulus (GDV) to a referral veterinary centre and to compare the results with those currently reported in veterinary literature. Materials and Methods The observational case-control study comprised a population of 215 dogs that attended the referral centre between 2000 and 2018. Medical records were searched for GDV and those matching the criteria were manually reviewed. A questionnaire was completed by the owners of the dogs involved in the study (both case and control populations) in order to gain further information that could be considered relevant to GDVs. In particular, information included the dogs’ behaviour and the dogs daily activities. Results The study included 115 cases of GDV and 115 controls. Out of the GDV dogs 13% (15/115) were small breed dogs and the remaining 87% (100/115) either large or giant breeds. The following risk factors for developing a GDV have been identified: Purebred dogs over 3 years old and either large of giant breeds, weighing > 30 kg. Foreign body ingestion, diarrhoea, and grass consumption were also associated to increase the likelihood in developing GDV. Behavioural temperament was not associated with developing GDV. Clinical Significance The findings support previously identified risk factors in the development of GDV, but characteristics related to the dogs temperament warrant further investigation. Knowledge of these results will further allow clinicians to make evidence‐based recommendations to owners in attempting to prevent GDV in dogs. Furthermore this paper confirms that the risk of GDV in certain breeds and in certain conditions is always high and that GDV is still an extremely current disease.
Oct 2018 DOI 10.14302/issn.2578-2371.jslr-18-2213
Introduction: Granulomas in gastric biopsy specimens are extremely rare. The final diagnosis of granulomatous gastritis is based on morphological findings, clinical and laboratory data. The aim of our study is to evaluate the clinical fields and to determine the etiology of gastric granulomatosis in our experience Patients and Methods: Thirty nine patients were reviewed retrospectively in the department of pathology of Habib Thameur between 2000 and 2018. Slides from all cases were stained by hematoxylin and eosin. The clinic-pathologic findings and the associated lesions were analyzed and the final etiology of the gastric granulomatosis was noted. Results: Biopsies from the 39 patients diagnosed as having granulomatous gastritis were reviewed. Mean age was 49 years (24 – 96) and sex ratio was 0,25 (M/F=8/31). Indication of endoscopy was gastric pain in 12 cases, chronic diarrhea in 6 cases, anemia in 2 cases, vomiting in 4 cases. Other symptoms were rare. Upper endoscopy was normal in 8 cases, showed antral gastropathy in 20 cases (erythematous in 6 cases, nodular in 8 cases and ulcerated in 6 cases). In four cases, fundic lesions were observed. Granuloma was unique in 14 cases and multiple in 25 cases. Localisation of granuloma was the antrum in 25 cases, the fundus in 7 cases, and both of them in 7 cases. An associated chronic gastritis was noted in 25 cases. Concerning the etiology, 10 of our patients had Crohn's disease while 6 of them had gastric tuberculosis. In five cases, H Pylori was the retained cause of gastric granulomatosis. In the other patients, the final diagnosis was sarcoidosis (n=3), foreign body reaction (n=1), yersiniosis (n=1). In our series, thirteen cases were unclassifiable. Conclusion: Although many cases remain unclassified, in most cases of granulomatous gastritis, a diagnosis of Crohn's disease or tuberculosis could be established. If this cases are excluded, an association between H. pylori and granulomatous gastritis cannot be ruled out. The others causes are extremely rare.
Sep 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1196
Background and Context: Autologous bone grafts require a second surgical exposure to harvest the graft with a significant risk of post-operative complications and donor site morbidity. Employment of allografts potentially eliminates donor site morbidity but carries the potential of causing foreign body immune reactions with a high rate of rejection and failures. Hence, Alloplasts have emerged as novel materials to overcome the drawbacks of autogenous and allogenous bone grafts. Today’s advanced dentistry is enterprising a putty form of calcium phosphosilicate (CPS) into several aspects of reconstructive domain of dentistry including the sinus augmentation procedures, osseous regeneration of periodontal bone defects, cystic cavity defects and alveolar socket preservation. This eccentric multifaceted study was planned as an honest effort on the path of proving the efficiency of CPS as an alloplastic bioactive graft material and aimed at quantitative evaluation of regenerated bone radiographically using Cone Beam Computed Tomography (CBCT) scans following sinus augmentation procedures. Materials and Methods: A total of 20 sinus augmentations were carried-out in 17 patients satisfying the criteria (inclusion and exclusion) requiring placement of implants in atrophic maxilla and in other situations of anatomic constraints. The graft material used was calcium phosphosilicate (CPS) putty (Nova bone dental putty, Novabone products, Alachua, Fla). The residual bone height was recorded using CBCT scans and a computer based software where the measurements were made from the crest of the ridge till the sinus floor lining. The patients were assessed clinically at immediate post-operative, 1 week, 1 month, 3 months and 6 months follow-up recalls post-operatively. Radiographic assessment for bone height was done pre-operatively and at 6 months follow-up recall post-operatively using Cone Beam Computer Tomography scans. Results: The post-treatment bone height (11.76+0.97mm) was found to be significantly higher than the pre-treatment bone height (6.8 +0.70mm) in indirect sinus augmentation procedures (t=14.4, p<0.005). In case of direct sinus augmentation group also, the post-treatment bone height (11.27 +0.71mm) came-out to be significantly higher than the pre-treatment bone height (2.44 +0.81mm) (t=32.17, p<0.005). The post-treatment bone grafted sinus floor measurements (1107.6 + 155.6mm) were also found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (412+ 65.5mm) (t=16.6, p<0.001) in case of indirect sinus augmentation procedures. Similarly, the post-treatment bone grafted sinus floor measurements (1169.6+136.7mm) were found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (416.4+ 0.70mm) (t=17.9, p<0.001) in case of direct sinus augmentation group. Conclusion: Calcium Phosphosilicate (CPS) was accepted well at the recipient sites without any complications demonstrating its efficiency and reliability in sinus augmentation procedures.