Metallic Foreign Body Penetrating the Carotid Sheath: A Case Report
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Metallic Foreign Body Penetrating the Carotid Sheath: A Case Report
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
This page presents a generated summary with additional references; See source (below) for actual content.
Original source:
This page is merely a summary which is automatically generated hence you should visit the source to read the original article which includes the author, publication date, notes and references.
Hemanth Vamanshankar, Arun B Nair, Nandakumar Rajan
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Metallic Foreign Body Penetrating the Carotid Sheath: A Case Report
Year: 2011
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Foreign bodies (FBs) ingestion poses a significant concern in otolaryngology, with many cases reported; however, metallic foreign bodies are notably less common. One of the rare but serious complications related to foreign body ingestion is its penetration and migration into surrounding tissues. This case report presents a unique instance of a migrating metallic foreign body found in a 50-year-old woman who experienced odynophagia following accidental ingestion. The foreign body, a metallic wire, migrated extraluminally into the carotid sheath, highlighting the critical nature of diagnosing and managing such cases effectively.
Challenges in Diagnosis and Management
The case emphasizes the challenges associated with the diagnosis and retrieval of migrated foreign bodies, particularly those that penetrate the aerodigestive tract wall. While traditional imaging techniques like radiography are often employed to locate the FB, they may lack sensitivity due to overlapping anatomical structures. In this case, the initial examinations suggested a retropharyngeal foreign body, but advanced imaging, specifically a CT scan, confirmed its lateral location in the pharyngeal wall. Surgical intervention was necessary to remove the embedded FB, showcasing that a systematic approach to exploring the neck and employing intraoperative aids can significantly enhance the likelihood of successful removal.
Conclusion
This case underscores the importance of maintaining a high level of suspicion for perforation and migration of ingested foreign bodies, especially when patients present with prolonged symptoms. Prompt identification and surgical intervention are paramount to prevent potentially serious complications that arise from such occurrences. In cases where endoscopic removal is unsuccessful or symptoms persist, a CT scan can aid in locating extraluminal foreign bodies, guiding a more effective surgical approach to avoid morbidity and enhance patient outcomes.
FAQ section (important questions/answers):
What are common complications from ingested foreign bodies?
Common complications include perforation of the aero-digestive tract, migration of foreign bodies into surrounding soft tissues, and potential life-threatening vascular issues. These complications necessitate prompt diagnosis and intervention to avoid severe morbidity.
How rare is it for a foreign body to migrate extraluminally?
Migration of foreign bodies extraluminally is quite rare, occurring in only a small fraction of cases. Most cases involve intraluminal foreign bodies, making the detection of migration essential for urgent treatment.
What imaging methods are effective in locating migrating foreign bodies?
Computed tomography (CT) scans are the preferred method for locating migrating foreign bodies, providing detailed images of their relationships with vital structures. Traditional radiographs may have limitations in sensitivity and accuracy.
What steps are taken if a foreign body is detected?
If a foreign body is detected, an external surgical approach is often required for removal. Intraoperative radiography may assist in locating the foreign body if direct exploration fails.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Metallic Foreign Body Penetrating the Carotid Sheath: A Case Report”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Wall:
In the context of foreign body ingestion, the ‘wall’ refers to the tissue layer of the aero-digestive tract that may be penetrated by sharp or larger foreign bodies. Perforation of this wall can lead to complications like extraluminal migration of the foreign body into surrounding tissues, potentially causing serious health risks.
2) Post:
The term ‘post’ relates to the postoperative phase where the patient recovers after a surgical procedure. In the case report, ‘post’ indicates the follow-up management of the patient, including monitoring for complications such as infections or lingering symptoms, particularly throat pain which persisted for two weeks.
3) Fish:
In otolaryngological practice, ‘fish’ often denotes fish bones—common ingested foreign bodies. Fish bones are particularly notorious for causing injury within the throat or esophagus. This term highlights the need for precautions when eating fish and the challenges they present for removal due to their sharp and pointed nature.
4) Pain:
‘Pain’ is a significant symptom often reported by patients with foreign body ingestion. In the described case, the patient experienced odynophagia (painful swallowing), which warranted further medical evaluation. Pain serves as an indicator of possible complications such as perforation and should be closely monitored for timely intervention.
5) Fixation:
In the context of migrating foreign bodies, ‘fixation’ refers to the adherence of a foreign body to the tissue structures within the neck. Such fixation can complicate the removal process and may lead to surrounding tissue damage, infection, and further medical issues that necessitate careful surgical planning.
6) Incision:
‘Incision’ relates to the surgical cut made during exploratory procedures to locate and remove foreign bodies. The description of an oblique incision in the neck underlines the surgical approach taken to access and retrieve the foreign body embedded within the carotid sheath, highlighting the complexity of such cases.
7) Quality:
‘Quality’ pertains to the clarity and accuracy of imaging techniques used in diagnosing and locating foreign bodies in the neck. Inadequate quality of radiographs may lead to misdiagnosis and challenges during surgery. It emphasizes the importance of high-quality imaging, particularly CT scans, for precise location during exploration.
8) Edema (Oedema):
‘Oedema’ indicates swelling, particularly swelling caused by fluid accumulation in tissues, which can occur in response to injury or irritation from a foreign body. Its presence during direct laryngoscopy can suggest injury to the surrounding area and may indicate complications related to a penetrating foreign body.
9) India:
‘India’ is relevant as it specifies the geographical context in which the case study occurs. The case presentation at a tertiary care center in Bangalore, India, demonstrates the local medical practices and challenges faced in managing foreign body cases, thus adding cultural and regional relevance to the study.
10) Doubt:
‘Doubt’ refers to uncertainty during diagnosis or surgical procedures, as evidenced by initial endoscopic examination results. The absence of the foreign body during rigid endoscopy led to doubt about its location, necessitating further imaging studies to clarify the situation and inform the surgical approach.
11) Fever:
‘Fever’ signifies a systemic response that may arise from infections or inflammation due to foreign body perforation. It serves as a clinical symptom indicating potential complications, highlighting the urgency in addressing cases of foreign body ingestion to prevent severe outcomes such as sepsis and associated morbidity.
12) Life:
‘Life’ underscores the potential life-threatening complications associated with foreign body migration, including vascular injury or abscess formation. This term illustrates the critical nature of timely diagnosis and intervention, emphasizing the serious implications that can arise from delayed treatment of ingested foreign bodies.
13) Pur:
‘Poor’ denotes the inadequacy of certain diagnostic techniques, such as suboptimal radiographic quality. In the context of locating foreign bodies, poor image quality can hinder effective diagnosis and subsequently influence surgical decisions. This term underscores the necessity for reliable imaging methods during foreign body evaluation.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Metallic Foreign Body Penetrating the Carotid Sheath: A Case Report’. Further sources in the context of Science might help you critically compare this page with similair documents:
Abscess, Foreign body, Foreign bodies, Throat pain, CT scan, Medical imaging, Nasogastric tube, Computed tomography, General anaesthesia, High index of suspicion, Surgical exploration, Persistent symptoms, Evisceration, Surgical complication, Foreign body ingestion, Endoscopic removal, Metallic foreign bodies, Soft tissue, Aero-digestive tract, External approach.
Concepts being referred in other categories, contexts and sources.
Neck.