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4 results

  • A piercing story: ingestion of a grill wire brush bristle

  • R Chen, J Koh, Y C Zhao, E Pudel
  • Journal:
    The Journal of Laryngology & Otology / Volume 135 / Issue 5 / May 2021
    Published online by Cambridge University Press:
    16 April 2021, pp. 467-469
    Print publication:
    May 2021
  • Background

    This paper reports the dangers of an ingested metal wire bristle from a barbeque brush, which resulted in oesophageal perforation.

    Case report

    A 49-year-old gentleman presented to the emergency department with foreign body sensation and odynophagia after having consumed barbequed lamb for lunch. Computed tomography of the neck demonstrated a thin linear opacity near the thoracic inlet. The object could not be visualised on emergent rigid oesophagoscopy. Subsequent neck exploration enabled localisation of a retropharyngeal abscess and a thin wire bristle from a barbeque brush.

    Conclusion

    Always consider the utensils employed in food preparation as a differential in ingested foreign bodies. Thin wire objects have a high propensity to migrate and result in complications, hence urgent intervention is vital.

  • 57 - Necrotizing soft tissue and skin infections

  • from Section 9 - Infectious disease emergencies
  • Edited by Kaushal Shah, Jarone Lee, Kamal Medlej, American University of Beirut, Scott D. Weingart
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 375-380

  • Summary

    This chapter discusses the diagnosis, evaluation and management of esophageal perforation and mediastinitis. About a third of patients present with atypical symptoms or signs including sepsis, peritonitis, respiratory distress, fever, pneumo/hydrothorax, fulminant shock, and multi-system organ failure. Approximately 17% of esophageal perforations are diagnosed only at autopsy. 90% of patients have findings suggestive of perforation on simple chest radiography. A contrast study such as esophagography with Gastrograffin should be performed if perforation is suspected. Although barium has superior sensitivity, it causes a worsened mediastinal/peritoneal inflammatory response if a leak is present. In addition, Gastrograffin is recommended because it does not obscure visualization during endoscopy. Computed tomography (CT) of the chest and abdomen with oral contrast may better define the leak, assess complications, and exclude other diagnoses.

  • Unwitnessed lithium ion disc battery ingestion: case report and review of best practice management of an increasing clinical concern

  • N Dawe, M Puvanendran, L Flood
  • Journal:
    The Journal of Laryngology & Otology / Volume 127 / Issue 1 / January 2013
    Published online by Cambridge University Press:
    07 December 2012, pp. 84-87
    Print publication:
    January 2013
  • Objective:

    To describe a case of unwitnessed lithium ion disc battery ingestion, with a review of radiology findings and current best practice management.

    Case report:

    A three-year-old girl presented following ingestion of a foreign body, which her four-year-old brother claimed was a one pound coin. The patient was managed non-urgently and transferred for specialist ENT assessment 6 hours following the initial ingestion, with no evidence of airway compromise. A corroded battery was removed from the level of the cricopharyngeus after 8 hours, with an associated circumferential mucosal burn.

    Conclusion:

    There is increasing concern regarding the acknowledged rising incidence of lithium ion disc battery ingestion. The lack of a high index of suspicion and the inability to recognise subtleties on imaging may lead to suboptimal management with a higher degree of unnecessary immediate and delayed morbidity. The recently published American Academy of Pediatrics Guidelines may guide the approach to managing battery ingestions.

  • Management of sword-swallower injuries

  • A C Moberly, M H Fritsch, K M Mosier
  • Journal:
    The Journal of Laryngology & Otology / Volume 125 / Issue 2 / February 2011
    Published online by Cambridge University Press:
    26 October 2010, pp. 217-219
    Print publication:
    February 2011
  • Objective:

    To report an unusual case of hypopharyngeal perforation in a sword-swallower, with emphasis on management options.

    Method:

    Case report and review of the English language literature concerning sword-swallowing injuries to the hypopharynx and oesophagus.

    Results:

    A 29-year-old male sword-swallower suffered hypopharyngeal perforation during a performance. The patient received conservative management, with intensive care unit admission, infectious disease consultation, intravenous antibiotics, discontinuation of oral intake and close observation. He progressed well, resumed oral intake on hospital day six, and was discharged home on hospital day eight.

    Conclusion:

    Sword-swallowing is an unusual vocation which may lead to potentially devastating injuries. This case report and review of the literature illustrates the management options for such hypopharyngeal and oesophageal injuries.