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Ophthalmic Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The possibility of foreign bodies in the wound or trapped sub-tarsally (under the lid—seen on lid eversion) should be considered. The wound should be searched for foreign bodies and CT scanning performed if a foreign body is suspected. Small wounds can hide large foreign bodies.
Respiratory system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Symptoms of foreign body aspiration include acute apnoea if the foreign body is lodged in the larynx or trachea, severe respiratory distress if the foreign body is lodged in a major bronchus, wheezing when the obstruction is partial, and signs of consolidation when there is superadded infection. Most foreign respiratory bodies are food (and therefore are not radio-opaque) and occur in children below the age of 4 years.
Corneal abrasion
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
A corneal abrasion occurs when the corneal epithelium is damaged, and can result from direct trauma or prolonged contact lens use. Symptoms include foreign body sensation, pruritus, and pain. Photophobia may also occur if there is an associated iritis. A corneal ulcer is an infected corneal abrasion. This may occur due to bacteria from the external environment or may be the precipitating etiology, as in cases of viral or fungal keratitis. The latter can be differentiated by the presence of conjunctival injection, purulent discharge, elevation of the ulcer edges from inflammation, or the presence of dendritic lesions.
Inflammatory reaction to suture materials after flexor tendon repair. A retrospective study of 594 patients
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Marianne Arner, Linda Unge, Mikael A. Franko, Jonas Svingen
In 11 out of 115 patients (123 fingers) operated with FiberLoop® (9.6%), clinical records reported of wound healing problems, such as those described for the braided polyester group. One patient (0.9%) had a deep infection leading to rupture of the sutured tendon. In four patients (3.5%), longstanding subcutaneous granulomas were observed. The four patients with granulomas were reoperated at 3, 7, 9 and 30 months after the tendon repair, respectively and are presented in Table 2. One case history (patient number 2 in Table 2) is described in Figures 2 and 3. One patient had injured two fingers, but a granuloma had only occurred in one. Skin healing was complete before reoperation in three of the cases with a small exuding sinus present after the primary operation in one. Pathological examinations showed foreign body reactions in all four cases. Bacterial cultures were positive with Staphylococcus aureus in three of the patients. Bacterial growth was unfortunately not examined in one of the four patients. There were no tendon ruptures and healing was uneventful in three of the cases directly after removal of the FiberLoop® suture. In one patient (number 4 in Table 2) who had been reoperated 30 months after the primary tendon repair, a subsequent postoperative wound infection led to another reoperation with surgical revision, but the finger then healed. After the end of the inclusion period of this study in June 2019, at least one very similar granuloma case has been diagnosed.
Noninvasive Diagnosis of Viral Keratouveitis with Retro-corneal Endothelial Plaques: A Case Series
Published in Ocular Immunology and Inflammation, 2022
Shuo Yu, Debo You, Rupesh Agrawal, Yun Feng
Twelve eyes of six male and six female patients with unilateral viral keratouveitis with retrocorneal endothelial plaques were included in the study, with a mean age of 63.3 ± 19.0 (range: 16–87) years. Three patients (Patients 4, 6, and 7) had a previous history of penetrating keratoplasty, while the rest of the patients had no history of previous corneal disease or pathology. Presenting symptoms included foreign body sensation, pain, and redness combined with severe vision loss. Snellen’s visual acuity varied between 20/200 and counting fingers. Slit-lamp examination revealed a unilateral large epithelial defect with stromal infiltration, gray-white keratic precipitates, and retrocorneal endothelial plaque underlying the area of active stromal infiltration in all patients (Figure 1). Hypopyon was noted in six eyes (Patients 1, 3, 5, 10, 11, and 12) (Figures 2 and 4). Corneal sensation was reduced or absent in all the affected eyes. The results are shown in Table 1.
Well-planned rather than rushed extraction of airway foreign body in 532 g preterm neonate
Published in Acta Oto-Laryngologica Case Reports, 2021
Samin Rahbin, Malin Kjellberg, Magnus Söderlind, Andreas Ekborn
The catheter tip was present for some time without giving rise to alarming symptoms and it was not until DOL 5 that a CXR showed signs of hypo-inflation, warranting further investigation. This is not surprising, as the small size and material composition of the foreign body made it chemically and biologically inactive. The present case thus demonstrates that unless such an object obstructs the main airflow through the trachea, it can be present in the airway for some time without giving rise to alarming symptoms or interfere with pulmonary function. Computed tomography (CT) is the primary imaging used when suspecting airway foreign bodies in the pediatric population and may have better revealed the object, however it is not routinely used in premature infants as it requires patient transport and exposes neonates to unnecessary radiation (even though the latter is significantly reduced when using airway foreign body protocols).