Intrapleural Foreign Body: Case Report

Berardino, Alessandro Di Marco; Rendina, Erino Angelo; Bonifazi, Martina; Zuccatosta, Lina; Latini, Letizia Lara; Gonnelli, Francesca; Latini, Agnese; Cirilli, Laura; Gasparini, Stefano

doi:10.1159/000516507

Cited by 3 publications

(1 citation statement)

References 6 publications

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“… 85 , 103 Most of these aspirated foreign bodies result in rapid symptom presentation, 104 though there have been rare cases with a latency of several months and, in some exceptional instances, even up to 25 years. 85 , 103 , 105 , 106 There are reported cases where small pointed foreign bodies, such as a wooden skewer, 107 a cedar branch, 108 heads of oats 85 , 109 or other plant material, 110 bored through the lung tissue, causing conditions such as pneumonia, hemoptysis, bronchopleural fistula, empyema and migration into the pleural space. These cases are associated with high morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies. Methods: We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options. Results: In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years. Conclusions: Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.

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Section: Discussionmentioning

confidence: 99%

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Seldinger chest drain guidewire retained in the pleural cavity—a never event complication

Mahboob

Garg

et al. 2022

Journal of Surgical Case Reports

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Intrapleural foreign body is an unusual complication. It most commonly occurs after the trauma but has been rarely seen after diagnostic or therapeutic procedures. We hereby, present an unusual occurrence of a retained guidewire after a chest drain insertion using a Seldinger technique in a patient with coronavirus disease of 2019 pneumonitis. Surgical removal of the guidewire has prevented this foreign body to cause further harm. We further discuss how to identify and prevent such a complication.

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A Case of an Intrathoracic Foreign Body Resembling a Metastatic Lung Tumor

OKUDA

2023

Nihon Rinsho Geka Gakkai Zasshi (J Jpn Surg Assoc)

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Intrapleural Foreign Body: Case Report

Cited by 3 publications

References 6 publications

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Seldinger chest drain guidewire retained in the pleural cavity—a never event complication

A Case of an Intrathoracic Foreign Body Resembling a Metastatic Lung Tumor

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