My patient is injured: identifying foreign bodies with ultrasound

Lewis, David A.; Jivraj, A.; Atkinson, Paul; Jarman, Robert

doi:10.1177/1742271x15579950

Cited by 14 publications

(3 citation statements)

References 12 publications

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“…The majority of foreign bodies consist either of metal, glass or wood [ 4 , 5 ]. In particular, wood, the most frequent type of foreign body in the extremities, is likely to be missed in 85–95% of patients at the initial radiographic examination because of its low attenuation property [ 1 , 3 , 4 , 6 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous wood and metal particle detection on dark-field radiography

et al. 2018

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BackgroundCurrently, the detection of retained wood is a frequent but challenging task in emergency care. The purpose of this study is to demonstrate improved foreign-body detection with the novel approach of preclinical X-ray dark-field radiography.MethodsAt a preclinical dark-field x-ray radiography, setup resolution and sensitivity for simultaneous detection of wooden and metallic particles have been evaluated in a phantom study. A clinical setting has been simulated with a formalin fixated human hand where different typical foreign-body materials have been inserted. Signal-to-noise ratios (SNR) have been determined for all test objects.ResultsOn the phantom, the SNR value for wood in the dark-field channel was strongly improved by a factor 6 compared to conventional radiography and even compared to the SNR of an aluminium structure of the same size in conventional radiography. Splinters of wood < 300 μm in diameter were clearly detected on the dark-field radiography. Dark-field radiography of the formalin-fixated human hand showed a clear signal for wooden particles that could not be identified on conventional radiography.Conclusionsx-ray dark-field radiography enables the simultaneous detection of wooden and metallic particles in the extremities. It has the potential to improve and simplify the current state-of-the-art foreign-body detection.

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Section: Introductionmentioning

confidence: 99%

Simultaneous wood and metal particle detection on dark-field radiography

et al. 2018

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“…It is our opinion that the removal of a knife should be carried out in a controlled environment, such as an operating room. Even if radiographic imaging indicates no foreign bodies present after direct withdrawal, surgical exploration and wound debridement should be performed to search for and extract any nonradiolucent foreign bodies, such as wood, plastic, or cloth fragments, which may remain [15]. Surgical intervention has been demonstrated to reduce delayed complications.…”

Section: Discussionmentioning

confidence: 99%

Breaking the Mold: Surgical Exploration for Spinal Impalement Injury Without Neurological Deficit

Kachare,

Jagiasi,

Sharan

et al. 2023

Cureus

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Spinal cord injuries (SCI) are a significant burden on society, particularly affecting the working population. Traumatic SCI can result from violent confrontations, involving firearms, knives, or edged weapons. Although surgical techniques for these injuries are not well defined, surgical exploration, decompression, and removal of the foreign body are currently indicated for patients with spinal stab wound injuries with neurologic impairment.We present a case of a 32-year-old male patient who presented to the emergency department with a stab injury with a knife. Radiographs and CT scans revealed a broken knife blade with a midline trajectory in the lumbar spine, moving toward the vertebral body of L2 occupying less than 10% of the intramedullary canal. The patient underwent surgery, and the knife was successfully extracted without any complications. Postoperative MRI showed no signs of cerebrospinal fluid (CSF) leak, and the patient did not exhibit any sensorimotor deficit.The acute trauma life support (ATLS) procedure must be followed while treating a patient with penetrating spinal trauma with or without neurological impairment. After availing appropriate investigations, any attempt to remove a foreign object should be done. Although spinal stab wound injuries are uncommon in developed nations, they continue to be a source of traumatic cord damage in underdeveloped countries. Our case highlights the successful surgical management of a spinal stab wound injury with a good outcome.

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“…Intra-cardiac foreign bodies are a rare occurrence and there is minimal literature on retained sutures post cardiac surgery. Due to the nonradiopaque structure of the sutures they are difficult to identify on plain radiography [4]. Intra-cardiac foreign bodies without a history of penetrating trauma are rare and may cause serious complications.…”

Section: Introductionmentioning

confidence: 99%

An Intracardiac Foreign Body: A Retained Suture in an Operated Infant with Congenital Heart Disease

Shortland¹

2021

JTCS

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Intra-cardiac foreign bodies are a rare occurrence and there is minimal literature on retention of sutures following cardiac surgery. This is an unusual case of a retained intracardiac prolene suture following surgical correction of Tetralogy of Fallot in a 6 month old patient. The patient had an uneventful post-surgical recovery but a foreign body was identified on a routine post-operative transthoracic echocardiogram. Due to the uncertain nature of the structure, the patient underwent fluoroscopy, chest X-ray and a cardiac CT which were unable to identify the nature of the structure. The best modality for identification was echocardiography, which consistently demonstrated the origin, and course of the suture. Due to a high level of suspicion and consistent findings on echocardiograms, the patient underwent surgical exploration 10 days following surgery and a prolene suture was identified originating in the right upper pulmonary vein extending though the mitral and aortic valve to the transverse aortic arch. This was thought to be from the purse string suture used for the left ventricular vent inserted via the right upper pulmonary vein during surgery.

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My patient is injured: identifying foreign bodies with ultrasound

Cited by 14 publications

References 12 publications

Simultaneous wood and metal particle detection on dark-field radiography

Simultaneous wood and metal particle detection on dark-field radiography

Breaking the Mold: Surgical Exploration for Spinal Impalement Injury Without Neurological Deficit

An Intracardiac Foreign Body: A Retained Suture in an Operated Infant with Congenital Heart Disease

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