Pleural effusion in a 10-year-old boy 1 year after a fall through a glass door

Brady, Jodi; Kost, Susanne

doi:10.1097/00006565-200304000-00006

Cited by 1 publication

(8 citation statements)

References 26 publications

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“…This minimally invasive approach was also effectively employed in 4 instances immediately after glass impalement 6,7,9,113 and once with an 8-month delay 8 . In other situations, involving intrathoracic glass near critical or complex structures as the heart, major blood vessels, diaphragm, or during emergency situations with limited visibility, an open approach was preferred even in recent years 11,15,17–20 . Glass foreign bodies appear to induce minimal fibrotic or adhesive reaction in their surroundings, likely due to their smooth and aseptic surfaces.…”

Section: Discussionmentioning

confidence: 99%

“…Glass foreign bodies appear to induce minimal fibrotic or adhesive reaction in their surroundings, likely due to their smooth and aseptic surfaces. Adhesions were only encountered in cases where there was a hematoma, infection, or repeated trauma 11,14,15,17,22,37 . In contrast, many nonglass foreign bodies reported in the literature caused strong pleural adhesions, necessitating open surgical access 3 …”

Section: Discussionmentioning

confidence: 99%

“…Traumatic damage to the parietal pleura often results in certain expected consequences such as pleural effusion, hemothorax, and, particularly with sharp glass foreign bodies, pneumothorax. 6,7,9,15 Documented cases exist where sharp foreign bodies, such as glass shards, 8,11 acupuncture needles, 69,70 and loose Kirschner wires, 71 have gradually migrated into the pleura, ultimately causing the development of hemothorax and pneumothorax. However, there have been cases involving other types of sharp foreign bodies, such as needles, [72][73][74][75] Kirschner wires, [76][77][78] and fixation pins, [79][80][81] which appeared to migrate transthoracically into the lung without causing pneumothorax.…”

Section: Hypothesis Of a Current Impalement Traumamentioning

confidence: 99%

“…8 In other situations, involving intrathoracic glass near critical or complex structures as the heart, major blood vessels, diaphragm, or during emergency situations with limited visibility, an open approach was preferred even in recent years. 11,15,[17][18][19][20] Glass foreign bodies appear to induce minimal fibrotic or adhesive reaction in their surroundings, likely due to their smooth and aseptic surfaces. Adhesions were only encountered in cases where there was a hematoma, infection, or repeated trauma.…”

Section: Treatmentmentioning

confidence: 99%

“…Adhesions were only encountered in cases where there was a hematoma, infection, or repeated trauma. 11,14,15,17,22,37 In contrast, many nonglass foreign bodies reported in the literature caused strong pleural adhesions, necessitating open surgical access. 3 The question lingers as to whether the asymptomatic pleural foreign body in our case should have been removed sooner.…”

Section: Treatmentmentioning

confidence: 99%

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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%

Section: Discussionmentioning

confidence: 99%