RESUMEN
The WATCHMAN™ atrial appendage closure device is designed to reduce the risk of stroke in patients with nonvalvular atrial fibrillation who are not suitable candidates for long-term oral anticoagulation therapy. However, the device also carries small risks, including procedural complications such as device migration, embolization, or pericardial effusion. We describe a case of WATCHMAN device migration requiring surgical retrieval.
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Apéndice Atrial , Fibrilación Atrial , Remoción de Dispositivos , Migración de Cuerpo Extraño , Humanos , Migración de Cuerpo Extraño/etiología , Migración de Cuerpo Extraño/cirugía , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/terapia , Fibrilación Atrial/cirugía , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Resultado del Tratamiento , Apéndice Atrial/diagnóstico por imagen , Apéndice Atrial/cirugía , Masculino , Cateterismo Cardíaco/instrumentación , Cateterismo Cardíaco/efectos adversos , Femenino , Anciano , Ecocardiografía Transesofágica , Diseño de PrótesisRESUMEN
INTRODUCTION: An endoscopic intragastric balloon (IGB) placement is one of the minimally invasive methods of obesity treatment. One of the rare serious complications is mechanical bowel obstruction requiring operative management. We report a case of a male patient with small bowel obstruction due to IGB migration and the literature review of complications during IGB treatment. Detailed Case Description: A patient with a BMI of 28 kg/m2 was admitted to the hospital with spontaneous deflation of an IGB. Due to the suspected location of IGB in the ileum laparoscopy was performed. The enterotomy was performed and the IGB removed. The procedure and the postoperative period were uneventful. DISCUSSION: Spontaneous IGB ruptures are reported in the literature with a frequency ranging from 0.6 to 23%. The majority of deflated devices are spontaneously excreted with the stool with no abdominal symptoms. Only 0.38% of IGBs cause mechanical bowel obstruction of requiring surgical management. Based on our own experience and literature review, we propose the diagnostic and therapeutic algorithm. CONCLUSION: Complications after IGB placement can range from mild to severe, that is why it is so important to make an early diagnosis based on the emerging symptoms and to implement prompt management to reduce or avoid serious complications. Any patient reporting disturbing symptoms occurring over a pro- longed period of time requires hospitalization and careful observation for the occurrence of gastrointestinal obstruction. The ideal option is hospitalization in the center which implemented the IGB and start with the algorithm we proposed.
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Migración de Cuerpo Extraño , Balón Gástrico , Obstrucción Intestinal , Humanos , Masculino , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Balón Gástrico/efectos adversos , Migración de Cuerpo Extraño/cirugía , Migración de Cuerpo Extraño/etiología , Obesidad Mórbida/cirugía , Resultado del Tratamiento , Intestino Delgado , Adulto , Laparoscopía/efectos adversos , Persona de Mediana EdadRESUMEN
RATIONALE: Gossypiboma is a term that refers to the condition of accidentally retained surgical gauze after surgeries. While many manifestations and complications are possible in this case, the migration of the retained gauze into the gastric cavity is one of the rarest. In this paper, we report the largest migrated surgical towel to the gastric cavity in the literature, measuring 90â cmâ ×â 90â cm. PATIENT CONCERNS: A 33-year-old woman with recurrent epigastric pain unresponsive to treatment was referred to our hospital. She had undergone an open surgery cholecystectomy 11 years before admission during wartime in Syria. DIAGNOSES: Abdominal computed tomography with contrast showed a large mass in the stomach, indicating malignancy. However, upper gastrointestinal endoscopy revealed a gray-black foreign body occupying the entire gastric lumen, which indicated the presence of bezoar. Upon surgery, the final diagnosis of gastric gossypiboma was made; which was a retained surgical towel from the previous cholecystectomy that had fully migrated to the stomach and resembled both malignancy and bezoar upon investigation. INTERVENTIONS: The patient underwent open surgery to excise the foreign body. OUTCOMES: The gossypiboma was successfully removed, and the patient was discharged 5 days after the operation without complications. LESSONS: Retained surgical items, such as gossypiboma, can lead to significant medical complications. The migration of gossypiboma to the stomach, though rare, poses challenges in diagnosis and management, often requiring open surgical removal to prevent adverse outcomes. Early detection and intervention are crucial to avoiding associated morbidity and mortality. It is important to consider gossypiboma in patients with unexplained abdominal pain following surgery and to emphasize meticulous sponge counting to prevent this complication.
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Migración de Cuerpo Extraño , Estómago , Tapones Quirúrgicos de Gaza , Humanos , Femenino , Adulto , Migración de Cuerpo Extraño/cirugía , Migración de Cuerpo Extraño/diagnóstico , Tapones Quirúrgicos de Gaza/efectos adversos , Estómago/cirugía , Colecistectomía/efectos adversos , Colecistectomía/métodos , Cuerpos Extraños/cirugía , Tomografía Computarizada por Rayos XRESUMEN
This case report details a rare case of contraceptive implant migration in a young woman. The migration was discovered three years post-insertion during a routine replacement visit. Despite the absence of pulmonary symptoms, a CT scan revealed the implant in the inferior lobe of the right lung. The patient was referred for further evaluation, but immediate surgical removal was deferred. This case report highlights the importance of healthcare providers recognising migration as a rare complication during implantation and suggests self-examination as a potential preventive strategy.
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Anticonceptivos Femeninos , Implantes de Medicamentos , Migración de Cuerpo Extraño , Tomografía Computarizada por Rayos X , Humanos , Femenino , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/cirugía , Implantes de Medicamentos/efectos adversos , Anticonceptivos Femeninos/efectos adversos , Anticonceptivos Femeninos/administración & dosificación , Pulmón/diagnóstico por imagen , Pulmón/cirugía , Adulto , Desogestrel/efectos adversos , Desogestrel/administración & dosificaciónRESUMEN
Hardware breakage in the form of guide wire or drill bit is a devastating complication particularly if occurs around hip joint during cephalo-medullary nailing. It should be removed on urgent basis as it can migrate to the pelvic cavity and damages adjacent neuro-vascular bundle and visceral organ immediately as well joint arthritis later on. There are very few cases report available in the literature with retrieval techniques by using disc forceps, pituitary forceps, oversized reamers, arthrotomy with joint dislocation and through ilioinguinal approaches occasionally. We are presenting an interesting and rare case of broken guide wire inside hip joint protruding into the pelvic cavity which got retrieved through lower midline open laparotomy approach.
RésuméLa rupture du matériel sous forme de fil de guidage ou de foret est une complication dévastatrice, en particulier si elle se produit autour de l'articulation de la hanche lors du clouage céphalo-médullaire. Il doit être retiré de toute urgence car il peut migrer vers la cavité pelvienne et endommager immédiatement le faisceau neuro-vasculaire et l'organe viscéral adjacents, ainsi que l'arthrite articulaire plus tard. Il existe très peu de cas rapportés dans la littérature avec des techniques de récupération utilisant des pinces discales, des pinces hypophysaires, des alésoirs surdimensionnés, des arthrotomies avec luxation articulaire et occasionnellement par des approches ilio-inguinales. Nous présentons un cas intéressant et rare de fil guide cassé à l'intérieur de l'articulation de la hanche faisant saillie dans la cavité pelvienne, qui a été récupéré par une approche de laparotomie ouverte sur la ligne médiane inférieure.
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Articulación de la Cadera , Humanos , Articulación de la Cadera/cirugía , Articulación de la Cadera/diagnóstico por imagen , Resultado del Tratamiento , Remoción de Dispositivos/métodos , Femenino , Hilos Ortopédicos/efectos adversos , Falla de Equipo , Fijación Intramedular de Fracturas/instrumentación , Fijación Intramedular de Fracturas/efectos adversos , Migración de Cuerpo Extraño/cirugía , Masculino , Adulto , Cuerpos Extraños/cirugía , Cuerpos Extraños/diagnóstico por imagen , PelvisAsunto(s)
Prótesis Valvulares Cardíacas , Corazón Auxiliar , Humanos , Resultado del Tratamiento , Cateterismo Cardíaco/instrumentación , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Reemplazo de la Válvula Aórtica Transcatéter/instrumentación , Masculino , Implantación de Prótesis de Válvulas Cardíacas/instrumentación , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Embolia/etiología , Embolia/diagnóstico por imagen , Embolia/terapia , Migración de Cuerpo Extraño/etiología , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/terapia , Anciano , Femenino , EmbolectomíaRESUMEN
BACKGROUND: The aim of this research was to analyse the current literature on displaced dental implants in the mandibular body, including local and systemic variables related to their cause, and to identify the most frequent location. METHODS: The study conducted a search of three databases (Pubmed, Scopus, and Web of Science) using specific index terms such as 'dental implant', 'displacement', 'dislocation', 'displaced', and 'mandible'. The analysis focused on the direction of displacement and the characteristics of the bone tissue (bone quality, density, and quantity) in cases where dental implants were displaced. RESULTS: A total of 371 articles were obtained. Thirteen of these articles were selected and read in full. To define bone quality, the Lekholm and Zarb classification, modified by Rosas et al., was used. The type II-B bone, which is characterized by thick cortical bone surrounding cancellous bone with extremely wide medullary spaces, presented the largest number of complications. Twenty-two cases were found in which the displacement direction was horizontal. Of these, four were displaced vestibularly, fourteen lingually, and four remained in the center. Additionally, 24 cases presented vertical displacement, with 12 displaced towards the inferior border of the mandible, 9 towards the middle or adjacent to the inferior dental nerve canal, and 3 above the inferior dental nerve canal. CONCLUSION: The accidental displacement of implants within the mandibular body is associated with various risk factors, including the characteristics of the bony trabeculum and the size of the medullary spaces. It is reasonable to suggest that only an adequate pre-surgical diagnostic evaluation, with the help of high-resolution tomographic images that allow a previous evaluation of these structures, will help to have better control over the other factors, thus minimizing the risk of displacement.
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Implantes Dentales , Mandíbula , Humanos , Implantes Dentales/efectos adversos , Mandíbula/diagnóstico por imagen , Factores de Riesgo , Migración de Cuerpo Extraño/prevención & control , Migración de Cuerpo Extraño/etiología , Densidad Ósea , Fracaso de la Restauración DentalRESUMEN
A woman in her 20s was referred to a tertiary hospital emergency department for management of a migrating Implanon NXT. The Implanon was inserted 1 week prior by the patient's general practitioner who was unable to palpate the Implanon after insertion and hence, ordered an ultrasound scan which showed an actively migrating Implanon in the left basilic vein. She had mild chest pain, and her physical examination, ECG and blood tests were unremarkable. A CT chest showed a 31 mm foreign body within the right lower lobar artery. The foreign body was removed by interventional radiology by accessing the right internal jugular vein under ultrasound guidance and inserting a 6 FR pig catheter into the pulmonary trunk. The position was confirmed with angiogram and the foreign body was removed using a goose neck snare. The patient was discharged the same day with no complications, and fell pregnant a few months afterwards.
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Desogestrel , Migración de Cuerpo Extraño , Arteria Pulmonar , Humanos , Femenino , Migración de Cuerpo Extraño/cirugía , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/complicaciones , Arteria Pulmonar/diagnóstico por imagen , Desogestrel/efectos adversos , Desogestrel/administración & dosificación , Anticonceptivos Femeninos/efectos adversos , Anticonceptivos Femeninos/administración & dosificación , Remoción de Dispositivos , Procedimientos Endovasculares , Adulto Joven , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Fish bone ingestion is commonly encountered in emergency department. It poses a diagnostic and therapeutic challenge particularly when it migrates extraluminally, necessitating a comprehensive and multidisciplinary approach for successful management. CASE PRESENTATION: Here we reported four cases of extraluminal fish bone. The first patient was a 68-year-old Chinese man who had odynophagia shortly after a meal involving fish. The second was a 50-year-old Iban man who reported a sharp throat pain after consuming fish 1 day prior. The third patient was a 55-year-old Malay woman who developed throat pain and odynophagia after consuming fish 1 day earlier. The fourth patient, a 70 year-old Iban man, presented late with odynophagia, neck pain, swelling, and fever 1 week after fish bone ingestion. These unintentional fish bone ingestions faced challenges and required repeat computed tomography scans using multiplanar reconstruction in guiding the surgical removal of the fish bone. CONCLUSION: We underscore the significance of multiplanar reconstruction in pinpointing the fish bone's location, demonstrating the migratory route, and devising an accurate surgical plan.
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Peces , Cuerpos Extraños , Tomografía Computarizada por Rayos X , Humanos , Anciano , Masculino , Femenino , Persona de Mediana Edad , Animales , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/cirugía , Huesos/diagnóstico por imagenRESUMEN
CASE: We present a unique case of a 45-year-old man with his right middle finger embedded with rings. Limited finger flexion was noted because of flexor tendon injury caused by the dorsal migration of the embedded ring through joint. The rings were removed under anesthesia, resulting in the resolution of swelling and recover of osseous structure. Follow-up examinations revealed no residual edema or numbness, indicating preserved neurovascularization, despite the dorsal migration of the ring. CONCLUSION: Our unique case reveals continuous finger ring migration without compromising neurovascular bundles, with review of 30 cases emphasizing the importance of psychiatric consultation. Timely intervention yielded nearly half of patients achieving full recovery.
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Articulaciones de los Dedos , Humanos , Masculino , Persona de Mediana Edad , Traumatismos de los Dedos/cirugía , Migración de Cuerpo Extraño/diagnóstico por imagenRESUMEN
Proximal migration of double J (DJ) stent after pyeloplasty poses a difficult problem in infants whose small ureter renders retrograde ureteroscopic retrieval difficult. Previously described antegrade techniques used large access sheaths or blind removal under fluoroscopic guidance. We describe a technique for antegrade retrieval of the stent under direct vision. A 8F vascular access sheath is placed into the renal pelvis under ultrasound guidance. A 6F nephroscope with 3F forceps placed through the sheath grasps and retrieves the stent under direct visualization. This technique is simple, quick, avoids radiation exposure and was used by us successfully in 2 small infants.
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Remoción de Dispositivos , Migración de Cuerpo Extraño , Pelvis Renal , Stents , Obstrucción Ureteral , Humanos , Pelvis Renal/cirugía , Lactante , Migración de Cuerpo Extraño/cirugía , Remoción de Dispositivos/métodos , Obstrucción Ureteral/cirugía , Masculino , FemeninoRESUMEN
The current state of the literature for a bullet embolization to the heart and/or pulmonary vasculature indicates the occurrence is rare but could increase due to the rise in civilian low-kinetic-energy firearm acquisition and use. We present the case of an older teenage male who sustained a gunshot wound to the left flank. The bullet entered the iliac vein, travelled through the heart and lodged in the pulmonary artery. Successful relocation of the bullet to the internal iliac vein was performed by the interventional radiologist. This article highlights the advancement of interventional radiology as a successful non-invasive endovascular technique for bullet embolus removal.
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Procedimientos Endovasculares , Migración de Cuerpo Extraño , Arteria Pulmonar , Heridas por Arma de Fuego , Humanos , Heridas por Arma de Fuego/complicaciones , Heridas por Arma de Fuego/diagnóstico por imagen , Heridas por Arma de Fuego/cirugía , Masculino , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/lesiones , Arteria Pulmonar/cirugía , Resultado del Tratamiento , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/etiología , Migración de Cuerpo Extraño/cirugía , Migración de Cuerpo Extraño/terapia , Procedimientos Endovasculares/instrumentación , Adolescente , Radiografía Intervencional , Vena Ilíaca/diagnóstico por imagen , Vena Ilíaca/lesiones , Vena Ilíaca/cirugía , Angiografía por Tomografía Computarizada , Embolia Pulmonar/etiología , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/cirugía , Embolia Pulmonar/terapiaRESUMEN
Percutaneous testicular varicocele embolisation for symptomatic and subfertile males is often preferred over surgical ligation of the gonadal vein due to its minimally invasive approach and reduced complication rate. Glues, coils, vascular plugs, balloons and sclerosants are used in various combinations to achieve sufficient venous occlusion. Here, we report on the first known case of sclerosant material migration beyond the placement of an embolisation coil for treatment of a varicocele, resulting in a left renal vein thrombus. A man in his 20s presented to the emergency department 2 days following uncomplicated left varicocele embolisation with acute left-sided abdominal pain, found to have sclerosant material causing an ipsilateral non-occlusive left renal vein thrombus with extension towards his inferior vena cava on CT. He was treated with 3 months of anticoagulation and follow-up imaging at 3 months showed resolution of this thrombus without renal impairment.
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Embolización Terapéutica , Venas Renales , Varicocele , Humanos , Masculino , Varicocele/terapia , Embolización Terapéutica/métodos , Embolización Terapéutica/efectos adversos , Venas Renales/diagnóstico por imagen , Migración de Cuerpo Extraño , Soluciones Esclerosantes/administración & dosificación , Soluciones Esclerosantes/uso terapéutico , Adulto , Adulto Joven , Tomografía Computarizada por Rayos XRESUMEN
Ventriculoperitoneal shunt (VPS) is the most common procedure done for hydrocephalus in the paediatric population. While shunt infection and shunt malfunction remain the most common complications, shunt migration is not frequently observed. Being present in a large peritoneal cavity, theoretically, a shunt can travel to a variety of locations. Even among these, scrotal migration is quite uncommon. This case highlights the significance of keeping this possibility in mind while evaluating a case of shunt malfunction. It also discusses various nuances of surgically managing scrotal migration.
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Migración de Cuerpo Extraño , Hidrocefalia , Escroto , Derivación Ventriculoperitoneal , Humanos , Derivación Ventriculoperitoneal/efectos adversos , Masculino , Escroto/cirugía , Migración de Cuerpo Extraño/cirugía , Hidrocefalia/cirugíaRESUMEN
BACKGROUND: Conversion of SG to Roux-en-Y gastric bypass (RYGB) is increasing. Intrathoracic migration of the sleeve (ITM) often seems associated and is increasingly reported. MATERIAL AND METHODS: Patients who underwent a conversion of SG to RYGB from August 2013 to December 2022 were included. Two groups were compared: patients operated on for weight loss failure (WLF gp) and those operated on for gastroesophageal reflux disease (GERD gp). Demographic data, the incidence of ITM, weight loss outcomes, resolution of symptoms, and morbidity were analyzed. RESULTS: Fifty-nine patients were included with an average follow-up of 32 months: 46 patients in the GERD gp (78%) were compared to 13 patients (22%) in the WLF gp. Groups were comparable regarding age and gender, but BMI and commodities were significantly higher in the WLF gp. In the GERD gp, on preoperative gastroscopy, 30% had a esophagitis, 48% had an ITM which required a posterior crural closure versus no esophagitis (p=0.02) and 23% of ITM in the WLF gp (p=0.11). Conversion led to 93% of GERD symptom improvement. In the WLF gp, mean TWL% was 15.3%, significantly greater than in the GERD gp (TWL% = 4.6%, p = 0.01). The complication rate was 10% at 30 days and 3.4% after 30 days, not significantly different between groups. CONCLUSION: The main indication of conversion of SG to RYGB was because of GERD: in these indications, the incidence of ITM was high requiring a surgical treatment with a very good efficacy on symptoms. Weight loss results were disappointing.