Missing Radiopaque Foreign Body in Plain X-ray

Year 2016, Volume: 7 Issue: 1, 9 - 11, 01.01.2016

Muhammet Demir Abdurrahman Emir Kubilay Kınoğlu Ali Tavaslı Habib Bostan

Abstract

Introduction: The radiological investigations that will be performed after the hemodynamic stabilization of trauma cases presenting to the emergency room are of vital importance when deciding on the treatment to be administered to the patient. Posteroanterior chest radiography was not applied in the proper position, to include all the soft tissues of the chest and shoulder, after an injury caused by a sharp object in our case. Therefore, a radiopaque foreign object retained within the body was not detected.Case Report: Our case was brought to the emergency room because of a stabbing injury, but no pathological findings were determined at the initial examination or based on the X-graphs taken. Approximately 1 year after discharge, the patient presented to another hospital because of a persistent swelling and pain in the left armpit. A metallic image consistent with a knife point 7–8 cm in length was determined to be under the left armpit. Conclusion: The radiographs not taken in the proper position may lead to undesirable consequences. Therefore, we recommend that great attention should be paid while taking the radiographs, ensuring the proper position and careful evaluation

Keywords

Diagnostic imaging, emergency medicine, malpractice, forensic medicine

References

• Lomoschitz FM, Eisenhuber E, Linnau KF, Peloschek P, Schoder M, Bank- ier AA. Imaging of chest trauma: radiological patterns of injury and di- agnostic algorithms. Eur J Radiol 2003; 48: 61-70. [CrossRef]
• Gandhi TK, Kachalia A, Thomas EJ, Puopolo AL, Yoon C, Brennan TA, et al. Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. Ann Intern Med 2006; 145: 488-96. [CrossRef]
• Esme H, Solak O, Yavuz Y, Yurumez Y, Degirmenci B, Terzi Y. Effects of thoracic injuries that can only be detected by computed tomography on treatment and morbidity. Turkish J Thorac Cardiovasc Surg 2006; 14: 222-6.
• Trupka A, Waydhas C, Hallfeldt KK, Nast-Kolb D, Pfeifer KJ, Schweiberer L. Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospec- tive study. J Trauma 1997; 43: 405-11. [CrossRef]
• Reisdorf E, Schwartz T. Introduction to emergency radiology. In Schwartz T. Reisdorf E, Editor. Emergency Radiology. 1 st ed. New York: McGraw Hill, 2000. p. 1-10.
• Clinton J, Yaran M, Tsai S. Chest radiography in the emergency depart- ment. Ann Emerg Med 1986; 15: 254-6. [CrossRef]
• Bostan H, Karakaya MA, Demir M, Cagdir AS, Hanci V. A case of surgical instrument left in the abdomen and taken out of the transverse colon. Hippokratia 2014; 18: 77-9.
• Tugcu H, Yorulmaz C, Ceylan S, Baykal B, Celasun B, Koc S. The Knowl- edge And Ideas of the Physicians Who Participate in Emergency Ser- vices About Physician Responsibility in Emergency Cases and Forensic Medicine Problems. Gulhane Med J 2003; 45: 175-9.
• Kurtulus A, Acar K, Boz B. Legal responsibility of the physician. Journal of Academic Design 2008; 2: 10-4. JEMCR 2016; 1; 9-11
• Demir et al. Missing Radiopaque Foreign Body in Plain X-ray