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Görüntüleme Yöntemleriyle Saptanamayan Yabancı Cisim Batması

Year 2025, Volume: 16 Issue: 2, 59 - 61, 29.06.2025

Abstract

Giriş: Bu olgu sunumunda, görüntüleme yöntemlerinde gözden kaçan bir erkek çocuğun gluteal bölgesine batan yabancı cisim olgusunu sunmayı amaçladık.
Olgu sunumu: 11 yaşında bir erkek çocuk, ailesi tarafından, oyun oynamak için yerleştirdikleri eğimli bir tahtada kayarken sol iç kalça bölgesine bir kıymık girdiğini bildirmesi üzerine acil servise getirildi. Hastanın ağrı belirttiği sol iç kalça bölgesinde, muhtemelen giriş noktasına denk gelen bir lezyon tespit edildi. Ancak muayenede yabancı bir cisim veya sertlik hissedilmedi. Yüzeysel bir ultrason (US) incelemesi yapıldı ve lezyon bölgesinde veya çevresinde herhangi bir patoloji bulunamadı. Hastanın şiddetli ağrısı devam ettiği için pelvik bilgisayarlı tomografi (BT) taraması yapıldı. Pelvis BT tetkikinde cilt lezyonun olduğu bölgede hava dansiteleri tespit edildi ancak bunun dışında başka patoloji saptanmadı. Daha sonra hastanın şikâyetlerinin devam etmesi üzerine cilt lezyonundan başlayarak hava dansiteleri üzerinden devam eden trase boyunca tekrar muayene edildi. Bu muayenede cilt lezyonundan devam eden trase sonunda sağ kalça üst dış tarafta cilt altında ele gelen sertlik saptandı. Ele gelen sertlik olan yerin üzerinden bir insizyon yapıldı. Yabancı cisim görülmesi üzerine çocuk cerrahi bölümüne konsülte edildi. Daha sonra çocuk cerrahisi tarafından yapılan işlemle yaklaşık 35x0.8 cm boyutlarında yabancı cisim çıkarıldı.
Sonuç: Yabancı cisim batması vakalarında US ve BT gibi görüntüleme yöntemleri tanı için önemli olmakla birlikte, görüntüleme yöntemlerinin yardımcı olmadığı nadir durumlarda kapsamlı bir öykü ve fizik muayenenin en etkili yaklaşım olduğu unutulmamalıdır.

References

  • 1. Steele M, Tran L, Watson W, Muelleman RL. Retained glass foreign bodies in wounds: predictive value of wound characteristics, patient perception, and wound exploration. Am J Emerg Med 1998;16:627–30.
  • 2. Vukmir RB. Medical malpractice: managing the risk. Med Law 2004; 23:495-513.
  • 3. Potini VC, Francisco R, Shamian B, Tan V. Sequelae of foreign bodies in the wrist and hand. Hand (NY) 2013;8:77–81.
  • 4. Levine MR, Gorman SM, Young CF, Courtney DM. Clinical characteristics and management of wound foreign bodies in the ED. Am J Emerg Med2008;26:918–22.
  • 5. Kaiser CW, Slowick T, Spurling KP, Friedman S.Retained foreign bodies. J Trauma 1997;43:107–11.
  • 6. Halaas GW. Management of foreign bodies in the skin. Am Fam Physician 2007;76:683–90.
  • 7. DeBoard RH, Rondeau DF, Kang CS, Sabbaj A, McManus JG. Principles of basic wound evaluation and management in the emergency department. Emerg Med Clin North Am 2007;25:23–39.
  • 8. Haghnegahdar A, Shakibafard A, Khosravifard N. Comparison between Computed Tomography and Ultrasonography in Detecting Foreign Bodies Regarding Their Composition and Depth: an In Vitro Study. J Dent (Shiraz) 2016;17(3):177–84.
  • 9. Peterson JJ, Bancroft LW, Kransdorf MJ. Wooden foreign bodies: imaging appearance. AJR Am J Roentgenol 2002;178(3):557–62.
  • 10. Aras MH, Miloglu O, Barutcugil C, Kantarci M, Ozcan E, Harorli A. Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonography. Dentomaxillofac Radiol 2010;39(2):72–8.

Retained foreign body not detected by imaging methods

Year 2025, Volume: 16 Issue: 2, 59 - 61, 29.06.2025

Abstract

Introduction: In this case presentation, we aimed to present a case of a retained foreign body in the gluteal region of a male child that was overlooked in imaging methods.
Case report: An 11-year-old male child was brought to the emergency department by his family after reporting that a splinter had entered his left inner hip area while sliding on a slanted board they had placed to play. A lesion was detected on the left inner hip area, where the patient indicated pain, potentially corresponding to the point of entry. However, no foreign object or hardness was felt upon examination. A superficial ultrasound (US) examination was performed, and no pathology was found in the lesion site or the surrounding area. As the patient's severe pain persisted, a pelvic computed tomography (CT) scan was conducted. The pelvic CT scan revealed air densities in the region of the skin lesion, but no other pathology was identified. Later, due to the continuation of the patient’s complaints, the area was done repeat physical examination along the air densities starting from the skin lesion. During this examination, a hardness was detected under the skin on the upper outer side of the right hip, at the end of the tract originating from the skin lesion. An incision was made at the site of the palpable hardness. Upon finding a foreign object, the child was made consultation to the pediatric surgery department. The foreign body, measuring approximately 35x0.8 cm, was then removed in a procedure performed by the pediatric surgery team.
Conclusion: In cases of retained foreign body, although imaging methods such as US and CT are important for diagnosis, it should be remembered that in rare cases where imaging methods are not helpful, a thorough history and physical examination remain the most effective approach.

References

  • 1. Steele M, Tran L, Watson W, Muelleman RL. Retained glass foreign bodies in wounds: predictive value of wound characteristics, patient perception, and wound exploration. Am J Emerg Med 1998;16:627–30.
  • 2. Vukmir RB. Medical malpractice: managing the risk. Med Law 2004; 23:495-513.
  • 3. Potini VC, Francisco R, Shamian B, Tan V. Sequelae of foreign bodies in the wrist and hand. Hand (NY) 2013;8:77–81.
  • 4. Levine MR, Gorman SM, Young CF, Courtney DM. Clinical characteristics and management of wound foreign bodies in the ED. Am J Emerg Med2008;26:918–22.
  • 5. Kaiser CW, Slowick T, Spurling KP, Friedman S.Retained foreign bodies. J Trauma 1997;43:107–11.
  • 6. Halaas GW. Management of foreign bodies in the skin. Am Fam Physician 2007;76:683–90.
  • 7. DeBoard RH, Rondeau DF, Kang CS, Sabbaj A, McManus JG. Principles of basic wound evaluation and management in the emergency department. Emerg Med Clin North Am 2007;25:23–39.
  • 8. Haghnegahdar A, Shakibafard A, Khosravifard N. Comparison between Computed Tomography and Ultrasonography in Detecting Foreign Bodies Regarding Their Composition and Depth: an In Vitro Study. J Dent (Shiraz) 2016;17(3):177–84.
  • 9. Peterson JJ, Bancroft LW, Kransdorf MJ. Wooden foreign bodies: imaging appearance. AJR Am J Roentgenol 2002;178(3):557–62.
  • 10. Aras MH, Miloglu O, Barutcugil C, Kantarci M, Ozcan E, Harorli A. Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonography. Dentomaxillofac Radiol 2010;39(2):72–8.
There are 10 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Case Report
Authors

Mustafa Çiftçi 0009-0003-4021-8303

Muhammet Gökhan Turtay 0000-0002-6213-3963

Naim Hikmet Kalkan 0009-0007-5829-993X

Furkan Tayiz 0009-0001-4092-0202

Publication Date June 29, 2025
Submission Date March 2, 2025
Acceptance Date March 20, 2025
Published in Issue Year 2025 Volume: 16 Issue: 2

Cite

APA Çiftçi, M., Turtay, M. G., Kalkan, N. H., Tayiz, F. (2025). Retained foreign body not detected by imaging methods. Journal of Emergency Medicine Case Reports, 16(2), 59-61. https://doi.org/10.33706/jemcr.1649385
AMA Çiftçi M, Turtay MG, Kalkan NH, Tayiz F. Retained foreign body not detected by imaging methods. Journal of Emergency Medicine Case Reports. June 2025;16(2):59-61. doi:10.33706/jemcr.1649385
Chicago Çiftçi, Mustafa, Muhammet Gökhan Turtay, Naim Hikmet Kalkan, and Furkan Tayiz. “Retained Foreign Body Not Detected by Imaging Methods”. Journal of Emergency Medicine Case Reports 16, no. 2 (June 2025): 59-61. https://doi.org/10.33706/jemcr.1649385.
EndNote Çiftçi M, Turtay MG, Kalkan NH, Tayiz F (June 1, 2025) Retained foreign body not detected by imaging methods. Journal of Emergency Medicine Case Reports 16 2 59–61.
IEEE M. Çiftçi, M. G. Turtay, N. H. Kalkan, and F. Tayiz, “Retained foreign body not detected by imaging methods”, Journal of Emergency Medicine Case Reports, vol. 16, no. 2, pp. 59–61, 2025, doi: 10.33706/jemcr.1649385.
ISNAD Çiftçi, Mustafa et al. “Retained Foreign Body Not Detected by Imaging Methods”. Journal of Emergency Medicine Case Reports 16/2 (June 2025), 59-61. https://doi.org/10.33706/jemcr.1649385.
JAMA Çiftçi M, Turtay MG, Kalkan NH, Tayiz F. Retained foreign body not detected by imaging methods. Journal of Emergency Medicine Case Reports. 2025;16:59–61.
MLA Çiftçi, Mustafa et al. “Retained Foreign Body Not Detected by Imaging Methods”. Journal of Emergency Medicine Case Reports, vol. 16, no. 2, 2025, pp. 59-61, doi:10.33706/jemcr.1649385.
Vancouver Çiftçi M, Turtay MG, Kalkan NH, Tayiz F. Retained foreign body not detected by imaging methods. Journal of Emergency Medicine Case Reports. 2025;16(2):59-61.