- In these two cases the usefulness of the US / Fluoroscopy is shown; although very basic,
gives a lot of utility and benefits to the patients,
allowing less aggressive procedures,
which lead to a quick recovery.
- in both case a US with linear 9 Mhz transducer was used.
The fluoroscopic study was performed for the location of the foreign body; using minor surgery equipment to remove it.
- The performing technique uses a minimally invasive incisions and extracting the foreign body with minimal tissue damage which accelerates its quickly recovery.
CASE 1
Female patient,
31 years-old,
seamstress,
accidentally injured with a sewing machine needle 15 days ago,
introduced in the plantar region,
lodged in soft tissue,
in the lower portion of the left calcaneus bone,
which causes pain in the plantar region.
Evaluation by Rx
Fig. 2
Fig. 2: RX. Simple with projections A. Oblique and B. Lateral. Showing radio opaque foreign body, in soft tissue in lower portion of the calcaneus bone, intimately related to cortical bone.
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
Evaluation by US
Fig. 3
Fig. 3: US showing hyperechoic linear image of 27 mm in length, in soft tissue in the posterior plantar region of the left foot, no reverberation image is observed despite being a metallic object.
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
With asepsis and antisepsis technique,
and local anesthetics,
make a linear incision less than 1cm,
it is dissected with hemostatic forceps with minimal soft tissue lesion,
then guided by US,
a foreign body (needle) of 27mm in length is reached,
removing it,
with favorable evolution and without complications.
Fig. 4
Fig. 4: Multiple images, extraction a foreign body guided by US. Minimal soft tissue lesion with favorable evolution and without complications for the patient.
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
Fig. 5
Fig. 5: Multiple images of Rx. Simple and US, sequential photography of event management to solve the problem, with favorable evolution and without complications for the patient.
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
CASE 2
A 49-year-old housewife,
with a history of 3 weeks of evolution,
who accidentally a sewing needle fragment was introduced in the right hand,
with pain and inflammation.
The surgery service attempted to remove it without success by simple exploration.
It is assesed by an interventional radiology service,
proceeding to extract foreign body (needle) guided by US and Fluoroscopy,
with minimally invasive technique.
Fig. 6
Fig. 6: RX. Simple with multiple projections of the right hand, with a radio opaque foreign body, in a hypothenar region embedded in the base of the fifth metacarpal.
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
With asepsis and antisepsis technique,
and local anesthetics,
it is made the a linear incision less than 1cm,
it is dissected with hemostatic forceps with minimal soft tissue lesion,
then guided by FLUROSCOPY a foreign body (needle) is reached,
removed.
With favorable evolution and without complications.
Fig. 7
Fig. 7: Sequential images of Fluroscopy when extracting the foreign body.
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
EXTRACTING BY FLUROSCOPY,
VIDEO.
Fig. 8
Fig. 8: VIDEO 1: EXTRACTING BY FLUROSCOPY
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
Fig. 9
Fig. 9: Minimal soft tissue lesion when extraction guided by FLUROSCOPY
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.
Fig. 10
Fig. 10: Multiple images of Rx. simple, fluoroscopy and sequential photography of event management, until resolution of the problem, with favorable evolution and without complications for the patient
References: Department of Radiology, Hospital Escuela Universitario. Tegucigalpa, Honduras.