A Comparative Study of Ultrasound Guided Versus Blind Surgical Removal of Foreign Bodies in Western Nepal

Prakash Sharma^1, , Prasanna Ghimire², Amar Gurung³, Chandra Bahadur Mishra⁴, Subita Lalchan¹, Subash KC¹, Merina Gyawali¹ and Prabhat Kumar Tiwari¹

¹Department of Radiology, Manipal Teaching Hospital, Pokhara, Nepal

²Department of Radiology, Nepalgunj Medical College Teaching Hospital, Kohalpur, Nepal

³Department of Surgery, Metrocity Hospital, Pokhara, Nepal

⁴Department of Orthopedics, Metrocity Hospital, Pokhara, Nepal

Cite this paper

Prakash Sharma, Prasanna Ghimire, Amar Gurung, Chandra Bahadur Mishra, Subita Lalchan, Subash KC, Merina Gyawali and Prabhat Kumar Tiwari. A Comparative Study of Ultrasound Guided Versus Blind Surgical Removal of Foreign Bodies in Western Nepal. American Journal of Public Health Research. 2015; 3(5A):186-189. doi: 10.12691/AJPHR-3-5A-39

Abstract

Ultrasound is effective in localization and removal of foreign body. This study was done to evaluate the role of ultrasonography in localization of foreign body and to compare the ultrasound guided foreign body removal with that of conventional surgical exploration without ultrasound guidance. This prospective study was conducted between September 2013 and July 2015. Patients more than 14 years of age old with clinical suspicion of retained foreign body were included in our study. Ultrasonography was done using 7.5 to 10 MHZ probe in Sonoace X6 and Logiq P3 machines. After exact localization patients were randomly selected into two groups. In the first group, removal was done using ultrasonography guidance by a radiologist using a standard technique. In the second group, removal was done by referring surgeon. Statistical analysis was done using SPSS 18. Age of the patients ranged from 15 to 85 years with the mean age of 37.7±17.7 years. M: F ratio was 2.2:1. Most common location of retained foreign body was foot. Most common type of retained foreign body was wooden piece. Sensitivity of ultrasound in detection of retained foreign body was 96.8%. There was no statistical difference between the length of foreign body as measured by ultrasonography before removal and by scale after removal. Duration required for removal of foreign body under ultrasonography guidance was significantly less. Post-operative scar was smaller in patients with ultrasound guided removal. In conclusion, ultrasound has a sensitivity of 96.8% in localization of foreign body. Ultrasonography guided removal of foreign body reduces the operation time with reduction in the post-operative scar.

Keywords

foreign body, removal, ultrasonography

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Crowford R, Matheson AB: Clinical value of ultrasonography in detection and removal of radiolucent foreign bodies.Injury 1989; 20:341-3.
[2]	Ober CP, Jones JC, Larson MM, Lanz OI, Werre SR: Comparison of ultrasound, computed tomography, and magnetic resonance imaging in detection of acute wooden foreign bodies in the canine manus.Vet Radiol Ultrasound 2008; 49(5):411-8.
[3]	Sharma P, Ghimire P, Lalchan S. Implication of ultrasonography in detection of retained soft tissue foreign bodies in children: a hospital based study from western Nepal. American Journal of public health research 2015; 3(4A):41-4.
[4]	Mohammadi A, Ghasemi-Rad M, Khodabakhsh M: Non-opaque soft tissue foreign body: Sonographic findings. BMC Medical Imaging 2001; 11: 9.
[5]	Callegari L, Leonardi A, Bini A, Sabato C, Nicotera P, Spano' E et al. Ultrasound-guided removal of foreign bodies: personal experience. Eur Radiol 2009; 19: 1273-9.
[6]	Jacobson JA, Powell A, Craig JG, Bouffard JA, van Holsbeeck MT. Wooden foreign bodies in soft tissue: detection at US. Radilogy 1998; 206 (1): 45-8.
[7]	Bray PW, Mahoney JL, Campbell JP: Sensitivity and specificity of ultrasound in the diagnosis of foreign bodies in the hand. J Hand Surg Am 1995; 20:661-6.
[8]	Gilbert FJ, Campbel RSD, Bayliss AP: The role of ultrasound in detection of non- opaque foreign bodies. Clin Radiol 1990; 40:109-12.
[9]	Sah PL, Ahmad K,Gupta MK,Dhungel K, Gupta RK, Ansari S. Wooden foreign bodies in soft tissue: role of tissue harmonic sonography. Health Renaissance 2013; 11(3):267-9.
[10]	Gibbs ST. The use of sonography in the identification, localization, and removal of soft tissue foreign bodies. J Diagn Med Sonogr 2006; 22: 5-21.
[11]	Casadei GFCuerpos extranos en partes blandas: diagnostic extraccion mediante guia ecograficaRevista de Imagenología 2012; 16 (1): 41-6.
[12]	Shiels WE 2nd, Babcock DS, Wilson JL, Burch RA. Localization and guided removal of soft-tissue foreign bodies with sonography. AJR Am J Roentgenol 1990; 155(6):1277-81.