William Eugene Shiels DO, Presenter: President, Mauka Medical Corporation Owner, Mauka Medical Corporation Patent holder, Shiels Intussusception Air Reduction Device

Adam Stephen Young BS, Abstract Co-Author: Nothing to Disclose

James Walter Murakami MD, Abstract Co-Author: Nothing to Disclose

Mark Joseph Hogan MD, Abstract Co-Author: Nothing to Disclose

Andrew Jered Rabe DO, Abstract Co-Author: Nothing to Disclose

Nicholas Andrew Zumberge MD, Presenter: Nothing to Disclose

Brian D. Coley MD, Abstract Co-Author: Nothing to Disclose

To report a 15 year clinical experience with image guided percutaneous soft tissue foreign body removal (IGFBR).

Six hundred four patients, ages 9 mo-55yr (avg=114 mo) underwent IGFBR with sonographic or fluoroscopic guidance (or combination). IGFBR was performed with either local anesthesia, or IV sedation. Blunt dissection and removal were performed with small Kelly or Hartman forceps. Sharp dissection was performed with either large gauge needle (12-18G) or #11 scalpel blade. US guided wire localization for operative removal was performed when IGFBR was not recommended. Data included location, FB size, FB type, incision size, duration, and complications.

Six hundred four patients underwent IGFBR with sonographic (393) or fluoroscopic guidance(118) (or combination; 74), for removal of 790 FBs. FB number-mean =1.39 FB/patient (range 1-15/patient). IGFBR was successful in 592/604 (98%) patients; fragmentation during removal occurred in 13/604 (2.1%). US guided wire localization was performed in 3/604 (0.4%). FB location: foot 338, leg 88, hand78, arm 50, face 15, abdoment 8, orbit 2, other 25. FB size-mean=13.4 mm; incision size, mean =5.1 mm; duration- mean=52.9 days (range=1-7300 days); FB type-wood 202, glass 187, metal 147, plastic 18, other-50. No complications occurred, to include no tendon, nerve, vascular injury, or hemorrhage.

IGFBR is safe and effective with sonographic and/or fluoroscopic guidance, in locations ranging from the trunk, extremities, face, neck, and orbit.

Soft tissue foreign body injury is a common clinical challenge; IGFBR is safe and effective with sonographic and/or fluoroscopic guidance, with sharp or blunt dissection.

Shiels, W, Young, A, Murakami, J, Hogan, M, Rabe, A, Zumberge, N, Coley, B, Percutaneous Image-guided Soft Tissue Foreign Body Removal: A 15 Year Experience.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010422.html