Image-guided soft-tissue foreign body extraction - success and pitfalls

Abstract

Aim: To outline the pitfalls for image-guided percutaneous removal of foreign bodies (FBs).

Materials and methods: Three hundred and fifty prospective patients were referred for ultrasound imaging for FB diagnosis and percutaneous removal during 2008-2010. Those patients with suitable FBs were offered guided percutaneous removal. The procedural methods and difficulties were recorded and all outcomes were noted, including surgical success and complications.

Results: Sixty-three patients had a negative ultrasound for FB and they were discharged with no subsequent attendances. Of the remaining 287 patients, 12 were deemed unsuitable for percutaneous removal, 15 attempted percutaneous removals failed, and eight were not attempted due to lack of symptoms. The remaining 252 patients underwent successful retrieval and there were no procedural complications. The procedural limitations were mainly related to the anatomical site, type of FB, instrumentation, bubbles, ultrasound beam width, and mobility of the FB.

Conclusion: Ultrasound-guided percutaneous removal of FBs is a safe and viable approach to the management of FBs achieving at least 88% success overall and with attention to the pitfalls, the learning curve should improve the success rate.