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Retained wooden foreign body in a child's parotid gland: a case report
A L Woolley1, L T Wimberly, S A Royal
1Children's Hospital of Alabama, Birmingham 35216, USA.
Abstract:
Foreign bodies can present a diagnostic challenge to even the experienced surgeon. In one review of 200 surgical cases involving retained foreign bodies, one-third of the cases had been initially missed. Wooden foreign bodies in particular pose a challenge to the physician. In the review cited above, only 15% of wooden foreign bodies were well visualized on plain radiographs. Acutely, on computed tomography (CT) scans, wooden foreign bodies will usually mimic air. However, with time, the attenuation value of a wooden foreign body may increase as moisture is absorbed from the surrounding tissues. Once this occurs, the wooden foreign body may mimic fat, water or muscle. We present an interesting case of a wooden foreign body in the parotid gland in order to illustrate a common presentation of such a foreign body, to review current guidelines for their clinical and radiologic diagnosis, and to suggest strategies for the management of their unique complications.
Insights
Diagnosing retained foreign bodies, especially wooden ones, is difficult. This case highlights challenges in imaging and suggests management strategies for these often-missed surgical complications.
Area of Science:
- Medical Imaging
- Surgical Pathology
- Diagnostic Challenges
Background:
- Retained foreign bodies pose significant diagnostic challenges in surgery.
- A review of 200 cases found one-third of retained foreign bodies were initially missed.
- Wooden foreign bodies are particularly difficult to diagnose radiographically.
Observation:
- Plain radiographs poorly visualize wooden foreign bodies (15% visualization rate).
- Computed tomography (CT) initially shows wooden foreign bodies mimicking air.
- Over time, wooden foreign bodies can mimic surrounding tissues (fat, water, muscle) due to moisture absorption.
Findings:
- Presents a case of a wooden foreign body in the parotid gland.
- Reviews clinical and radiologic diagnostic guidelines for foreign bodies.
- Discusses management strategies for complications associated with wooden foreign bodies.
Implications:
- Highlights the diagnostic difficulties posed by wooden foreign bodies.
- Emphasizes the need for awareness and advanced imaging interpretation.
- Suggests improved diagnostic and management protocols for retained wooden foreign bodies.
