The aim of this study was to examine the effectiveness of helical CT in the assessment of intraocular foreign bodies, evaluating two protocols with different collimation. We performed helical-CT studies in 30 patients. Fifteen patients were examined with 1.5-mm collimation and the other 15 patients with 3.0-mm collimation. All other imaging parameters were identical in both protocols. Multiplanar images were reconstructed. The examinations were reviewed for presence, localization and size of intraocular foreign bodies. We compare our results with the surgical data. We estimate the required examination time. In the first group (collimation 1.5 mm) an intraorbital foreign body was detected in 8 of 15 patients. In 3 of 8 patients an intraocular foreign body (all were metallic) was detected. In the second group (collimation 3.0 mm) an intraorbital foreign body was detected in 9 of 15 patients. In 8 of 9 patients an intraocular foreign body (all were metallic) was detected. Our results were confirmed by surgery in all cases. Examination time was 36 s in the first group and 18 s in the second group. Computed tomography should be considered the imaging modality of choice in the assessment of metallic intraocular foreign bodies and 3.0-mm collimation is optional, because of reduced examination time and radiation exposure.
A woman in her 50s was undergoing a repeat liver resection surgery for recurrence of liver metastasis when the intravenous fluid flow was noted to be sluggish on multiple occasions. On the third examination of the right hand where the intravenous cannula was located, surgery was halted as there was extensive swelling from the hand to the biceps and the hand had started turning blue. A diagnosis of acute upper limb compartment syndrome secondary to extravasation exacerbated by metaraminol was made by the anaesthetist and surgeon. Fasciotomies of the right upper limb were performed, and perfusion was restored. A hand surgeon arrived shortly after and completed decompressing the upper limb compartments.A literature review revealed risk factors such as communication barriers, age and chemotherapy were present in this case. Enhanced monitoring is needed in the context of unsatisfactory infusion flow rates perioperatively.
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