Ever done an ultrasound-guided removal of migrating foreign bodies?

Journal of Small Animal Practice 2025

Author

Obi Veterinary Education
September 28, 2025

C. Brincin, O. J. Anderson, E. J. Field, C. Howes, E. Reeve, D. Sutton

Background
Migrating foreign bodies, such as grass awns and wood splinters, frequently affect dogs and cats, causing abscesses, granulomas, and tissue inflammation. Traditional surgical removal can be invasive and technically challenging, especially in anatomically complex regions such as the retrobulbar space and cervical soft tissues. This study aimed to describe a novel, minimally invasive ultrasound-guided technique for retrieving migrating foreign bodies using a large-bore cannula and flexible grasping forceps.

Methods
A retrospective case series was conducted at a single veterinary referral hospital, including seven dogs and one cat diagnosed with migrating foreign bodies between July and December 2022. All cases underwent computed tomography (CT) and ultrasound to identify the foreign bodies' locations. The minimally invasive technique involved inserting a 14-gauge cannula adjacent to the foreign body under ultrasound guidance. Flexible 16-gauge grasping forceps were then passed through the cannula to retrieve the foreign material. Success was determined by complete retrieval and resolution of clinical signs.

Results
The technique successfully removed foreign bodies from the cervical region (n = 4) and retrobulbar space (n = 3). One retrobulbar foreign body could not be removed due to its proximity to the globe. The median procedure duration was 20 minutes (range: 5–35 minutes). Follow-up data were available for seven cases (median: 6 months). Six patients had no recurrence of clinical signs, while one had a recurrent swelling at a different site without further foreign material detected.

Limitations
This study was retrospective and included a small sample size, limiting the generalizability of findings. The follow-up period varied, and one case was lost to follow-up. Additionally, CT failed to identify foreign bodies in some cases, highlighting the need for improved imaging protocols. The technique may not be suitable for larger or deeply embedded foreign bodies.

Conclusions
Ultrasound-guided removal of migrating foreign bodies using a cannula-assisted technique was an effective and minimally invasive alternative to surgery, reducing morbidity and procedural time. This method is particularly useful for foreign bodies in difficult-to-access regions and may improve patient outcomes. Further studies are warranted to compare its efficacy with other minimally invasive and surgical techniques.

Schematic drawing of the ultrasound-guided procedure. (A) Visualisation of the foreign body with the ultrasound probe. (B) Insertion of a large bore cannula under ultrasound guidance until the tip of the cannula reaches the foreign body. (C) Removal of the stylet of the cannula. (D) Insertion of the flexible endoscopic forceps through the sheath of the cannula. (E) Grasping of the foreign body with the forceps, then retrieval of the forceps, foreign body and sheath of the cannula. (Copyright: Dr. Charlie Brincin).

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