added that each time there was considerable delay in diagnosis and appropriate treatment, in one patient it was 12 years. He opinionated that the delay was probably because of difficulty in accepting the patient’s history. A foreign body within the submandibular gland duct mostly presents as obstructive sialadenitis with features masquerading as acute or chronic sialadenitis. Obstructive sialadenitis is the most frequent non- neoplastic salivary disorder. It can be due to calculi, strictures and kinks of the ductal system, mucous plugs and rarely foreignbodies. 17 Such a foreign body can be
Rarely, foreignbodies can also progress into the lumen of the appendix and cause obstruction, resulting into acute appendicitis (7). It should be noted, however, that the pres- ence of a foreign body in the lumen of the appendix does not always lead to obstruction and direct inflammation. It is known that smooth and spherical objects, such as bul- lets, seeds, and others can create endoluminal formations, enteroliths that grow progressively and cause delayed ap- pearance of inflammation (8). In cases of a foreign-body presence in the lumen of the appendix, it is also possible that acute appendicitis never develops (9). Nowadays, the prevailing view is that, if a foreign body that would be unlikely to regress in the intestine from the lumen of the appendix is found during a radiological examination, an on-the-spot appendectomy should be recommended.
All the 7 cases with trans-gastric migration of foreignbodies were found to have ingested sharp metallic pins and all the 7 patients were young girls. Authors observed that headscarf/headgear worn by these girls in deference to the cultural beliefs is fastened around head by sharp metallic pins with a slippery rounded plastic head (Figure 4). While wrapping the head scarf these girls have a tendency to hold these pins between their lips or in their mouth and accidently ingest them. Trans-luminal migration of these sharply pointed foreignbodies induces transient gastric wall inflammation near the site of penetration, thus endoscopy done after gap of few days might not reveal any insignia of antecedent penetration by the foreign body.
In planning the extraction, one of the important points to considered is the proper choice of the instruments. This is particularly important in the case of sharp and pointed foreignbodies, such as denture with protruding hooks, shaving blades, and open safety pins, which increase the danger of perforation. Extraction of these objects requires special attention and experience. Some may have to be drawn, sometimes only partially, into the lumen of the rigid esophagoscope, to enable their manipulation and extraction while protecting the esophageal mucosa. 15 This protection is not possible with the flexible instrument. Historically, the initial method of management of esophageal foreignbodies was extraction through the rigid esophagoscope.
removed by aural forcep or Jobson Horne’s probe (65%), followed by sucker machine (30%) and syringing (5%). All these studies are in agreement with the present study. In the present study, the per-meatal approach was used in majority of cases 195 (97.5%) while only 5 (2.5%) cases required a post aural approach to effectively remove the foreign body. The post aural approach was used for deep foreignbodies which have lodged through a perforation in tympanic membrane in unreachable middle ear space. This observation is similar to the study of Afolabi et al who have approached most of the foreignbodies through per-meatal approach 116 (98.3%) while only 2 (1.7%) had both per-meatal and post auricular approach under general anaesthesia. 23
Perforating eye injuries due to intraocular foreign bodies Med J Malaysia Vol 47 No 3 September 1992 Perforating eye injuries due to intraocular foreign bodies Y K Lai, FRCSE M Moussa, MBBCh Departmen[.]
Out of 52 patients, 32(61.53%) were males and 20(38.46%) were females. Majority of cases, 24 (46.15%) were in the age group of 1-2 years (Table 1). In most of the cases, 42(80.76%) the history of foreign body inhalation was negative and in only 10(19.23%) cases there was positive history of inhalation. Almost 50% of the cases (26) presented within 24 hours of onset of symptoms and about 14 cases presented after one month (Table 2). The most common symptom was cough, which almost 84.6% of the cases had. Respiratory distress and wheeze were experienced by about 61.5% of the cases. About 46.15% of the patients also complained of fever (Table 3). On clinical examination, most of the cases had decreased air entry (84.6%), followed by rhonchi (69.2%) and crepitations (42.30%) (Table 4). Out of 52 foreignbodies retrieved, 45 (86.53%) were organic in type, and 7 (13.46%) were in organic in type. Ground nut and tamarind seeds were the most common types of foreignbodies inhaled (Table 5). On bronchoscopic examination most of the foreignbodies were lodged in right main bronchus31(59.61%) which was the most frequent site followed by left main bronchus 14(26.92%), trachea 5 (9.61%), and larynx 2 (3.84%).
Foreign bodies in the larynx and tracheo bronchial tree Med J Malaysia Vol 43 NO 2 June 1988 Foreign bodies in the larynx and tracheo bronchial tree C H Yip MBBS (Mal) FRCS (Glasg) T J Wong MBBS FRCS[.]
Christoph Zellweger (Switzerland/UK) is one of the most thought provoking con- temporary jewellery designers in Europe. In 2007 he published ForeignBodies which extends the definition of body adornment today. Christoph worked for several years in the trade in Switzerland before attending the Royal College of Art in London. Besides running his studio and exhibiting internationally, he lectures in Europe’s leading Design and Art Colleges and holds a Professorial research post at Sheffield Hallam University. He has developed work at the European Ceramic Work Centre in Holland, haute-couture textile at Jakob
A foreign body is an endogenous or exogenous substance, incongruous with the anatomy of the site where it is found. Chevalier Jackson defined a foreign body as “an object or a substance that is foreign to its location” 1 . Foreign body ingestion and aspiration can affect persons of any age, but the vast majority of these accidents occur in children under the age of five 1 . It is estimated that 150 deaths occur annually in children, due to asphyxiation 3 . Foreignbodies in the airway, pharynx and oesophagus continue to be a diagnostic and therapeutic challenge to practising otolaryngologists. Despite improvements in public awareness and emergency care, death due to aspiration is a leading cause of death in children. A high index of suspicion for foreign body aspiration or ingestion is needed, because a foreign body can mimic other medical conditions, particularly without a witnessed event. Hence there can be a delay in management, that may lead to complications. According to the National safety council, suffocation from foreign body ingestion and aspiration is the third leading cause of accidental death in children younger than one year and the fourth leading cause in children between 1 and 6 years 8 .
Radiologic images are next only to a high index of suspicion in the evaluation of patients with intravesical foreignbodies. The extent and modality required depends on the type of foreign body and the presence or otherwise of complications. Radiologic evaluation is necessary to determine the exact size, number, and nature of the foreign body. Ultrasonography is usually able to localize the foreign body to the bladder and determine the exact size and number but is unable to evaluate the exact nature (Figure 1). Plain abdominal X-ray is, however, able to classify the objects into radiopaque and radiolucent, and therefore to a large extent determine their nature, eg, radiopaque metals (Figure 2). In the presence of bladder perforation, computed tomographic cystography is a reliable diagnostic tool where enhancement of the bladder contents is necessary. 28 Cystoscopy confirms
Only 10% of aspirated foreignbodies were spot diagnosed on X-ray chest as they were radio opaque. Other findings were emphysema (44%), atelectasis and pneumonitis (18%), and 32% patients had normal X-ray findings. In presence of positive clinical diagnosis and inconclusive chest radiography, CT virtual bronchoscopy was carried out in 21 patients. In all 21 patients virtual bronchoscopy showed foreign body and when compared with gold standard bronchoscopic finding, in 19 cases it came as true. Rigid bronchoscopy confirmed the same result but in two patients impacted mucus plug was present in left bronchus.
Due to the contamination, and a fairly large enterotomy that had to be made in the transverse colon and also to safeguard the IC junction an ileostomy was made through the same enterotomy used for taking out the foreignbodies, about 20 cms proximal to the IC junction. The other enterotomy was closed in three layers using Polydiaxone(PDS) 3- 0. The duodenal rent due to the fistula was also closed using PDS 3-0 after putting a patch of omentum upon it. A thorough wash was given and a drain was kept, abdomen was closed in layers. Post operatively the patient was shifted to an ICU for observation.
Among the 19% living organic foreignbodies retrieved, majority were cockroaches. This is predominantly due to having home-based grain storages breeding these pests and the habit of sleeping on the floor by many in this area. Animate foreignbodies can rarely present with complications, however an idiosyncratic type of localized inflammatory response to an insect’s sting can lead to dangerous complications. Zamzil et al. reported isolated facial palsy due to intra-aural tick (Ixodoidea) infestation. 25 In this regard, attempt at foreign body
A 3 year old girl attended ENT clinic for chronic cough and haemoptesis. She was treated for chest infection for several weeks with no improvement. Although chest x-ray was taken but it was reported to be normal! On auscultation there was diminished breathing sound in the left lung and unilateral wheezing and rhonchi. On reviewing her chest x-ray, a metallic FB was seen in left main bronchus which was missed as it was covered by the heart shadow (Figure 4). Rigid bronchoscopy was done and a sharp metallic FB (clips) was removed from the left main bronchus. Inhaled Foreignbodies 5
Following the diagnosis and to localize the rectal FB, transanal route is the first choice for extraction espe- cially in low lying objects. Before transanal interventions, acute abdomen due to rectal or colonic perforation should be excluded. In various literature attempts to re- move FB in the emergency room or at bedside is initially preferred [10,11]. The succes rate of bedside or emer- gency room attempts are about 16 to 75% in some litera- tures . Repeated and vigorous efforts to remove rectal FB cause distress, pain and profound involuntary anorectal spazm; it is the main source of this reduced succes rate. In this study all the efforts to extract the rectal FB was carried out in the operating room. Patient personal privacy, Turkish sociocultural assets, and tech- nical and medical requirements cause surgeons to choose this method. In the operating room adequate anesthesia is applied and various instruments are used depending on the foreignbodies characteristics and this improves the nonoperative success rate [12-15]. Ad- equate anal dilatation by way of caudal or anal block and intravenous sedation is essential for succesful transanal extraction. Sphincter function, tone and contractilitiy and continence should be evaluated. Bimanual pressure on anterior abdominal wall, grasping with forceps, manuplation with foley catheter,magnets for metal ob- jects and rectosigmoidoscopy is complementary tech- niques for transanal removal of the FB . These methods can be more effectively used only in the operat- ing room.
Urogenital foreignbodies are well reported in the literature and commonly en- countered in urologic practice. Removal of these objects can usually be managed by minimally invasive or endoscopic approach with minimal long-term damage to the genitals. Occasionally removal requires ingenious methods devised by staff based on the anatomic location and nature of the object used. Magnetic urogenital foreignbodies however are a less common entity with only a few re- ported cases in the literature  . There is an increased availability of mag- netic sex objects on the internet and in stores with an increasing trend and de- mand for their use. In view of this increasing demand, genital injuries are ex- pected to be seen more often in the future.
The most common foreignbodies seen in our study were eraser (27.5%) and seeds(24.16%). Other foreignbodies seen were crayons, buttons, beads, paper, chalk, battery button and nose pins. In a large series of nasal foreign body by Alberto Chinski et al.  found Pearls (399, 25.59%), Pins, nails, screws, floats (119, 7.63%), Paper (93, 5.97%), Stones (92, 5.90%), Rubber (82,5.26%), Seeds (63, 4.04%) mainly with only one cases of battery was found (0.06%). In
A Prospective Evaluation of Foreign Bodies Presenting to the Ear, Nose and Throat Clinic, Hospital Kuala Lumpur A Prospective Evaluation of Foreign Bodies Presenting to the Ear, Nose and Throat Clinic[.]