Andrew Del Gaizo M.D - The Foreign Body: A collection of the most interesting X-rays of things that dont belong and the stories behind how they got there!

Its whats on the inside that counts

The Foreign Body:A collection of the most interesting X-rays of things thatdont belong and the stories behind how they got there!

Andrew Del Gaizo, M.D.

EmergencyRadiologist

Greensboro,N.C.

_____________________________

Publication Information

Copyright 2013 Andrew Del Gaizo,M.D.

ISBN-13: Pending.

All rights reserved. This book isprotected by copyright. No part of the book may be reproduced in any form or byany means, including digital and photocopying, without the written permissionfrom the copyright owner.

The publishers have made all effortsto reach the copyright holders for borrowed material. If any have inadvertentlybeen overlooked, the publishers will be pleased to make the necessaryarrangements at first opportunity.

INTRODUCTION:

When I firsttell people outside of the medical profession that I am an emergencyradiologist, some variation of the following conversation often occurs:

Them: So, youre the one that takesthe x-rays of people? My friend/uncle/sister/former roommate is a radiologisttoo.

Me: No, the hard working people whotake the x-rays are the radiologic technologists. The radiologists like me aredoctors behind the scenes, interpreting the x-rays and getting a report to yourprimary physician.

Them Oh, so you see all the x-rays?Whats the craziest thing youve ever seen up someones butt on an x-ray, ordoes that even really happen?

Me: Youre referring to what we call aforeign body, and Ive seen everything you can imagine trust me, if its outthere, its been in someone.

Now, as thereader, you may be questioning the sanity of the people I associate with andshocked by my response; or, perhaps youre pondering the rectal foreignbody possibilities, certain that I underestimate the boundaries of yourimagination. Either way, if you cant wait to find out, feel free to skipahead to the .

For the rest of us, lets start with a couple definitions;

Foreign for-n:1- alien in character: 2- occurring in an abnormal situation.

Body b-d:a mass of matter distinct from other masses.

(As defined by the Merriam-Webster Dictionary, m-w.com)

When taken together;

Foreign Body:any object or substance found in an organ or tissue in which it does not belongunder normal circumstances.

(As defined by Mosby's Medical Dictionary, 8thedition. 2009, Elsevier)

Foreignbodies can be inserted, ingested, inhaled, or introduced (intentionally or byaccident), and therefore can end up nearly anywhere within the body. From theskin surface, their position is often uncertain. However, x-rays can be used todetect a foreign bodys location and decipher the best approach for removal.

This bookwill focus on foreign bodies that brought patients to emergency rooms. Promptdetection is often critical to minimizing complications. Therefore, allclinicians should be aware of what the various foreign bodies may look like onx-rays.

From theperspective of the general public, this book is written without complex medicalterminology so that everyone can benefit from it. Ill show you the x-ray andlet you guess what the foreign body is. Occasionally, I provide you with a clueto get started. But, as a picture is worth a thousand words, Ill often justlet the image do the talking! On the subsequent page, Ill tell you whatthe foreign body was and how it got there. Often why its there is as interestingas the image itself. Of course, all patient identifying information has beenremoved or changed to protect patient privacy and anonymity.

DISCLAIMER: The information provided in this book is forentertainment and educational purposes only, and should not be considered asoffering medical advice. If you or someone you know may have a foreign body,please check with a qualified physician or other appropriate health careprovider.

___________________________

FOREIGN BODYCATEGORIES:

The mouthinnocuously enough accepts foreign bodies. Unfortunately, there are tight areaswithin the gastrointestinal tract where these items can get stuck. Furthermore,some objects (such as sharp items or certain types of batteries) can bedangerous or toxic if not retrieved. Inhaled foreign bodies are theones that end up in the nose or airway, and in my experience, are most oftenthe byproduct of turning your back for 2 seconds while your toddler exploresthe living room.

Welcome tothe gun and knife show. Whether inadvertently caused by the patient orinflicted by someone else intending harm to the patient, x-rays play animportant role in characterizing and localizing introduced foreign bodies. Inaddition to the medical relevance, these images often end up in forensics,delineating the type and trajectory of the weapon involved. Well cover some ofthe ballistic basics as they pertain to x-rays in this section. The categoryalso includes non-weapon foreign bodies that are introduced into the body, suchas from stepping on a nail.

Last but notleastthe XXX-rays. Technically, these foreign bodies could also be classifiedas introduced. However, given the unique circumstances under which many ofthese cases present, they deserve a category of their own. When activitiesoccurring in the privacy of ones home go wrong, an embarrassing visit to theER often ensues.

___________________________

TABLE OF CONTENTS:

Crucifix

Pencil

Chicken bones

Bottle caps

Batteries

Button battery

Nail

Retainer

Earring

Earring post

Test tubes

Ring

Screws

Quarter

Penny

Nickel

Dime

Flat penny

Key

Lock

Birdshot 1

Birdshot 2

Bullet 1

Bullet 2

Bullet 3

Bullet 4

Knife 1

Knife 2

Knife 3

Knife 4

Knife 5

Fishhook

Rod

Nail

Screw

Glass

Blade

Shampoo

Body Packer

Toothbrush

Zucchini

Paperclips

Pipe

Fist

Screw

Spring

Coffee

Clippers

Vibrator 1

Vibrator 2

Vibrator 3

Egg

____________________________

CATEGORY 1: INGESTED/INHALED

Crucifix

This littletyke was brought to the emergency room by his mother. He was drooling anddemonstrating discomfort with swallowing. Mom wasnt sure what he had gotten ahold of, but was pretty sure hed swallowed something. We took an x-ray andfound Jesus!

Clue: Pop Quiz

Pencil

Everyone take out your number 2 pencils.

We see the metal ring that holds the eraser and if you lookcarefully, you also see a straight white line that represents the lead. Thewood of the pencil is harder to see but takes the dark density of air. Theeraser is invisible by x-ray.