Foreign Body Misadventures

My introduction to the wild and wacky world of x-rays and foreign bodies came late one night during the first year of my radiology residency. I was asked to read an abdominal x-ray on a young woman, the concern being that a rectal thermometer had become misplaced – and inaccessible – within her urinary bladder. I asked the attending emergency medicine physician why the patient was certain that the thermometer was in her bladder rather than the appropriate – or other regional – orifice. The emergency doc paused, gave me a wry smile, told me she asked the patient the very same question and was given an angry reply. I’m paraphrasing after 20+ years, but the response was something along the lines of, “It’s in my #@!*% bladder – I’m not stupid!!”

X-rays done to locate a foreign body usually don’t lead to such acerbic confrontations, the most common situation probably being a cute toddler who accidentally swallowed a coin. But variants of “I have no idea how that wine bottle got in there” do occur fairly often, and I have yet to meet the radiologist without a foreign body anecdote. A book published earlier this year, Stuck Up! 100 Objects Inserted and Ingested in Places They Shouldn’t Be, has probably been long in coming. I do regret that it was written by three non-radiologists, the authors being two psychiatrists and an emergency medicine physician. I have known two radiologists who collected dozens of similar – and in my opinion better quality – images, one of whom I used to regularly beg to pursue publishing as a coffee table book. But to no avail.....

Before I come off callous and uncaring, let me assure you that I completely empathize with these patients who must be horribly embarrassed having to explain their predicaments. And the people described in such a book deserve anonymity and respect, as well as prompt and appropriate treatment for what can be a true medical emergency. I like to think that this is why my radiologist colleagues never “went public” with their collections. But the x-rays – and even more so the stories – can be fascinating, and the ones in Stuck Up! do not disappoint.

I personally have only a handful of noteworthy foreign body tales. In addition to the “thermometer debacle”, my most memorable – and disturbing – case involved a woman (despite my examples, men are much more likely to be involved in such incidents) who would bend and break razor blades prior to swallowing them. When asked why she broke them before ingesting, her reply – again paraphrasing – was very matter-of-fact, “They’d be far too big and difficult to swallow otherwise.”

While often sad, such sagas provide a unique window and insight into human behavior. People do peculiar things, some of which are dangerous and require medical attention. And – for better or worse – unexpected metal in the human body can make a really cool x-ray.

This was originally posted in the Buffalo Grove Patch on 12/20/2011.