Foreign Bodies
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A foreign body (FB) is any object originating outside the body of an
organism In biology, an organism () is any living system that functions as an individual entity. All organisms are composed of cells (cell theory). Organisms are classified by taxonomy into groups such as multicellular animals, plants, and ...
. In machinery, it can mean any unwanted intruding object. Most references to foreign bodies involve propulsion through natural
orifice An orifice is any opening, mouth, hole or vent, as in a pipe, a plate, or a body * Body orifice, any opening in the body of a human or animal *Orifice plate, a restriction used to measure flow or to control pressure or flow, sometimes given specia ...
s into hollow organs. Foreign bodies can be inert or irritating. If they irritate they will cause
inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
and
scar A scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a na ...
ring. They can bring
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
into the body or acquire infectious agents and protect them from the body's immune defenses. They can obstruct passageways either by their size or by the scarring they cause. Some can be
toxic Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacterium, or plant, as well as the effect on a subst ...
or generate toxic chemicals from reactions with chemicals produced by the body, as is the case with many examples of ingested metal objects. With sufficient force (as in firing of
bullet A bullet is a kinetic projectile, a component of firearm ammunition that is shot from a gun barrel. Bullets are made of a variety of materials, such as copper, lead, steel, polymer, rubber and even wax. Bullets are made in various shapes and co ...
s), a foreign body can become lodged into nearly any tissue.


Gastrointestinal tract

One of the most common locations for a foreign body is the
alimentary tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
. It is possible for foreign bodies to enter the tract from the mouth or rectum. Both children and adults experience problems caused by foreign objects becoming lodged within their bodies. Young children, in particular, are naturally curious and may intentionally put shiny objects, such as coins or button batteries, into their mouths. They also like to insert objects into their ear canals and nostrils. The severity of a foreign body can range from unconcerning to a life-threatening emergency. For example, a coin causes local pressure on the tissue but generally is not a medical emergency to remove. A button battery, which can be a very similar size to a coin, generates hydroxide ions at the anode and causes a chemical burn in two hours. An ingested button battery that is stuck in the esophagus is a medical emergency. In 2009, Avolio Luigi and Martucciello Giuseppe showed that although ingested nonmagnetic foreign bodies are likely to be passed spontaneously without consequence, ingested magnets (magnetic toys) may attract each other through children's intestinal walls and cause severe damage, such as pressure necrosis, perforation, intestinal fistulas, volvulus, and obstruction.


Pancreas

Sometimes foreign bodies can pass spontaneously through the gastrointestinal tract and perforate or penetrate the wall of stomach and duodenum and migrate into pancreas. The laparoscopic approach before open surgery could be performed safely for the removal of foreign bodies embedded in the pancreas. File:CoinAP.jpg, A coin seen on AP CXR in the esophagus File:CoinL.jpg, A coin seen on lateral CXR in the esophagus File:9mmbatteryintestines.png, AP X ray showing a 9mm
battery Battery most often refers to: * Electric battery, a device that provides electrical power * Battery (crime), a crime involving unlawful physical contact Battery may also refer to: Energy source *Automotive battery, a device to provide power t ...
in the intestines File:9mmbatteryintestineslt.png, Lateral X ray showing a 9mm battery in the intestines File:BatteriesInStomach.jpg, Multiple button batteries in the stomach


Airways

It is possible for a foreign body to enter the airways and cause
choking Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen de ...
. A choking case can require the fast usage of basic anti-choking techniques to clear the airway. In one study,
peanut The peanut (''Arachis hypogaea''), also known as the groundnut, goober (US), pindar (US) or monkey nut (UK), is a legume crop grown mainly for its edible Seed, seeds. It is widely grown in the tropics and subtropics, important to both small ...
s were the most common obstruction. In addition to peanuts, hot dogs, grapes, and latex balloons are also serious choking hazards in children that can result in death. A latex balloon will conform to the shape of the trachea, blocking the airway and making it difficult to expel with basic anti-choking techniques.


Eyes

Airborne particles can lodge in the eyes of people at any age. These foreign bodies often result in
allergies Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...
which are either temporary or even turn into a chronic allergy. This is especially evident in the case of
dust Dust is made of fine particles of solid matter. On Earth, it generally consists of particles in the atmosphere that come from various sources such as soil lifted by wind (an aeolian process), volcanic eruptions, and pollution. Dust in homes ...
particles. It is also possible for larger objects to lodge in the eye. The most common cause of intraocular foreign bodies is
hammer A hammer is a tool, most often a hand tool, consisting of a weighted "head" fixed to a long handle that is swung to deliver an impact to a small area of an object. This can be, for example, to drive nails into wood, to shape metal (as w ...
ing. Corneal foreign bodies are often encountered due to occupational exposure and can be prevented by instituting safety eye-wear at work place. Foreign bodies in the eye affect about 2 per 1,000 people per year.


Skin

Splinter A splinter (also known as a sliver) is a fragment of a larger object, or a foreign body that penetrates or is purposely injected into a body. The foreign body must be lodged inside tissue to be considered a splinter. Splinters may cause initia ...
s are common foreign bodies in skin. ''
Staphylococcus aureus ''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
'' infection often causes
boil A boil, also called a furuncle, is a deep folliculitis, which is an infection of the hair follicle. It is most commonly caused by infection by the bacterium ''Staphylococcus aureus'', resulting in a painful swollen area on the skin caused by an ...
s to form around them.
Tetanus Tetanus, also known as lockjaw, is a bacterial infection caused by ''Clostridium tetani'', and is characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. Each spasm usually ...
prophylaxis may be appropriate.


Peritoneum

Foreign bodies in the
peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesoth ...
can include
retained surgical instruments A retained surgical instrument is any item inadvertently left behind in a patient’s body in the course of surgery. There are few books about it and it is thought to be underreported.Gibbs, Verna C. “Chapter 22. The Retained Surgical Sponge.” ...
after
abdominal surgery The term abdominal surgery broadly covers Surgery, surgical procedures that involve opening the abdomen (laparotomy). Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, l ...
. Rarely, an
intrauterine device An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting rever ...
can perforate the uterine wall and enter the peritoneum. Foreign bodies in the peritoneum eventually become contained in a
foreign body granuloma A foreign body reaction (FBR) is a typical tissue response to a foreign body within biological tissue. It usually includes the formation of a foreign body granuloma. Tissue-encapsulation of an implant is an example, as is inflammation around a sp ...
. In the extremely rare case of retained
ectopic pregnancy Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. ...
, this forms a
lithopedion A lithopedion ( also spelled lithopaedion or lithopædion; from grc, λίθος "stone" and grc, παιδίον "small child, infant"), or stone baby, is a rare phenomenon which occurs most commonly when a fetus dies during an abdominal pregna ...
.


Other

Foreign bodies can also become lodged in other locations: * anus or rectum * blood vessels or thoracic system *
ear An ear is the organ that enables hearing and, in mammals, body balance using the vestibular system. In mammals, the ear is usually described as having three parts—the outer ear, the middle ear and the inner ear. The outer ear consists of ...
s *
nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes th ...
*
teeth A tooth ( : teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tear ...
and
periodontium The periodontium is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The word comes from the Greek terms περί ''peri''-, meaning "around" and -''odont'', meaning "tooth". ...
* urethra *
vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...


Other animals

Foreign bodies are common in animals, especially young
dog The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the wolf. Also called the domestic dog, it is derived from the extinct Pleistocene wolf, and the modern wolf is the dog's nearest living relative. Do ...
s and
cat The cat (''Felis catus'') is a domestic species of small carnivorous mammal. It is the only domesticated species in the family Felidae and is commonly referred to as the domestic cat or house cat to distinguish it from the wild members of ...
s. Dogs will readily eat toys, bones, and any object that either has food on it or retains the odor of food. Unlike humans, dogs are susceptible to gastrointestinal obstruction due to their ability to swallow relatively large objects and pass them through the
esophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...
. Foreign bodies most commonly become lodged in the
stomach The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
because of the inability to pass through the
pyloric sphincter The pylorus ( or ), or pyloric part, connects the stomach to the duodenum. The pylorus is considered as having two parts, the ''pyloric antrum'' (opening to the body of the stomach) and the ''pyloric canal'' (opening to the duodenum). The ''pylori ...
into the
jejunum The jejunum is the second part of the small intestine in humans and most higher vertebrates, including mammals, reptiles, and birds. Its lining is specialised for the absorption by enterocytes of small nutrient molecules which have been previous ...
. Symptoms of gastrointestinal obstruction include vomiting, abdominal pain often characterized by aggression, acute infection, and depression due to
dehydration In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
. Treatment of a foreign body is determined by its severity. The amount of time a foreign body is present, location of the object, degree of obstruction, previous health status of the animal and the type of material from which the foreign body is made can all determine the severity of the condition.
Peritonitis Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or ...
results if either the stomach or intestine has ruptured. Foreign bodies in the stomach can sometimes be removed by
endoscopic An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...
retrieval or if necessary by
gastrotomy Gastrostomy is the creation of an artificial external opening into the stomach for nutritional support or gastric decompression. Typically this would include an incision in the patient's epigastrium as part of a formal operation. It can be perfor ...
. Very often, a simple instrument to remove foreign bodies without operation endoscopy is the Hartmann Alligator Forceps. The instrument is manufactured from 8 cm to 1 m length. Foreign bodies in the jejunum are removed by
enterotomy Enterotomy is the surgical incision into an intestine. It may be purposeful or a complication of an abdominal surgery, such as exploratory laparotomies or hernia repair Hernia repair refers to a surgical operation for the correction of a hernia ...
. Certain foreign bodies in animals are especially problematic. Bones or objects with sharp edges may cause tearing of the wall of the esophagus, stomach, or small intestine and lead to peritonitis.
Pennies A penny is a coin ( pennies) or a unit of currency (pl. pence) in various countries. Borrowed from the Carolingian denarius (hence its former abbreviation d.), it is usually the smallest denomination within a currency system. Presently, it is t ...
swallowed in large numbers may cause
zinc Zinc is a chemical element with the symbol Zn and atomic number 30. Zinc is a slightly brittle metal at room temperature and has a shiny-greyish appearance when oxidation is removed. It is the first element in group 12 (IIB) of the periodi ...
poisoning, which in dogs leads to severe
gastroenteritis Gastroenteritis, also known as infectious diarrhea and gastro, is an inflammation of the gastrointestinal tract including the stomach and intestine. Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of energy, and dehydra ...
and
hemolytic anemia Hemolytic anemia or haemolytic anaemia is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular). This most commonly ...
. Linear foreign bodies can especially be dangerous. A linear foreign body is usually a length of string or yarn with a larger object or clump of material at either end. One end is usually lodged in the stomach or proximal small intestine and the other end continues to travel through the intestines. The material becomes tightly stretched and the intestines may "accordion up" on themselves or be lacerated by it. This is especially common in cats who may enjoy playing with a ball of string or yarn. Sometimes the linear foreign body anchors in the mouth by catching under the tongue.Glossary Term: Linear Foreign Body
Pantyhose is a common linear foreign body in dogs. File:Bottle top swallowed by dog 2.JPG, Bottle top swallowed by a dog File:X-ray Needle swallowed by cat.JPG, Needle swallowed by a cat


References


External links


''Ingested Magnets''
The New England Journal of Medicine.
The Susy Safe Project
A Surveillance System on Suffocation Injuries due to Foreign Bodies in European Children. {{DEFAULTSORT:Foreign Body