Foreign bodies

In medicine, foreign bodies are any object that originates outside of the human body. More often than not, foreign bodies will occur involuntarily as a result of an accident such as motor vehicle collisions, stepping on broken glass, gunshot wounds, or explosions. On occasions, foreign bodies can be voluntary, often inserted into natural and unnatural cavities 1-7.

Most rectal foreign bodies are inserted via the anus, and there are times that an object has been ingested and now is sitting in the rectum. Commonly, rectal foreign bodies are used for sexual purposes 1-3 . Rectal foreign bodies have a large variety from sex toys to light bulbs to vegetables.The main problem with this is the often delayed presentation due to the reluctance of patients to present to emergency departments. Patients may suffer from extraperitoneal mucosal injuries or suffer from a more severe complication such as perforation 1-5.

Two plain radiographs are recommended to accurately demonstrate the size, shape and location of the rectal foreign body. This should be performed before a digital examination to prevent staff related injuries from sharper foreign bodies.

Ingested foreign bodies range from children putting whatever they want in their mouths, mental health related issues of swallowing strange objects to bones stuck in the throat or gastrointestinal tract. Coins account for 70% of paediatric ingested foreign bodies; coins will typically become ‘stuck’ at the level of the cricopharyngeus muscle 8,14. Usually, coins visualised in the sagittal plane (acquired while entering through vocal cords) on anteroposterior radiographs are in the trachea, whereas coins in the oesophagus will have a coronal orientation on anteroposterior chest radiographs.

An important thing to consider when assessing coin like objects is button batteries, button batteries may look like coins, yet they will have a slight step in profile with an inner ring on the AP. Button batteries can be potentially fatal when in contact with surrounding tissue they can generate an electric current that will break down fluid turning it hydroxide leading to severe, potentially fatal mucosal damage 6,13,14.

Sharp ingested foreign bodies can be potentially problematic when lodged in the oesophagus patients will often require emergency endoscopy, more often than not if the sharp object is within reach of endoscopy it will be removed before it progresses further 12.
Plastic bread clips are diagnostically challenging, the limited literature on this foreign body suggests they are invisible on both plain radiography and CT, and the rigid shape can cause bowel perforations or gastrointestinal haemorrhage 15,16.

Most soft tissue foreign bodies are involuntary, resulting from an accident. The most commonly reported soft tissue foreign bodies are glass, metal and splinters from wood 5. It is imperative to locate foreign bodies before they become infected or worse damage close by organs.

Metal, glass and stone can be visualised very well using conventional plain film radiography, yet more organic structures such as wood may require further imaging such as ultrasonography 5-7.

Commonly, aspirated foreign bodies will have a clear clinical correspondence: choking, coughing, neck pain or struggling to breathe. The right main bronchus is the most common site of obstruction due to the anatomy of the bronchial tree favouring the right side (larger diameter, more vertical orientation). Often two orthogonal plain radiographs are the primary investigation of choice 12.

Drug packing is a well documented foreign body; it is also one of the most common recorded anal foreign bodies Often drugs are concealed within condoms, foil, latex or cellophane, then swallowed or inserted anally. These should be considered hazardous to the patient until evacuated due to the likelihood of the concealment method breaking.

The investigation of foreign bodies rely heavily on radiology, yet every foreign body will have an optimal modality for investigation. 

Plain radiography

The radiological appearance in plain radiography of foreign bodies is dependent on two factors: the x-ray attenuation of the foreign object, the surrounding structures and any overlying structures that may veil the object. 

The anatomical location will not only affect the radiopacity of the suspected foreign body, but the rate of magnification as the object is placed further or closer to the detector, lateral cervical radiographs can have a magnification rate of up to 21.6% 9-11.

Share Article

Article Information

rID: 1349
Section: Gamuts
Synonyms or Alternate Spellings:
  • Foreign body

Support Radiopaedia and see fewer ads

  • Drag
    Stiletto shoe
    Drag here to reorder.
  • Drag
    Pen through orbit
    Drag here to reorder.
  • Drag
    Bullet
    Drag here to reorder.
  • Drag
     Nail gun into head
    Drag here to reorder.
  • Drag
    Knife in head
    Drag here to reorder.
  • Drag
    Prosthetic eye
    Drag here to reorder.
  • Drag
    Tarsal plate weight for facial palsy
    Drag here to reorder.
  • Drag
    Crayon in nose
    Drag here to reorder.
  • Drag
    Tongue stud
    Drag here to reorder.
  • Drag
    Hook with prawn in pinna
    Drag here to reorder.
  • Drag
    Swallowed T-bone
    Drag here to reorder.
  • Drag
    Ingested foreign body: fish bone
    Drag here to reorder.
  • Drag
    Air rifle pellet
    Gunshot wound to the neck
    Drag here to reorder.
  • Drag
    Soft tissue foreign body: fish hook
    Drag here to reorder.
  • Drag
    Fish bone in oesophagus - ultrasound
    Drag here to reorder.
  • Drag
    Slow K tablet in trachea
    Drag here to reorder.
  • Drag
    Aspirated foreign body: dental crown
    Drag here to reorder.
  • Drag
    Chicken bone in bronchus
    Drag here to reorder.
  • Drag
    Needle in breast
    Drag here to reorder.
  • Drag
    Guide wire
    Drag here to reorder.
  • Drag
    2 metallic FB's
    Drag here to reorder.
  • Drag
    Pedicle screw ind...
    Pedicle screw in aorta
    Drag here to reorder.
  • Drag
    Coin in oesophagus
    Drag here to reorder.
  • Drag
    Intra-cardiac nail
    Drag here to reorder.
  • Drag
    Esophageal knife
    Drag here to reorder.
  • Drag
    Swallowed pen
    Drag here to reorder.
  • Drag
    <br />
    Lost CVC wire in IVC
    Drag here to reorder.
  • Drag
    Foreign body
    Swallowed bead
    Drag here to reorder.
  • Drag
    iPhone 6 Charger
    Drag here to reorder.
  • Drag
    Ingested foreign body: nail
    Drag here to reorder.
  • Drag
    Razor blades
    Drag here to reorder.
  • Drag
    Knife in liver
    Foreign body: knife in liver
    Drag here to reorder.
  • Drag
    Fishbone in liver
    Drag here to reorder.
  • Drag
    Body packer
    Drag here to reorder.
  • Drag
    Initial presentation
    Electronic cigarette
    Drag here to reorder.
  • Drag
    Ring most likely in stomach
    Drag here to reorder.
  • Drag
    Partial denture
    Drag here to reorder.
  • Drag
    Toothbrush
    Drag here to reorder.
  • Drag
    AP Scout
    Knife in abdomen
    Drag here to reorder.
  • Drag
    Vaginal pessary
    Drag here to reorder.
  • Drag
    Tampon
    Drag here to reorder.
  • Drag
    Body packer
    Drag here to reorder.
  • Drag
    Penile implant
    Drag here to reorder.
  • Drag
    Sewing needle
    Drag here to reorder.
  • Drag
    AP
    Paperclip in urethra
    Drag here to reorder.
  • Drag
    Pelvic sickle cel...
    Pelvic sickle cell complications
    Drag here to reorder.
  • Drag
    Foreign body: wire in finger
    Drag here to reorder.
  • Drag
    Gunshot
    Drag here to reorder.
  • Drag
    Staple gun injury
    Drag here to reorder.
  • Drag
     Palm frond
    Drag here to reorder.
  • Drag
    Knife in hand
    Drag here to reorder.
  • Drag
    Lead pencil tip in palm
    Drag here to reorder.
  • Drag
     Thorn
    Drag here to reorder.
  • Drag
    Screw through thong
    Drag here to reorder.
  • Drag
    Needle
    Drag here to reorder.
  • Drag
    Foreign body in f...
    Foreign body in foot
    Drag here to reorder.
  • Drag
    Foreign body
    Drag here to reorder.
  • Drag
    Wooden foreign body
    Drag here to reorder.
  • Drag
    Ingested button batteries
    Drag here to reorder.
  • Drag
    Menstrual cup device
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.