Hook, Line, and Sinker: Unusual and Interesting Foreign-Body Cases

The patient was sheepish and the mother was very chagrined. We took him to the operating room and intubated him carefully. Under direct vision we grabbed the fish hook and gently removed it out of the mucosa, to which there had only been slight damage.

click for large version

Figure. X-ray of the foreign bodies: hook, line and sinker.

click for large version

Figure. Photo of the actual foreign body extracted from the patient’s esophagus.

When I began to write my consult, I realized I was about to write the phrase that he had swallowed a hook, line, and sinker, and that was probably the must amusing part to me. In the years since, I’ve lectured on this case.

Steven D. Handler, MD

Professor of Otolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine and The Children’s Hospital of Philadelphia

Christmas in July

The most incredible thing I ever found in a patient’s nose occurred when I was at Yale in 1978. In July, a father brought his 5-year-old son in to see me and he was vexed because the boy had had pus coming from his nose for the past 6 months. He had been to three or four doctors who had treated him with antibiotics, without success. I was the first to look into his nose using a head mirror and a nasal speculum. To my surprise, there was something green in his nostril. I placed a forceps in his nose and pulled out a frond from a Christmas tree! It had been there since the previous holiday season. When the boy had put the piece of fir in his nostril, it had lodged itself in like an umbrella. When his father came into the room, he just shoved it in far enough to be hidden. He never revealed to his dad what he had done until I pulled it out.

Harold (Rick) Pillsbury III, MD

Thomas J. Dark Distinguished Professor of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill Medical Center, and President-elect of the Triological Society

Creepy Crawlies

My favorite story is about encountering a live spider in a patient’s ear. I could see the eyes looking at me under the microscope. I instilled mineral oil into the canal, expecting to kill it. The spider, however, had other ideas and quickly left its lair. When viewed under the microscope as it crawled out it looked enormous-and far too close. I pushed back so violently I fell backward off the stool. The patient brushed it to the floor and squashed it with his foot as I watched, speechless.