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December 12, 1977

'Radiopaque' Foreign Bodies

JAMA. 1977;238(24):2598. doi:10.1001/jama.1977.03280250024007

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To the Editor.—  Foreign bodies are a common emergency room problem. Diagnosis and treatment frequently are relatively simple, especially if the object is radiopaque. We recently had a case that demonstrates a possible diagnostic hazard.

Report of a Case.—  After an altercation, with a classmate, a 13-year-old boy arrived at the Clinton Primary Care Center with a ball-point pen embedded in his palate. His vital signs were stable, and results of physical examination showed only a blue pen projecting approximately 15 cm from his palate. X-ray films were taken (Fig 1 and 2).The area was anesthetized with 1% lidocaine with epinephrine, and the pen was extracted. It was noted that the pen had a plastic cap and was thus several centimeters longer than shown in the X-ray films (Fig 3 and 4).The patient was given 0.5 ml of tetanus toxoid, and therapy with phenoxymethyl penicillin, 250 mg four