Foreign Body Removal from Stomach: An Innovative Approach Using C-arm in ENT.

The ingestion of foreign body is a very common occurrence in pediatric age group. The retrieval is an emergency procedure performed mostly by the Otolaryngologist and Gastroenterologist. We present a case of coin ingestion who reported to a tertiary care center. It was retained in the lower part of esophagus as confirmed by imaging. Subsequently during the rigid esophagoscopy it was found missing from distal esophagus. A 9 year old female child presented with accidental ingestion of coin. The imaging done immediately prior to intervention confirmed position of coin in distal esophagus. However, up on visualization with rigid esophagoscope the coin was not found in esophagus and suspected to have passed in to stomach. We used C-arm to confirm the location which has its own limitations. There have been various case reports of using c-arm for tracing lost needles and broken instruments by oro-maxillo-facial surgeons. There are no reports where it has been used to aid foreign body removal from gastro-intestinal tract. This is first case report where the use has been improvised due to lack of advanced facilities available at better and well equipped centers.The retrieval of foreign body from stomach aided by c-arm has not been reported in literature till now. The case report would add to the knowledge, options and practice at a center which does not have any super speciality facilities.

Conventional-based contact lens fitting in pure microphthalmia associated with irregular cornea.

In this case, a female teenager presented to the clinic with blurring of vision at a distance in both eyes since 2 years. All preliminary examinations were recorded. Retinoscopy revealed split reflex in both eyes. Both anterior and posterior segment findings seem to be within normal limits except for the microcornea. Topography depicts an asymmetric bow tie with superior steeping in both eyes. This case was diagnosed as pure microphthalmos associated with irregular corneal curvature, suggestive of keratoconus without corneal thinning with the help of topography and biometric measurements. Contact lens trial was advised to improve the visual potential. Fitting this patient in RGP lenses has been a challenging task because of narrow palpebral fissure height and small cornea.