How Social Media Helped Identify an Abdominal Foreign Body

This foreign body was removed from a non-healing abdominal wall incision in an elderly lady with many comorbidities and previous operations. It was a rigid plastic tube which was 7 cm long and 2 to 3 mm in diameter. There were four transverse grooves at either end. Physicians caring for her were unable to identify it. One of them emailed me the photos and asked for help. I didn’t know what was, but I knew where to look for the answer.

I tried a Google image search, but the brownish discoloration of the object was interpreted as wood by the algorithm. None of the many images on Google resembled the foreign body.

Next, I posted the photo and a brief summary of the history to Twitter and the picture, a website with over 1 million medical professionals as subscribers.

On both sites, many guesses were made. Most thought it was a broken piece of a drain or tube of some sort.

The correct answer came 30 minutes later when Twitter follower Filippe Vasconcellos ‏ (@fvguima) identified it as a Q-Tip. He then posted a photograph of a slightly different brand of Q-Tip that measured about 7 cm long and contained similar grooves at each end.

A few minutes later, a psychology student who calls himself “Rogue” also got it right.

Here are some statistics from Twitter Analytics. During the 24 hours after the photograph was posted on Twitter, 5,653 people had viewed the tweet and 1,412 (25 percent) had clicked on some part of it — most often the photograph. More than 50 users commented on the picture.

No one knows how the Q-Tip ended up in the wound or where the cotton from both ends went. I suspect either the patient or someone taking care of the wound was cleaning it and accidentally left the Q-tip in place. The cotton probably was broken down over time or fell off and exited the wound in whatever drainage was present.

I emailed the surgeon who had contacted me to tell him the answer, and he was delighted.

So the next time someone tells you social media is a waste of time for doctors, share this story.

–by Skeptical Scalpel, MD

See the article at KevinMD here.

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