Creepy crawlies aren't something you would want in your body but they do sometimes find a way in.

That was what a young man found out a few weeks ago, when he sought help at the emergency department of National University Hospital (NUH) for intense pain in his left ear.

"He woke up in the middle of the night with a scurrying sensation in his ear and suspected that an insect had got inside," said Associate Professor Malcolm Mahadevan, a senior consultant and head of the emergency medicine department at NUH.

"True enough, when we looked in his ear with an auroscope, we could see a juvenile cockroach lodged deep in his external auditory canal."

This follows a widely reported incident described in The BMJ medical journal last month, where a "bluish" mass of 17 contact lenses was found in the eye of an elderly woman in Britain who was scheduled for cataract surgery.

Another 10 lenses were found upon further examination.

Doctors do, from time to time, find foreign objects in the body, ranging from coins to toothpicks and creepy crawlies.

Objects can also be swallowed accidentally, inserted forcefully or unknowingly left behind.

Here are some of the items.

CONTACT LENSES

Convenient as they may be, contact lenses also pose hazards. They can, for instance, become lodged in the lower or upper eyelid.

Sometimes, a torn portion of the contact lens may be left behind.

Adjunct Associate Professor Lim Li, a senior consultant at the Singapore National Eye Centre's corneal and external eye disease department, said she has removed a broken lens from the lower eyelid of a patient and retrieved a whole lens from the upper eyelid of another patient.

Referring to the BMJ case, she said: "The case was unusual as the British woman continued to wear her contact lenses even when her vision was blurred. And she must have been quite forgetful if she couldn't remember whether she had removed her lenses or not."

That is why doctors advise patients not to wear contact lenses if their vision is blurred from an eye condition, such as a cataract, Prof Lim added.

If a contact lens is lodged in the lower eyelid, it can be detected and removed by the patient.

However, if it is stuck under the upper eyelid, it may be more difficult to detect and will require an eye examination.

An ophthalmologist will be able to flip up the upper eyelid and remove the lens, she said.

INSECTS

Prof Mahadevan said cockroaches in the ear are quite common. "It can be painful after the nymph or juvenile cockroach burrows itself deep in the ear canal next to the ear drum."

What doctors do is to drown the insect with some olive oil before removing it with a pair of forceps.

Apart from cockroaches, insects such as ants, moths and beetles can also find their way into a person's ear.

COINS, BATTERIES AND OTHER SMALL THINGS

Children can accidentally swallow or stuff small objects like coins, beads or bits of erasers into their nose or ears.

Dr S.M. Tan, a general practitioner, said she once attended to a child with a magnet inside his ear.

"As I was using a forcep to try to retrieve it, the magnet "jumped" out, attracted to the metal of the forcep."

In another case that she saw many years ago when she was working in a polyclinic, a three-year-old had swallowed a five-cent coin and a 10-cent coin.

The coins showed up in the abdominal X-ray and were later passed out naturally, so the child was not adversely affected.

But not all small items can be passed out easily. Button batteries, in particular, must not be inserted into the body.

"I often tell parents to keep small batteries, such as the disc-shaped ones used in wristwatches, away from children, said Dr Tan.

" If they get lodged in a child's ear or nose, the acid that leaks from the battery can lead to catastrophic damage of the tissue."

COTTON TIPS

In Singapore, the cotton-tipped swab is one of the common objects that get left in the ear, said Prof Mahadevan.

Agreeing, Dr Tan said: "I see such cases and ENT (ear, nose and throat) surgeons see it all the time."

This is because people like to clean their ears with Q-tips, she said.

"An ENT colleague related how he had to take out three cotton buds from a patient's ear at one sitting," said Dr Tan. "The patient wasn't even aware of it until he noticed his hearing had diminished."

Sticking cotton swabs in your ears can result in ear wax being "impacted", said Dr Tan. This means the wax is pushed back into the ear, blocking the ear canal, which can cause pain, muffled hearing, tinnitus (ringing in the ears) and a feeling of imbalance.

UNEXPECTED THINGS

Sometimes, doctors find the most surprising things in the body which may have to be removed surgically.

These items can be unintentionally left behind by people seeking sexual gratification, for instance, or during an operation.

A doctor in private practice said soap, soap cases and even shampoo bottles and bananas have been found in the rectum of patients.

Dr Tan said that many years ago, she heard about a man who went to an emergency department here to get a vibrator which went too far up his anus to be removed.

"The sound of the vibrator, which was still turned on, could be heard through his abdomen."

Dr Yang Ching Yu, a general and colorectal surgeon and consultant at Raffles Surgery Centre, said he had extracted an unlikely object from a foreign patient who saw him for severe abdominal pain about four months ago.

The woman had been having frequent abdominal pain after undergoing a caesarean operation five months ago, before she relocated to Singapore.

"When I cut open her abdomen, there was a pungent, rotten smell that was released from the abdominal cavity," said Dr Yang.

And in the intra-abdominal abscess was a 20cm x 20cm soiled towel, which was stuck to the obstructed segment of the small bowel, he said.

"The towel did not have the usual radio-opaque thread found in the pad or towels used in surgery. Otherwise, it would have been detected in the pre-operative CT (computed tomography) scan."

The towel was probably left behind in the abdomen during the caesarean section procedure that was performed in another country.

Fortunately, after the obstructed segment of the intestine was resected and the abdomen cavity cleaned thoroughly, the woman recovered without complications.

Her abdominal pain also disappeared, said Dr Yang.