PT  - JOURNAL ARTICLE
AU  - Murray Smith
AU  - Eugene Wong
AU  - Navid Ahmadi
AU  - Narinder Pal Singh
TI  - A nose out of joint: first reported case of prison-acquired marijuana-based rhinolith
AID  - 10.1136/bcr-2019-231989
DP  - 2019 Oct 01
TA  - BMJ Case Reports
PG  - e231989
VI  - 12
IP  - 10
4099  - http://casereports.bmj.com/content/12/10/e231989.short
4100  - http://casereports.bmj.com/content/12/10/e231989.full
SO  - BMJ Case Reports2019 Oct 01; 12
AB  - Rhinoliths are calcareous concretions of the nasal cavity formed around a nidus that may be endogenous (eg, dislodged tooth) or an exogenous foreign body (eg, plastic bead inserted by a child). Rhinoliths are often found incidentally on endoscopy or imaging to assess for other pathologies. The incidence is estimated to be 1 in 10 000 of all otolaryngology outpatient presentations, but this is likely to be an underestimate due to the often asymptomatic nature of this condition. We describe the unique case of a rhinolith that developed from a marijuana-filled balloon that the patient attempted to smuggle into a correctional facility. After inserting the package into his nostril, the patient then mistakenly believed it had been accidentally swallowed. Despite experiencing persistent symptoms of nasal obstruction and recurrent sinonasal infections, the marijuana package was only discovered 18 years after insertion following imaging for an unrelated indication