A rhinolith is a stone present in the nasal cavity. The word is derived from the roots rhino- and -lith, literally meaning "nose stone". It is an uncommon medical phenomenon, not to be confused with dried nasal mucus. A rhinolith usually forms around the nucleus of a small exogenous foreign body, blood clot or secretion by slow deposition of calcium and magnesium carbonate and phosphate salts. Over a period of time, they grow into large irregular masses that fill the nasal cavity. They may cause pressure necrosis of the nasal septum or lateral wall of nose. Rhinoliths can cause nasal obstruction, epistaxis, headache, sinusitis and epiphora. They can be diagnosed from the history with unilateral foul-smelling blood-stained nasal discharge or by anterior rhinoscopy. On probing, the probe can be passed around all its corners. In both CT and MRI a rhinolith will appear like a radiopaque irregular material. Small rhinoliths can be removed by a foreign body hook. Whereas large rhinoliths can be removed either by crushing with Lucs forceps or by Moores lateral rhinotomy approach. Signs and symptoms
Rhinoliths present as a unilateral nasal obstruction. Foul-smelling, blood-stained discharge is often present. Nosebleed and pain may occur due to the ulceration of surrounding mucosa. Management
They are removed under general anaesthesia. Most can be removed through anterior nares. Large ones need to be broken into pieces before removal. Some particularly hard and irregular ones may require lateral rhinotomy. References


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Other potential causes of vomiting and diarrhea, white foam from the mouth include gastrointestinal parasites, bacterial infections including E. coli, Campylobacter, or Salmonella, protozoal infections such as coccidiosis or giardiasis, and gastrointestinal cancer. Treatment
The most important aspect of treatment of HGE is intravenous fluid therapy to replace lost fluid volume. The vomiting and diarrhea are treated symptomatically and will usually resolve after one to two days. Antibiotics targeting C. perfringens are also used but recent studies have shown no difference in outcome or survival rate between patients given antibiotics and those not when no signs of sepsis were present. In other words, if there are no signs of sepsis, antibiotics will not hasten a recovery or improve outcome. With prompt, aggressive treatment, the prognosis is good. There is less than 10 percent mortality with treatment, but 10 to 15 percent of cases will recur. See also
Gastroenteritis


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