Back to Basics: Foreign Body Ingestion

Can you see it on X-ray?

• Plastic & wood tend to be radiolucent (less seen on X-ray)
• Stone & metal tend to be radiopaque (more seen on X-ray)
• Glass depends on density

What’s the best imaging for foreign body?

• US is excellent for superficially embedded
• CT often visualizes radiolucent objects missed on X-ray
• Provides better localization
• Assesses for complications
• IV contrast is recommended
• Contrast enema suggested for rectal foreign bodies

What are the most common sites of foreign body ingestion?

• Cricopharyngeus muscle is most common site of esophageal impaction
• Right bronchial tree most common location for aspiration

What are some items that require emergent removal?

• Blunt objects >2.5 cm wide or >6 cm long up to the pylorus (can generally pass after)
• Button batteries
• Multiple magnets or magnet-metal pair

Reference:

Tseng HJ, Hanna TN, Shuaib W, et al. Imaging foreign bodies: ingested, aspirated and inserted. Ann Emerg Med. 2015; 66(6): 570-582.

SA Health.  Button Battery Safety. Retrieved from http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/healthy+living/protecting+your+health/your+home/button+battery+safety on 7/16/18.