foreign bodies

 

Ingestion of objects not meant to be swallowed usually happens in children under 6, but it can happen in older children and adults as well. Ingestion tends to occur accidentally rather than deliberately as people get older, though deliberate swallowing of foreign objects sometimes occurs in those with intellectual impairment or mental illness.

Coins are the most commonly swallowed objects in children, and other objects commonly ingested include batteries, small toys, safety pins, hairpins, and writing instruments. Many accidentally-swallowed objects are food-related, such as fish bones, and adults with dentures have been known to occasionally swallow them accidentally.

Most ingested objects pass through the digestive system safely. However, you can’t assume a swallowed foreign body will make it safely through the gut, because sometimes they can become lodged or cause damage to the gastrointestinal tract.

Doctors generally want to find swallowed objects with the help of medical imaging, and may use medical imaging to track progress of an object as it works its way through the digestive system. Pediatric radiologists in particular must possess knowledge of how swallowed objects behave, how they show up in medical imaging, and which medical imaging types are appropriate.

Where Foreign Bodies May Be Trapped When Swallowed

In children, if a swallowed object becomes trapped, usually it is just above or below the upper esophageal sphincter, and patients can usually feel something trapped there. When an object obstructs the esophagus itself, there is often a feeling of an item being “stuck” in the center of the chest. Vomiting and throat pain may occur too. Objects trapped below the esophagus may present any number of symptoms depending on where the object has progressed to.

X-Rays

Most ingested objects swallowed by children are radiopaque, meaning they show up on x-rays. This makes x-rays a primary type of medical imaging in cases of children swallowing objects. An x-ray image can locate an object and confirm or rule out entrapment in the esophagus. However, many types of food bones that are accidentally ingested are not opaque on x-rays, and other types of medical imaging must be used.

Computed Tomography

If there is reason to suspect that a swallowed object has caused a perforation or abscess, computed tomography (CT) is the preferred type of medical imaging. But CT scanning is not always necessary in cases of ingested food bones. When swallowing of a food bone is suspected, only a fraction of those who feel a sensation of a “trapped” object actually have one, but feel the sensation due to minor mucosal injury in the digestive tract.

Ultrasound

Ultrasound is a type of medical imaging sometimes used to find ingested objects, but more often it is used to evaluate the area surrounding the location of a swallowed object, and is sometimes used to guide in the removal of the object. With the help of an ultrasound transducer to visualize the location of an object, a doctor can then make an incision and remove it. Doctors can also use ultrasound in real time to help in guiding instruments to the exact location of the object to be removed.

Endoscopy

Endoscopy is a type of medical imaging that examines the interior of a cavity or hollow organ. Endoscopes are inserted directly into the organ, and may be used when swallowed objects cause airway obstruction or other complications. For example, there is a high rate of complications when objects like toothpicks or aluminum bottle tabs are swallowed, and endoscopy may be the medical imaging technique of choice in these cases. It may also be used when multiple objects are swallowed, or when the objects are elongated or oddly shaped.

Conclusion

Sometimes people swallow things that aren’t supposed to be swallowed. In most cases objects simply pass through the digestive system and the patient is fine. However, medical imaging is needed to ensure objects don’t become entrapped or cause damage to the digestive system. Typically, it is pediatric radiologists like those of SteleRAD who must make the important decisions about which types of medical imaging are appropriate when foreign objects are ingested.

The radiology specialists who own and operate SteleRAD have over 40 years of experience in medical imaging, and are available for second opinions, to cover personnel shortages, and for consultation in hospitals, imaging centers, and physician groups. If you would like to know more about what SteleRAD can do for your medical imaging needs in South Florida, call 954-358-5250 or contact SteleRAD online.