A Retrospective Study of the Round Radiopaque Foreign Bodies in the Oesophagus
Article Sidebar
Main Article Content
Abstract
Introduction
Ingested foreign bodies (FBs) of the digestive tract can be divided into radiolucent and radiopaque, based on their appearance in Roentgenogram. Coins and button-batteries (BBs) constitute majority of the radiopaque FBs that are round in shape.
Materials and Methods
Medical records of children admitted with foreign bodies in the GI tract during the last 5 years have been reviewed. We have taken into our study, round radio-opaque FBs and analyzed the results.
Results
Out of 120 radiopaque FBs, in 112 cases they are lodged in cricopharyngeal sphincter (CPS), which were removed. Of these, 103 were coins and 9 were BBs. Five coins, which had crossed the CPS, ultimately passed out naturally with faeces. Three BBs, impacted in the oesophagus, distal to the CPS, were removed via esophagoscopy, on emergency basis. One child with impacted BB developed mediastinitis and died.
Conclusion
A round opaque disc shaped FB which is impacted or seen below CPS should not be treated as coin every time. High index of suspicion is needed to rule out BB ingestion as it is associated with high morbidity and mortality. Aim of this study is to stress on the need for educating primary care physicians and rural medical practitioners to avoid wait and watch policy, thus reducing misdiagnosis of coins for BBs.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Anderson KL, Dean AJ. Foreign bodies in the gastrointestinal tract and anorectal emergencies. Emerg. Med. Clin. North Am. 2011; 29(2):369-400
Al Lawati TT, Al Marhoobi RM. Timing of button battery removal from the upper gastrointestinal system in children. Pediatr Emerg Care. 2018 Dec 27. doi: 10.1097/PEC.0000000000001697
Zhang XR, Li Q. [A case of magnetic pharyngeal foreign body in children]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018; 32(18):1432-3. Chinese. doi: 10.13201/j.issn.1001-1781.2018.18.017
Malik SA, Qureshi IA, Muhammad R. diagnostic accuracy of plain x-ray lateral neck in the diagnosis of cervical esophageal foreign bodies keeping oesophagoscopy as gold standard. J Ayub Med Coll Abbottabad. 2018; 30(3):386-8
Lee, JH, Lee JH, Shim JO, Lee JH, et al. Foreign body ingestion in children: should button batteries in the stomach be urgently removed? Pediatr Gastroenterol Hepatol Nutr. 2016; 19:20-8. doi: 10.5223/pghn.2016.19.1.20
Wyllie R. Foreign bodies in the gastrointestinal tract. Curr Opin Pediatr. 2006; 18:563-4. doi: 10.1097/01.mop.0000245359.13949.1c
Lee JH, Lee JS, Kim MJ, Choe YH. Initial location determines spontaneous passage of foreign bodies from the gastrointestinal tract in children. Pediatr Emerg Care 2011; 27:284-9. doi: 10.1097/PEC.0b013e318213131a
Kay M, Wyllie R. Pediatric foreign bodies and their management. Curr Gastroenterol Rep. 2005; 7:212-8. doi: 10.1007/s11894-005-0037-6
Sung SH, Jeon SW, Son HS, Kim SK, et al. Factors predictive of risk for complications in patients with oesophageal foreign bodies. Dig Liver Dis. 2011; 43:632-5. doi: 10.1016/j.dld.2011.02.018
Beata R, Grazyna N, Artur N, Ewa RD, Pawel R. Esophageal foreign bodies in pediatric patients: a thirteen-year retrospective study. Sci World J. 2012; 2012:102642. doi: 10.1100/2012/102642
Arana A, Hauser B, Hachimi-Idrissi S, Vandenplas Y. Management of ingested foreign bodies in childhood and review of the literature. Eur J Pediatr. 2001; 160:468-72. doi: 10.1007/s004310100788
Lee JH, Kim HC, Yang DM, Kim SW, et al. What is the role of plain radiography in patients with foreign bodies in the gastrointestinal tract? Clin Imaging 2012; 36:447-54. doi: 10.1016/j.clinimag.2011.11.017
Nation J, Jiang W. The utility of a handheld metal detector in detection and localization of pediatric metallic foreign body ingestion. Int J Pediatr Otorhinolaryngol. 2017; 92:1-6. doi: 10.1016/j.ijporl.2016.10.035
ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011; 73:1085-91. doi: 10.1016/j.gie.2010.11.010
Tringali A, Thomson M, Dumonceau JM, Tavares M, et al. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Guideline Executive summary. Endoscopy 2017; 49:83-91. doi: 10.1055/s-0042-111002
Birk M, Bauerfeind P, Deprez PH, Häfner M, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48:489-96. doi: 10.1055/s-0042-100456
Arora R, Kumar S, Singh GB et al. Predictors of nature of ingested foreign bodies in children & assessment of operative outcomes: Int J Pediatr Otorhinolaryngol. 2018 Oct; 113:150-55
Leinwand K, Brumbaugh DE, Kramer RE. FASGE Button battery ingestion in children: A paradigm for management of severe pediatric foreign body ingestions: Gastrointest Endosc Clin N Am. 2016; 26(1): 99-118
Krom H, Visser M, Hulst JM, et.al. Serious complications after button battery ingestion in children. Eur J Pediatr. 2018; 177(7): 1063-70.