Not All Radiopaque Foreign Bodies Shadow on Ultrasound

Chan, Sherwin S; Russell, M. T.; Ho-Fung, Víctor

doi:10.1097/ruq.0000000000000071

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…We have shown that both Buckyball-type and button magnets are intrinsically highly echogenic and produce significant reverberation artifact due to their smooth and highly reflective surfaces. This is congruent with findings published in a 2014 study of magnets in the stomach [ 25 ]. Furthermore, ultrasound allows us to further evaluate the orientation of magnets in relation to the bowel loops.…”

Section: Discussionsupporting

confidence: 93%

Ultrasound evaluation of intraluminal magnets in an ex vivo model

Lee

Rugg

et al. 2023

Emerg Radiol

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Purpose The management of foreign body ingestion proves to be a challenge. Magnets pose a unique set of risks when ingested due to their attractive forces and subsequent risk of adherence, pressure necrosis, and perforation complications. Radiographs only provide a limited snapshot in the setting of multiple magnet ingestion when the risk of complication is highest. We hypothesize that abdominal ultrasound (US) has the potential to supplement radiographs in assessing ingested magnets by determining the presence of bowel loop entrapment and of any extraluminal fluid. Methods We recreated various scenarios of magnet configurations using animal cadaveric bowel models. X-ray and US images were obtained in various bowel-magnet orientations. Results We identified several key US features to suggest bowel wall tethering. These include direct visualization of bowel wall entrapment between magnets (what we term the “dangerous V sign”), anti-dependent positions of the magnets, and inability to separate loops of bowel with compression. Conclusion These findings could potentially provide valuable information when directing the urgency of intervention in foreign body ingestion. Ultrasound may supplement and improve the current guidelines in management of magnet ingestion.

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Section: Discussionsupporting

confidence: 93%

Ultrasound evaluation of intraluminal magnets in an ex vivo model

Lee

Rugg

et al. 2023

Emerg Radiol

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“…This is because if the FB is completely surrounded by the mucosa, only gastric mucosa edema and purulent external pressure can be seen under the endoscope. Even with further ultrasound gastroscopy, not all radiopaque FBs produce shadows on ultrasound images [ 30 ]. On the other hand, patients often suffer from unspecific symptoms without a clear chief complaint of FB ingestion.…”

Section: Discussionmentioning

confidence: 99%

Misdiagnosis of peripheral abscess caused by duodenal foreign body: a case report and literature review

Wang

Zhou

et al. 2020

BMC Gastroenterol

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Background: The induction of chronic inflammation, perforation, and abscess by foreign bodies (FBs) in adults is uncommon. We present a delayed diagnosis case for a patient who had a fishbone stuck in the duodenal bulb, resulting in chronic abdominal pain for nearly 3 months. We present the diagnosis and treatment procedures for chronic patients, which differ from those for acute and emergency FB ingestion, and also summarize the characteristics of such patients through a systematic literature review. Case presentation: A 68-year-old woman was brought to our hospital with repeated right upper abdominal pain lasting for 3 months and aggravation for 9 h. Computed tomography (CT) showed a streaky high-density shadow (approximately 3 cm in length) on the posterior wall of the gastric antrum extending outside the wall. Endoscopic ultrasonography showed hyperechoic space with a cross-section of approximately 0.1 × 0.1 cm in the deep submucosal layer of the local stomach, accompanied by an acoustic shadow in the rear. The possibility of a fishbone as well as perforation was considered and the object was removed using FB forceps. Fasting as well as acid inhibition and anti-infection medication were prescribed for the patient. She eventually recovered and was discharged from the hospital. Conclusion: Endoscopic intervention can be recommended as the first option for patients with gastrointestinal FBs.

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“…However, despite the relevance of this phenomenon from the public health perspective, it is often neglected (Gregori et al, 2011 ; Passali et al, 2015 ). Generally, studies in this field are retrospective, single-center, case series (Brown et al, 2014b ; Sahadan et al, 2011 ) or case studies (Chan et al, 2014 ; Nivatvongs et al, 2015 ), but a systematic collection of data on choking injuries is lacking. In this framework, one of the few examples of systematic data collection on FB injuries is represented by the Susy Safe registry (Gregori, 2006 ).…”

Section: Introductionmentioning

confidence: 99%

Temporal and regional trends of choking injuries in children in Italy, 2001–2013

et al. 2018

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BackgroundChoking injuries in children are a significant public health problem. The present study was aimed at examining the epidemiologic patterns of choking injuries in children using Italian official data from hospital discharge records.MethodsHospital discharge records (from 2001 to 2013) reporting cases of choking injuries corresponding to the ICD-9 CM codes 933 (“Foreign body in pharynx and larynx”), 934 (“Foreign body in trachea, bronchus, and lung”), and fourth digit specifications (933.0 “pharynx”, 933.1 “larynx”, 934.0 “trachea”, 934.1 “main bronchus”, 934.8 “other specified parts”, 934.9 “respiratory tree, unspecified”) occurred in children aged 0–14 years were analyzed to assess the temporal and regional trends. Annual rates of hospitalizations due to choking injuries per 100,000 person-years were calculated and compared between boys and girls.ResultsDuring the 13-year study period, there were a total of 7143 hospitalizations due to choking injuries in Italian children. The annual rates of hospitalizations due to choking injuries per 100,000 person-years decreased from 5.28 in 2001 to 3.46 in 2013 (p < 0.001). The reduction in choking injuries occurred across all the regions, particularly in Campania, Lombardia, Puglia, and Veneto.ConclusionsHospitalizations for choking injuries in Italian children have decreased significantly in recent years. Choking injuries in children remain a cause of concern in some regions. Future research needs to elicit the causal factors underlying the downward trends and regional variations and develop targeted interventions to further reduce choking injuries in Italian children.Electronic supplementary materialThe online version of this article (10.1186/s40621-018-0160-0) contains supplementary material, which is available to authorized users.

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Not All Radiopaque Foreign Bodies Shadow on Ultrasound

Cited by 8 publications

References 7 publications

Ultrasound evaluation of intraluminal magnets in an ex vivo model

Ultrasound evaluation of intraluminal magnets in an ex vivo model

Misdiagnosis of peripheral abscess caused by duodenal foreign body: a case report and literature review

Temporal and regional trends of choking injuries in children in Italy, 2001–2013

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