Foreign Bodies in the Abdominal Gastrointestinal Tract: Clinical and Radiological Features

Alec Krosser 2 Michal Marianne Amitai 2 Eyal Klang 1,2 Nir Horesh 3 Shelly Soffer 1,2 Michal Eifer 1,2 Victor Belsky 1,2 Eli Konen 1,2
1Department of Diagnostic Imaging, Tel Aviv University Sackler School of Medicine
2Department of Diagnostic Imaging, Sheba Medical Center
3Department of Surgery, Sheba Medical Center

Purpose: To present clinical and radiological features associated with gastrointestinal foreign bodies.

Materials and methods: Consecutive patients with foreign bodies in their gastrointestinal tract were retrospectively collected (2009-2016). Clinical data was retrieved from medical records. Foreign bodies were divided into seven groups: medical devices; fish bones; elongated metal objects; dental related objects; drugs; intra-rectal objects; and glass. Two radiologists analyzed all radiological examinations in consensus, evaluating which objects were missed on X-ray and registering the foreign bodies` shapes and complications (perforation, abscess, bowel obstruction). The different foreign bodies groups were statistically compared with clinical suspicion, X-ray visualization and presence of complications.

Results: Forty-two patients were included (4 medical devices, 3 fish bones, 3 drugs and 5 metal, 22 dental, 3 intra-rectal and 2 glass objects). Thirty-eight patients underwent X-ray and 14 underwent CT. Clinical suspicion was significantly higher for dental devices (p=0.002) and lower for fish bones (p0.001) and metal (p=0.005) objects. Fish bones were significantly less likely to be identified on X-ray (p=0.005) compared to other groups. The complication rate was higher for medical devices, metal, fish bones and drugs and significantly lower for the dental group (p=0.002). The only mortality case was due to cocaine absorption in a “body packer”.

Conclusion: Different groups of foreign bodies present with different clinical and radiological features. Knowledge of those features is important when looking for foreign bodies and their complications.









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