Diagnosis of Nonmigrating Metallic Foreign Bodies in the Abdomen Using Ultrasound: An Alternative Approach Using a Traditional Method

Abstract

Ingestion of foreign bodies (FBs) is a common phenomenon among young children. Plain radiography is the first step diagnostic modality to detect the radio-opaque FBs. And computed tomography has been recommended by several guidelines as useful modalities for diagnosing ingested FBs. However, there is a risk of radiation exposure, making it burdensome to use in asymptomatic patients. Ultrasound (US) is not a commonly used technique for diagnosing ingested foreign bodies. However, US can provide real-time imaging with good resolutions without radiation exposure in pediatric patients. Herein, we report two pediatric cases of metallic foreign body ingestion that were successfully diagnosed using US for localizing foreign bodies. This study indicates that US may be used as an alternative method for detecting the localization of metallic foreign bodies in the gastrointestinal tract without exposure of radiation, particularly in pediatric patients.

Keywords: Child; Foreign bodies; Metals; Ultrasonography.

Fig. 1. A 15-month-old girl presented with ingestion of a metallic screw. (A) The metallic screw is detected in the right lower quadrant of the abdomen on the abdominal plain radiograph. (B) A 3×9 mm metallic foreign body (arrow) is observed at the tip of the appendix on abdominal ultrasound. (C) The appendiceal orifice appears tightly closed on colonoscopy. (D) A metallic screw is visible at the tip of the resected appendix.

Fig. 2. A 14-month-old boy presented with ingestion of three magnetic beads. (A) The magnetic beads are detected in the right lower quadrant of the abdomen on the abdominal plain radiograph. (B) Ultrasound reveals three echogenic materials in the small bowel (short arrows) and cecum (long arrow). A suspicious extraluminal location of the foreign body in the cecum is noted.