[Diagnostic ultrasonography of perforating foreign bodies of the digestive tract]

Abstract

Perforations of the gastrointestinal tract by ingested foreign bodies such as chicken or fish bones are rare and may occur at any site from the oesophagus to the rectum; the diagnosis is often very uneasy with conventional radiography. For many years, sonography has been more frequently requested as the first modality for the evaluation of abdominal pathology, and in many cases allowed a correct diagnosis to be reached without further assessment. We report six cases of complicated foreign bodies very successfully and specifically diagnosed by sonography in six different sites of the gastrointestinal tract. Four of these cases were preliminary correctly suspected by CT but the shape, length and the probable nature of the body were always better appreciated by multiaxial real time sonography. The correct sonographic diagnosis and follow-up allowed a conservative treatment in three cases, avoiding surgical exploration. We recommend the systematic sonographic investigation of foreign bodies in close relation with the gastrointestinal tract in all atypical inflammatory processes or to perform sonography as a complement to CT.