Metallic foreign body in esophagus: Are multiple radiographs necessary?

Abstract

Multiple X-rays required for confirmation and localization of ingested metallic foreign body preoperatively predisposes children to increased radiation exposure. This study aims to highlight the current necessity or otherwise of these X-ray requests. This is a retrospective study of patients with ingested metallic foreign bodies over a five-year period in a tertiary health institution. Case notes and X-ray requests were studied. Of 39 cases of foreign body in esophagus, 29 (74.4%) were metallic and the coin accounted for 79.3% of all metallic foreign bodies. There were 20 males to 9 females and 28 children aged 2 months to 11 years to one adult. There were 62 pre-extraction X-rays consisting of 29 (46.8%) initial confirmatory films and 33 (53.2%) repeat films for localization of the foreign body. There were 10 post-extraction films for postoperative complications. More than half of the X-ray films were unnecessary and the radiation exposure was avoidable if alternative methods of localization of the foreign body such as the handheld metal detector were available.