Non-Ionizing Diagnostic Evaluation of Ingested Foreign Bodies

Abstract

The interesting article by Ambe et al. on the diagnostic and therapeutic approach to swallowed foreign bodies in adults indicates, among other issues, the all-too scarce use of sonography in the diagnostic evaluation of ingested foreign bodies (1). In our opinion, using non-ionizing imaging modalities are a welcome alternative in children and adolescents—the groups in which ingestion of foreign bodies occurs most commonly—but also in pregnant women. Magnetic resonance imaging (MRI) is ruled out, on the one hand, because of the unknown size of the bodies and the fact that it is not known whether the bodies contain metal. On the other hand, bodies consisting of stone, metal, ceramic, or glass do not display well on MRI. For this reason we immersed several metallic and non-metallic items into a solution containing water or jelly and conducted sonography using a commercially available ultrasound device with different probes (linear, convex) (2). We were able to clearly sound out, measure, and unequivocally identify all items (among others, a key, a shell, a plastic Smurf, a spring from a ballpoint pen, and a 2-Euro coin). We believe that this method could easily be used in vivo, in spite of possible masking effects, and would therefore encourage colleagues to conduct sonography before radiography or as an add-on, in order to obtain more data on the specificity and sensitivity of this method in this particular indication.