Pin Point Densities on Abdominal X-ray

Abstract

A 9-y-old boy presented to pediatric emergency with historyof high grade fever and cough for 4 d. During per-oraltemperature recording using mercury (glass) thermome-ter, the child bit the thermometer resulting in the acci-dental ingestion of its tip. There was no pain abdomen orbleeding per rectum. At presentation, the child was afebrile,consciousandresponsive.Abdomenwasnon-tenderandsoft.Chest X-ray was normal (Fig. 1) except for tiny densefoci in the left lower zone. Abdominal radiograph(Fig. 2), however, was striking. It showed multiple tinydiscrete dense foci. Follow up radiograph, 1 day laterrevealed change in the pattern of the densities, both interms of their number and position. Abdominalultrasound was normal. The child was kept under observa-tion for a couple of days.Thermometers contain mercury in elemental form [1]. It ispoorly absorbed from the gastro-intestinal tract (GIT) and ismildly toxic to the GIT mucosa [2]. Accidental ingestion ofelemental mercury is rare and has been reported inchildren in few case reports [3, 4]. Small particles maybe aspirated (as in our case), though innocuous. Injuriesrelated to glass should also be considered; no such injuriesoccurred in present case [5].