Tablets as Foreign Bodies

Abstract

Sometimes ingested foreign bodies do not only cause problems but actually service as a diagnostic indicator. We recently reported on a somnolent patient in whom a diagnosis of tablet-related intoxication was made primarily on the basis of a finding of several identical radiopaque foreign bodies in the stomach (1). Because of suspected trauma, this patient had undergone a CT scan. Many, but not all, tablets contain white pigments (titanium oxide) or other additives containing elements of a higher order (bromide, iodine) and are therefore radiopaque. However, it is also true that tablets can be radiologically confirmed only within a narrow time window between ingestion and resorption. Dissolved tablets cannot be distinguished with complete certainty from foods with a high calcium content or gastrointestinal hemorrhage. Even though findings of tablets in computed tomography are typical it is still unusual for a diagnosis of intoxication to be made primarily on a radiological basis.