Pediatric Gastrointestinal Foreign Bodies Workup
- Author: John A Sandoval, MD; Chief Editor: Carmen Cuffari, MD more...
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- No laboratory studies are usually necessary for diagnostic or treatment purposes; however, blood and urine mercury levels are reasonable adjuncts to the workup in the case of a fragmented rectal thermometer.
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- Plain radiography[13, 14]
- Radiography is mandated for children with suspected GI foreign body ingestion.
- This assists in locating radiopaque foreign bodies in the hypopharynx and esophagus. In small children, a mouth-to-anus film (babygram) can be obtained. In older children, anteroposterior (AP) and lateral chest radiographs that include the neck help to locate radiopaque foreign bodies in the hypopharynx and esophagus.
- Coins are usually observed in a coronal alignment on AP films. See the image below.
- If the foreign body is in the trachea, they typically lie in a sagittal orientation. Disk batteries appear as a circular double density on radiography, representing the cell's cathode and anode.
- Flat plate radiography of the abdomen/pelvis
- This may be helpful to assess whether the object has slipped into the stomach in an older child or teenager.
- A flat plate of the pelvis may be helpful when a rectal foreign body is suspected.
- Barium swallow or upper GI contrast study
- Contrast studies are helpful if the foreign body in question is radiolucent.
- Barium is contraindicated in cases in which esophageal perforation is suspected.
- Gastrografin may be used as the contrast agent if a study is necessary.
- CT scanning: CT scanning of the neck, chest, abdomen, and pelvis is highly reliable in localizing foreign bodies yet is necessary only in difficult or complicated cases.
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- Although the use of metal detectors for location of ingested metallic objects has proven efficacious, this technique is not commonly used in clinical practice.
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- No diagnostic procedures outside of the radiology suite are required.
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