| 1. Johansen A, Conners GP, Lee J, Robinson AL, Chew WL, Chan SS. Pediatric Esophageal Foreign Body: Possible Role for Digital Tomosynthesis. Pediatric Emergency Care. 37(4):208-212, 2021 Apr 01.Pediatr Emerg Care. 37(4):208-212, 2021 Apr 01. |
Observational-Dx |
17 patients |
To evaluate the sensitivity and specificity of DTS to detect FB in comparison to esophagram and clinical impression. |
A total of 17 patients underwent an esophagography with DTS for suspected esophageal FB, of which 9 (53%) were suspected of having an FB on esophagram. Compared with esophagram, DTS had a sensitivity of 44%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 62%. Compared with clinical impression, DTS had a sensitivity of 33%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 38%. |
3 |
| 2. Litovitz TL, Klein-Schwartz W, White S, et al. 2000 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2001;19:337-95. |
Review/Other-Dx |
N/A |
These data are used to identify hazards early, focus prevention education, guide clinical research, and direct training. |
No abstract available. |
4 |
| 3. Nutman TB, Ottesen EA, Cohen SG. The eosinophil, eosinophilia, and eosinophil-related disorders. IV. Eosinophil related disorders (continued). Allergy Proc 1989;10:47-62. |
Review/Other-Dx |
N/A |
Eosinophil related disorders. |
No abstract available. |
4 |
| 4. Seghers VJ, Kan JH, Somcio R, Sher AC, Paul Guillerman R, Sammer MBK. CT imaging of esophageal foreign bodies in children: a pictorial essay. Japanese Journal of Radiology. 40(3):262-270, 2022 Mar.Jpn J Radiol. 40(3):262-270, 2022 Mar. |
Review/Other-Dx |
NA |
Essay to illustrate our institutional experience and can help others to confidently diagnose esophageal foreign bodies using a dedicated CT foreign body imaging protocol. |
No results stated in abstract. |
4 |
| 5. Little DC, Shah SR, St Peter SD, et al. Esophageal foreign bodies in the pediatric population: our first 500 cases. Journal of Pediatric Surgery. 41(5):914-8, 2006 May.J Pediatr Surg. 41(5):914-8, 2006 May. |
Review/Other-Dx |
555 children |
Children with esophageal foreign bodies are frequently seen by pediatric surgeons. |
Two hundred ninety-eight boys and 257 girls presented with a mean age of 3.24 years. Dysphagia (37%) and drooling (31%) were the most common symptoms. Foreign bodies were lodged in the superior esophagus in 73%, and 88% of the objects were coins. Balloon extraction with fluoroscopy was performed in 468 children. Eighty percent of the objects were successfully removed with a mean fluoroscopy time of 2.2 min, and 8% were advanced into the stomach. The overall success rate was 88%, with failures necessitating rigid esophagoscopy under general anesthesia. Children younger than 1 year were the most likely to fail (25% failure rate). Airway aspiration never occurred. Significant savings in patient charges were observed with this approach. |
4 |
| 6. Laya BF, Restrepo R, Lee EY. Practical Imaging Evaluation of Foreign Bodies in Children: An Update. [Review]. Radiologic Clinics of North America. 55(4):845-867, 2017 Jul.Radiol Clin North Am. 55(4):845-867, 2017 Jul. |
Review/Other-Dx |
N/A |
To review commonly encountered FBs with regard to incidence, risk factors, mechanisms of entry, clinical presentation, associated complications, and typical imaging appearance in children. |
No results stated in abstract. |
4 |
| 7. Grey NEO, Malone LJ, Miller AL, et al. Magnetic resonance imaging findings following button battery ingestion. Pediatric Radiology. 51(10):1856-1866, 2021 Sep.Pediatr Radiol. 51(10):1856-1866, 2021 Sep. |
Review/Other-Dx |
23 patients |
To review MRI/MR angiography imaging in button battery ingestion cases and compare with other imaging, clinical data and outcomes in these patients. |
Twenty-three patients with button battery ingestions had a total of 51 MRI/MR angiograms. Seventy percent of the cohort was male with a median age of 2 years (range: 0.94-17 years). Severe complications were found in 48% of patients (11/23), including esophageal perforation (n=11), tracheoesophageal fistula (n=3) and spondylodiscitis (n=1). No patients had vascular injury. Cervical location of the battery was significantly associated with severe complications (10/11 cases). The length of the blooming artifact was greater than 2 cm in those with severe complications and, in most cases, <2 cm in those without severe complications. All complications were seen on initial screening MR exam with serial exams showing decreased inflammation. |
4 |
| 8. Litovitz T, Whitaker N, Clark L, White NC, Marsolek M. Emerging battery-ingestion hazard: clinical implications. Pediatrics 2010;125:1168-77. |
Review/Other-Dx |
3 data sets |
To identify battery ingestion outcome predictors and trends, define the urgency of intervention, and refine treatment guidelines. |
All 3 data sets signal worsening outcomes, with a 6.7-fold increase in the percentage of button battery ingestions with major or fatal outcomes from 1985 to 2009 (National Poison Data System). Ingestions of 20- to 25-mm-diameter cells increased from 1% to 18% of ingested button batteries (1990-2008), paralleling the rise in lithium-cell ingestions (1.3% to 24%). Outcomes were significantly worse for large-diameter lithium cells (> or = 20 mm) and children who were younger than 4 years. The 20-mm lithium cell was implicated in most severe outcomes. Severe burns with sequelae occurred in just 2 to 2.5 hours. Most fatal (92%) or major outcome (56%) ingestions were not witnessed. At least 27% of major outcome and 54% of fatal cases were misdiagnosed, usually because of nonspecific presentations. Injuries extended after removal, with unanticipated and delayed esophageal perforations, tracheoesophageal fistulas, fistulization into major vessels, and massive hemorrhage. |
4 |
| 9. Orsagh-Yentis D, McAdams RJ, Roberts KJ, McKenzie LB. Foreign-Body Ingestions of Young Children Treated in US Emergency Departments: 1995-2015. Pediatrics 2019;143. |
Review/Other-Dx |
759,074 children |
o describe the epidemiology of foreign-body ingestions (FBIs) of children <6 years of age who were treated in US emergency departments from 1995 to 2015. |
On the basis of those cases, 759 074 children <6 years of age were estimated to have been evaluated for FBIs in emergency departments over the study period. The annual rate of FBI per 10 000 children increased by 91.5% from 9.5 in 1995 to 18 in 2015 (R 2 = 0.90; P < .001). Overall, boys more frequently ingested foreign bodies (52.9%), as did children 1 year of age (21.3%). Most children were able to be discharged after their suspected ingestion (89.7%). Among the types of objects ingested, coins were the most frequent (61.7%). Toys (10.3%), jewelry (7.0%), and batteries (6.8%) followed thereafter. The rates of ingestions of those products also increased significantly over the 21-year period. Across all age groups, the most frequently ingested coin was a penny (65.9%). Button batteries were the most common batteries ingested (85.9%). |
4 |
| 10. Quitadamo P, Pascarella A, Gragnaniello P, et al. Esophageal food bolus impaction in pediatric age. Journal of Pediatric Gastroenterology & Nutrition. 78(6):1398-1402, 2024 Jun.J Pediatr Gastroenterol Nutr. 78(6):1398-1402, 2024 Jun. |
Review/Other-Dx |
41 children |
To provide further insights into EFI episodes in children. |
Over the study period, 41 children were admitted for a first episode of food impaction. Drooling was the most commonly reported symptom. Half children experiencing a first episode of food bolus were diagnosed with EoE (20/41, 48.8%). Almost a fourth of the episodes subtended a different condition, such as esophageal anastomotic, peptic or congenital strictures, stricturing caustic esophagitis, esophageal duplication, and achalasia. In the last fourth of patients the cause of EFI was not identified and thus probably related to quick eating and inadequate chewing of food. |
4 |
| 11. Diniz LO, Towbin AJ. Causes of esophageal food bolus impaction in the pediatric population. Digestive Diseases & Sciences. 57(3):690-3, 2012 Mar.Dig Dis Sci. 57(3):690-3, 2012 Mar. |
Review/Other-Dx |
43 patients |
To determine the frequency of the different causes of food impaction in patients who undergo an esophagram or upper GI examination. |
After querying the radiology database, 43 patients were identified with an impacted food bolus on esophagram or upper GI. There were three abnormalities associated with food impaction: eosinophilic esophagitis (23/43; 53%), prior esophageal atresia repair (11/43; 26%), and prior Nissen fundoplication (5/43; 12%). There were eight patients in whom no underlying abnormality was identified. |
4 |
| 12. Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr 60:562-74, 2015 Apr. |
Review/Other-Dx |
N/A |
This guideline is intended as an educational tool that may help inform pediatric endoscopists in managing foreign body ingestions in children. |
No results stated in abstract. |
4 |
| 13. Lao J, Bostwick HE, Berezin S, Halata MS, Newman LJ, Medow MS. Esophageal food impaction in children. Pediatr Emerg Care 2003;19:402-7. |
Review/Other-Dx |
12 patients |
To determine the clinical presentation, radiographic, endoscopic and manometric findings, and clinical outcome of esophageal food impaction (EFI) in pediatric patients. |
All 12 patients described initially presented to our emergency department for care. Four patients (25%) required previous endoscopic intervention for disimpaction of EFI. Eleven required endoscopic removal of their EFI, and 1 patient's food impaction resolved spontaneously. The mean duration of food impaction was 20 hours prior to endoscopic intervention. Endoscopy demonstrated an esophageal stricture in 1 patient with a history of trisomy 21 and tracheoesophageal fistula repair. While there was no visual evidence of esophagitis in any patient, 5 of 7 had histologic evidence of esophagitis. Upper gastrointestinal series demonstrated the esophagus to be anatomically normal in 10 of 12 patients (83%); 1 patient had an esophageal stricture and another an esophageal web. Four of 8 patients studied had nonspecific esophageal motility abnormalities. |
4 |
| 14. Straumann A, Bussmann C, Zuber M, Vannini S, Simon HU, Schoepfer A. Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients. Clin Gastroenterol Hepatol 2008;6:598-600. |
Review/Other-Dx |
251 patients |
Eosinophilic esophagitis is a rapidly emerging, chronic inflammatory disorder. Prolonged inflammation evokes structural alterations and a fragile esophageal wall prone to perforation/rupture and food impaction. This report assesses the risk of spontaneously arising and procedure-induced complications and proposes practical recommendations. |
During an 18-year period, 87 patients (34.7%) experienced 134 food impactions requiring flexible (124, 92.5%) or rigid (10, 7.5%) endoscopic bolus removal. Transmural perforation occurred in 20% (2/10) of rigid procedures, and 1 esophageal rupture (Boerhaave's syndrome) was observed. |
4 |
| 15. Taskinlar H, Bahadir GB, Erdogan C, Yigit D, Avlan D, Nayci A. A Diagnostic Dilemma for the Pediatrician: Radiolucent Tracheobronchial Foreign Body. Pediatrics & Neonatology. 58(3):264-269, 2017 06.Pediatr neonatol. 58(3):264-269, 2017 06. |
Review/Other-Dx |
236 children |
The purpose of this study is to determine the role of clinical history, physical examinations, and radiological findings in the evaluation of patients with suspected radiolucent foreign body aspiration. |
In 71.1% of all cases, the children were under the age of 3 years. The bronchoscopy showed the presence of a foreign body in 52.9% of cases, with the locations of the foreign bodies being as follows: (1) right main bronchus, 47.2%; (2) left main bronchus, 36.0%; (3) trachea, 11.2%; (4) both bronchi, 5.6%. Organic foreign bodies were found in 78% of the patients, whereas inorganic foreign bodies were detected in 22% of the patients. The sensitivity and specificity of clinical history, physical examinations, and radiological findings were 98.4% and 54.9%, 47.2% and 74.7%, and 35.2% and 92.7%, respectively. |
4 |
| 16. Yang C, Hua R, Xu K, et al. The role of 3D computed tomography (CT) imaging in the diagnosis of foreign body aspiration in children. European Review for Medical & Pharmacological Sciences. 19(2):265-73, 2015.Eur Rev Med Pharmacol Sci. 19(2):265-73, 2015. |
Observational-Dx |
590 children |
The aim of this study was to improve the understanding of foreign body aspiration (FBA) in children and to decrease the rate of misdiagnosis, missed diagnosis and morbidity. |
CT imaging revealed common complications of FBA including emphysema (n = 379), pneumonia (n = 174), and atelectasis (n = 26). The remaining 120 patients had no visible complications on the three-dimensional reconstructed CT images. Serious complications including pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumatorrhachis could also be observed. The types of foreign bodies were diverse: the most common were peanuts and sunflower seeds. The diagnostic accuracy of the three-dimensional CT imaging was high, with a sensitivity and specificity of 99.83% and 99.89%, respectively. |
3 |
| 17. Darras KE, Roston AT, Yewchuk LK. Imaging Acute Airway Obstruction in Infants and Children. [Review]. Radiographics. 35(7):2064-79, 2015 Nov-Dec.Radiographics. 35(7):2064-79, 2015 Nov-Dec. |
Review/Other-Dx |
N/A |
To provide an imaging approach to acquired causes of acute airway obstruction in children, including (a) abnormalities affecting the upper portion of the airway, such as croup, acute epiglottitis, retropharyngeal infection, and foreign bodies, and (b) abnormalities affecting the lower portion of the airway, such as asthma, bronchiolitis, and foreign bodies. |
No results stated in abstract. |
4 |
| 18. Pitiot V, Grall M, Ploin D, Truy E, Ayari Khalfallah S. The use of CT-scan in foreign body aspiration in children: A 6 years' experience. International Journal of Pediatric Otorhinolaryngology. 102:169-173, 2017 Nov.Int J Pediatr Otorhinolaryngol. 102:169-173, 2017 Nov. |
Observational-Dx |
200 children |
A foreign body aspiration is a risky situation, common in pediatric emergency. The "gold standard" to rule out a foreign body or proceed to its extraction, is rigid bronchoscopy (RB) under general anesthesia. However, RB is an intrusive exam with possible complications. Depending on authors, RB in emergency is a procedure at risk of complications in 4-17% of cases. Advances in radiology allow CT-scanners of fast acquisition and high definition, which could be used as an alternative to RB. |
200 children were included. The average age was 30 months. 132 were considered normal and 68 pathological. Among the 68 RB performed for pathological scanner, a foreign body was found in 59 cases, and we had 9 cases of false positives. Among the 132 considered normal, 27 have had a RB despite this, due to persistent symptoms, all were negative; 105 were discharged home without endoscopy with monitoring instructions. 1 child was reviewed three months later for asthma, without second choking event reported. A new CT-scan found a foreign body that was removed by RB. Due to the nature of the foreign body it is very unlikely to link it to the first choking event, but retrospectively we cannot be certain. Considering this case as the only false negative, the negative predictive value (NPV) of CT was 99.2% and positive predictive value (PPV) of 83.8%. |
3 |
| 19. Ahmed OG, Guillerman RP, Giannoni CM. Protocol incorporating airway CT decreases negative bronchoscopy rates for suspected foreign bodies in pediatric patients. International Journal of Pediatric Otorhinolaryngology. 109:133-137, 2018 Jun.Int J Pediatr Otorhinolaryngol. 109:133-137, 2018 Jun. |
Observational-Dx |
87 patients |
Foreign body aspiration (FBA) is the 4th leading cause of death in children between the ages 1-5. Although direct laryngoscopy and bronchoscopy (DL&B) is the reference standard for diagnosis of pediatric airway foreign bodies, there is a high negative bronchoscopy rate, exposing patients to unnecessary operative and anesthetic risks and costs. |
After implementation of the airway FB clinical care protocol entailing selective airway CT, the overall negative bronchoscopy rate decreased from an institutional historical rate of 37% (54/145) to 17% (10/56) (p?=?.06). The overall sensitivity, specificity, and positive and negative predictive value of airway CT for FB was 91%, 100%, 100%, and 97% respectively. |
3 |
| 20. Gibbons AT, Casar Berazaluce AM, Hanke RE, et al. Avoiding unnecessary bronchoscopy in children with suspected foreign body aspiration using computed tomography. [Review]. Journal of Pediatric Surgery. 55(1):176-181, 2020 Jan.J Pediatr Surg. 55(1):176-181, 2020 Jan. |
Observational-Dx |
133 patients |
To compare patients presenting with possible FBA who underwent bronchoscopy alone to those who had a low-dose CT scan of the chest, with or without bronchoscopy. |
A total of 133 patients were evaluated for FBA, and 84 were treated with bronchoscopy. For those with a CT demonstrating a foreign body, findings were confirmed on bronchoscopy in 17/18 (94.4%). For those with bronchoscopy alone, 39/64 (60.9%) were found to have a foreign body (p < 0.01). CT excluded FBA in 49 patients. Sensitivity was 100%, specificity was 98%, and interobserver reliability was excellent (? = 0.88). |
2 |
| 21. Sammer MBK, Kan JH, Somcio R, et al. Chest CT for the Diagnosis of Pediatric Esophageal Foreign Bodies. Current Problems in Diagnostic Radiology. 50(5):566-570, 2021 Sep-Oct.Curr Probl Diagn Radiol. 50(5):566-570, 2021 Sep-Oct. |
Review/Other-Dx |
220 exams |
We sought to determine if CT could be used for pediatric esophageal foreign bodies, preferably through modification for the existing airway FB-CT technique. |
For ages 1+ years, effective dose was lowest using the FB-CT protocol; esophagram mean dose showed the most variability, and was over double the dose of FB-CT for ages 5+ years. Routine CT chest doses were uniformly highest across all age ranges. Given these findings, we instituted a CT foreign body imaging protocol as the first-line imaging modality for radiolucent esophageal foreign body at our institution. |
4 |
| 22. American College of Radiology. ACR-ASER-SABI-SPR Practice Parameter for the Performance of Pediatric Computed Tomography (CT). Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=77+&releaseId=2 |
Review/Other-Dx |
N/A |
Guidance document to promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 23. Azzi JL, Seo C, McInnis G, et al. A systematic review and meta-analysis of computed tomography in the diagnosis of pediatric foreign body aspiration. International Journal of Pediatric Otorhinolaryngology. 165:111429, 2023 Feb.Int J Pediatr Otorhinolaryngol. 165:111429, 2023 Feb. |
Meta-analysis |
16 manuscripts |
To present a comprehensive synthesis detailing the present state of evidence with regards to diagnostic accuracy of CT imaging in patients with suspected foreign body aspirations (FBA). |
Sixteen manuscripts met all inclusion criteria. In total, 2056 pediatric patients ranging from 0.3 to 15 years underwent CT for suspected FBA. The sensitivity and specificity of CT were 98.8% and 96.6%, respectively. VB was used in 71.4% (1391/1948) of patients while sedation during CT was required in 70.2% (1263/1800) of patients. Radiation dosing ranged from 0.04 to 2 mSv, 0.99–59.1 mGy-cm and 0.03–16.99 mGy. |
Good |
| 24. Gordon L, Nowik P, Mobini Kesheh S, Lidegran M, Diaz S. Diagnosis of foreign body aspiration with ultralow-dose CT using a tin filter: a comparison study. Emergency Radiology. 27(4):399-404, 2020 Aug.EMERG. RADIOL.. 27(4):399-404, 2020 Aug. |
Review/Other-Dx |
136 children |
To compare the diagnostic performance of an ultralow-dose CT (DLP of around 1 mGycm) with that of conventional radiographic methods (fluoroscopy and chest radiography of the airways) in the diagnosis of FBA children's airways. |
The effective doses used in the ultralow-dose CT examinations were lower compared with those in conventional methods (p < 0.001). The median dose for CT was 0.04 mSv compared with 0.1 mSv for conventional methods. Sensitivity and specificity were higher for ultralow-dose CT than those for conventional methods (100% and 98% versus 33% and 96%) as were the positive and negative predicted values (90% and 100% versus 60% and 91%). |
4 |
| 25. Park S, Choi DS, Shin HS, et al. Fish bone foreign bodies in the pharynx and upper esophagus: evaluation with 64-slice MDCT. Acta Radiologica. 55(1):8-13, 2014 Feb.Acta Radiol. 55(1):8-13, 2014 Feb. |
Observational-Dx |
66 patients with suspected FB foreign body ingestion |
To investigate the efficacy of 64-slice multidetector computed tomography (MDCT) for the evaluation of pharynx and upper esophageal FB foreign bodies. |
On MDCT, 46 foreign bodies were detected. Among them, 45 were confirmed by endoscopy. The sensitivity of MDCT for the detection of foreign bodies was 100%, which was superior to that of the plain radiography (51.7%). The location of the foreign bodies was most common in the upper esophagus (n = 22, 47.8%), followed by pharyngoesophageal junction (n = 10, 21.7%), transjunctional (n = 7, 15.2%), hypopharynx (n = 5, 10.9%), and oropharynx (n = 2, 4.3%). Their longest length was 5.3-40.1 mm (mean, 21.3 mm). Thirty-three FBs (71.7%) were linear and 13 (28.3%) were flat in shape. They showed transverse (n = 23, 50.0%), parallel (n = 13, 28.3%), and oblique positions (n = 10, 21.7%) to the long axis of the pharynx and esophagus, respectively. |
4 |
| 26. Giannoni CM, Guillerman RP. Computed Tomography for the Evaluation of Suspected Airway Foreign Bodies. Clinical Pediatric Emergency Medicine 2015;16:230-34. |
Review/Other-Dx |
N/A |
The prompt diagnosis of foreign body aspiration (FBA) in children is essential to avoid complications such as postobstructive pneumonia and bronchiectasis. |
No abstract available. |
4 |
| 27. Adaletli I, Kurugoglu S, Ulus S, et al. Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration. Pediatric Radiology. 37(1):33-40, 2007 Jan.Pediatr Radiol. 37(1):33-40, 2007 Jan. |
Observational-Dx |
37 children |
To investigate the potential use of low-dose multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation and management of SFBA in children. |
Obstructive pathology was found in 16 (43.25%) of the 37 patients using MDCT and VB. In 13 of these patients, foreign bodies were detected and removed via CB. The foreign bodies were located in the right main bronchus (n = 5), in the bronchus intermedius (n = 6), in the medial segment of the middle lobe bronchus (n = 1), and in the left main bronchus (n = 1). In the remaining three patients, the diagnosis was false-positive for an obstructive pathology by MDCT and VB; the final diagnoses were secretions (n = 2) and schwannoma (n = 1), as demonstrated by CB. In 21 patients in whom no obstructive pathology was detected by MDCT and VB, CB was not performed. These patients were followed for 5-20 months without any recurrent obstructive symptomatology. |
3 |
| 28. Bai W, Zhou X, Gao X, Shao C, Califano JA, Ha PK. Value of chest CT in the diagnosis and management of tracheobronchial foreign bodies. Pediatrics International. 53(4):515-8, 2011 Aug.Pediatr Int. 53(4):515-8, 2011 Aug. |
Observational-Dx |
45 children |
To investigate the value of chest multidetector computed tomography (CT) in the evaluation of children with suspected foreign body aspiration. |
All 42 patients (100%) with tracheobronchial foreign bodies were identified on chest CT. Three patients avoided unnecessary operations due to negative CT scans. For the patients with tracheobronchial foreign bodies, the occurrence of unilateral hyperlucent lung and post-obstructive lobar or segmental infiltrates on plain chest X-ray was 42.9% (18/42) and 4.8% (2/42), respectively. Twenty-two of the 42 patients (52.4%) had no abnormalities on plain X-ray. The difference between multidetector CT and plain X-ray results was statistically significant (P < 0.001). Surgical plans were designed and appropriate foreign body forceps were selected based on the CT scans. All foreign bodies were removed successfully, and no severe complications were observed. The location, shape, and volume of the foreign bodies found at surgery were consistent with the CT images. |
2 |
| 29. El Khoury P, Makhoul M, El Hadi C, Haber C, Rassi S. CT Scan in Children Suspected of Foreign Body Aspiration: A Systematic Review and Meta-analysis. [Review]. Otolaryngology - Head & Neck Surgery. 170(1):1-12, 2024 Jan.Otolaryngol Head Neck Surg. 170(1):1-12, 2024 Jan. |
Meta-analysis |
18 articles |
The goal of this study is to evaluate the sensitivity and specificity of computed tomography (CT) scans in the diagnosis of foreign body aspiration (FBA) in children, and to determine whether chest CT scans would reduce the need for diagnostic rigid bronchoscopies. |
Eighteen articles (4178 patients) were included. The average age of the children was 2.26 (±0.75) years, and 65% (±5.64%) of them were boys. Cough was the most prevalent symptom upon presentation. The pooled analysis showed that the sensitivity of chest CT scan in detecting a foreign body in children was 99% (95% confidence interval, CI [97, 100]; I2 = 72%, t2 = 0.0065, p < .01). The false negative rate was 1.8% (95% CI [0.3, 2.7]; I2 = 72%, p < .01). The specificity of chest CT scan was 92% (95% CI [83, 98]; I2 = 83%, t2 = 0.0437, p < .01). |
Good |
| 30. Haliloglu M, Ciftci AO, Oto A, et al. CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration. European Journal of Radiology. 48(2):188-92, 2003 Nov.Eur J Radiol. 48(2):188-92, 2003 Nov. |
Review/Other-Dx |
23 children |
Computed tomography (CT) virtual bronchoscopy is a noninvasive technique that provides an internal view of trachea and major bronchi by three-dimensional reconstruction. The aim of this study was to investigate the usefulness of virtual bronchoscopy in the evaluation of suspected foreign body aspiration in children. |
CT virtual bronchoscopy and conventional bronchoscopy revealed the location of the foreign body in seven patients. It was in the right main bronchus in four patients, in the right lower lobe bronchus in one patient, and in the left main bronchus in two patients. There was no discordance between two modalities. CT examination revealed hyperaeration of the ipsilateral lung in four patients, hyperaeration of the ipsilateral lung and mediastinal shift in one patient and bronchiectatic changes in one patient. CT detected no additional finding in one patient with a foreign body in the right main bronchus. In 10 of 16 patients without foreign body, CT examination demonstrated atelectasis, infiltration, peribronchial thickening, and paratracheal lymphadenpoathy. |
4 |
| 31. Jung SY, Pae SY, Chung SM, Kim HS. Three-dimensional CT with virtual bronchoscopy: a useful modality for bronchial foreign bodies in pediatric patients. European Archives of Oto-Rhino-Laryngology. 269(1):223-8, 2012 Jan.Eur Arch Otorhinolaryngol. 269(1):223-8, 2012 Jan. |
Review/Other-Dx |
10 children |
Bronchial foreign bodies (FB) in children are difficult to diagnose when there is no witness to the aspiration event. |
No results stated in abstract |
4 |
| 32. Young CA, Menias CO, Bhalla S, Prasad SR. CT features of esophageal emergencies. [Review] [22 refs]. Radiographics. 28(6):1541-53, 2008 Oct.Radiographics. 28(6):1541-53, 2008 Oct. |
Review/Other-Dx |
N/A |
To present CT findings associated with the spectrum of acute esophageal disease facilitates the accurate and prompt diagnosis of esophageal emergencies and thereby contributes to a more successful outcome. |
No results stated in abstract. |
4 |
| 33. Luk WH, Fan WC, Chan RY, Chan SW, Tse KH, Chan JC. Foreign body ingestion: comparison of diagnostic accuracy of computed tomography versus endoscopy. Journal of Laryngology & Otology. 123(5):535-40, 2009 May.J Laryngol Otol. 123(5):535-40, 2009 May. |
Observational-Dx |
193 |
To investigate and compare the sensitivity and specificity of computed tomography and of endoscopy, as diagnostic tests for foreign body ingestion. |
Over the study period, 193 patients were admitted for foreign body ingestion, complaining of a persistent foreign body sensation in the neck. The sensitivity and specificity of computed tomography were 78 and 96 per cent, respectively; the positive predictive value was 75 per cent and the negative predictive value 97 per cent. The diagnostic accuracy of computed tomography was 94 per cent. |
1 |
| 34. Zhu Z, Li W, Zhang L, Hu J, Wang W, Ma Z. The predictive role of dual source CT for esophageal foreign bodies. American Journal of Otolaryngology. 35(2):215-8, 2014 Mar-Apr.Am J Otolaryngol. 35(2):215-8, 2014 Mar-Apr. |
Review/Other-Dx |
11 cases |
Esophageal foreign bodies can be a danger to a patient's life. Flexible or rigid endoscopy is a commonly used type of invasive investigation for these, and radiological examinations are also useful. |
Multi-slice spiral CT (MSCT) can confirm and locate most foreign bodies. Dual source CT (DSCT) is a more advanced technique with double speed, 20% of the radiation dosage and higher resolution, so it is more suitable for possible esophageal foreign bodies, especially in children, with no need for sedation. We provide a preliminary experiment of a DSCT scan of two fish, and we present a series of 11 cases with DSCT scans of which 5 were positive. |
4 |
| 35. Liu YC, Zhou SH, Ling L. Value of helical computed tomography in the early diagnosis of esophageal foreign bodies in adults. Am J Emerg Med 31:1328-32, 2013 Sep. |
Observational-Dx |
120 patients |
To investigate the relationship between early use of computed tomography (CT) and complications associated with esophageal foreign body impaction in adults. |
CT demonstrated 100% sensitivity, 92.6% specificity, 100% negative predictive value, and 97.9% positive predictive value. Esophageal foreign bodies were associated with a high incidence of complications in adults, and there was a significant difference in the incidence of complications between different durations of impaction (P < .01). In total, 37 patients presented with complications: 32 patients with grade I, 3 with grade II, 2 with grade III, and 0 with grade IV. |
3 |
| 36. Wei CJ, Levenson RB, Lee KS. Diagnostic Utility of CT and Fluoroscopic Esophagography for Suspected Esophageal Perforation in the Emergency Department. AJR. American Journal of Roentgenology. 215(3):631-638, 2020 09.AJR Am J Roentgenol. 215(3):631-638, 2020 09. |
Observational-Dx |
103 patients |
To evaluate the diagnostic utility of CT in emergency department (ED) patients with suspected esophageal perforation and assessed whether subsequent fluoroscopic esophagography is necessary. |
One hundred three patients met the inclusion criteria. Sensitivity, specificity, PPV, and NPV for diagnosing esophageal perforation were 100.0%, 79.8%, 32.1%, and 100.0%, respectively, with CT and 77.8%, 98.9%, 87.5%, and 97.9% with fluoroscopic esophagography. Combining CT and fluoroscopic esophagography did not improve sensitivity, specificity, PPV, or NPV relative to using CT alone. The true-positive esophageal perforation rate was 8.7% for CT and 6.8% for fluoroscopic esophagography. When CT showed only pneumomediastinum (n = 51) or no pneumomediastinum (n = 14), the NPV of CT was 100.0%. CT with oral contrast material had a PPV of 38.5%, whereas CT without oral contrast material had a PPV of 26.7%. |
3 |
| 37. Rybojad B, Niedzielska G, Niedzielski A, Rudnicka-Drozak E, Rybojad P. Esophageal foreign bodies in pediatric patients: a thirteen-year retrospective study. Thescientificworldjournal. 2012:102642, 2012.ScientificWorldJournal. 2012:102642, 2012. |
Review/Other-Dx |
192 cases |
We discuss clinical symptoms and radiological findings of variable esophageal foreign bodies as well as therapeutic procedures in Caucasian pediatric patients. |
A foreign body was removed from a digestive tract of 163 children aged 6 months to 15 years (mean age 4.9). Most objects were located within cricopharyngeal sphincter. Dysphagia occurred in 43%, followed by vomiting (29%) and drooling (28%). The most common objects were coins. Plain chest X-rays demonstrated aberrations in 132 cases, and in doubtful situations an esophagram test was ordered. In the group of thirty-seven patients whose radiograms were normal, esophagoscopy revealed fifteen more objects, which were eventually successfully removed. No major complications occurred. Esophagram should be a second X-ray examination if an object is not detected in plain chest X-ray. We recommend a rigid esophagoscopy under general anesthesia in doubtful cases as a safe treatment for pediatric patients. |
4 |
| 38. Sink JR, Kitsko DJ, Mehta DK, Georg MW, Simons JP. Diagnosis of Pediatric Foreign Body Ingestion: Clinical Presentation, Physical Examination, and Radiologic Findings. Ann Otol Rhinol Laryngol 2016;125:342-50. |
Review/Other-Dx |
543 patients |
To describe clinical and radiologic findings in patients with esophageal foreign bodies and to examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion. |
Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively. |
4 |
| 39. Fuentes Santos C, Steen B. Aspiration of barium contrast. Case Rep Pulmonol 2014;2014:215832. |
Review/Other-Dx |
1 case |
Case study of a 79-year-old male patient in whom we observed the presence of contrast medium residue in the lung parenchyma as an incidental finding during hospitalization. |
No result stated in abstract. |
4 |
| 40. Fadoo F, Ruiz DE, Dawn SK, Webb WR, Gotway MB. Helical CT esophagography for the evaluation of suspected esophageal perforation or rupture. AJR Am J Roentgenol 2004;182:1177-9. |
Review/Other-Dx |
11 patients |
To report a CT technique designed to specifically assess patients for esophageal perforation that may be performed after routine thoracic helical CT. This technique, which uses low-osmolar IV contrast material as the oral agent, may obviate fluoroscopic esophagography, therefore expediting the evaluation of patients presenting with chest pain. |
No results stated in abstract. |
4 |
| 41. Guelfguat M, Kaplinskiy V, Reddy SH, DiPoce J. Clinical guidelines for imaging and reporting ingested foreign bodies. AJR Am J Roentgenol 2014;203:37-53. |
Review/Other-Dx |
NA |
The purpose of this article is to familiarize radiologists with the specific characteristics of foreign bodies, obtained from image interpretation, to guide further management. Details of object morphologic characteristics and location in the body gained through imaging form the backbone of the classification used in the treatment of ingested foreign bodies. |
No results listed in abstract. |
4 |
| 42. McCrory D, Smith C, Hampton S. Foiling the barium swallow!. BMJ Case Rep. 2019 Jan 14;12(1):bcr-2018-228083. |
Review/Other-Dx |
1 patient |
Foreign body in the oesophagus carries a significant risk of morbidity and mortality; due to oesophageal perforation, fistulisation, mediastinitis/sepsis and airway obstruction. |
No abstract available. |
4 |
| 43. Cheng W, Tam PK. Foreign-body ingestion in children: experience with 1,265 cases. J Pediatr Surg 1999;34:1472-6. |
Review/Other-Dx |
552 children |
To elucidate the clinical presentation, the effectiveness of investigations, and treatment of foreign body ingestion in children and to formulate an algorithm of management. |
Foreign bodies were detected in 552 (43%) of the 1,265 children admitted. The age of the children ranged from 6 months to 16 years (mean, 5.2 years). The preschool toddlers (mean age, 3.8 years) were most prone to ingest inanimate objects. The most common objects were coins (49%) and nonmetallic sharp objects (NMSO; 31%). Although x-rays could detect all the metallic objects and 86% of glass objects, the sensitivity of fish bone detection is only 26%. Absence of symptoms was common (50% in metallic group and 29% in NMSO group). Forty-one percent of coins and 95% of NMSO were lodged at sites suitable for removal by direct laryngoscopy alone with success rates of 86% and 77%, respectively. There were 3 disease-related complications and 1 mortality. Two of these children were mentally retarded and presented late. |
4 |
| 44. Meyer TJ, Grunz JP, Taeger J, et al. Systematic analysis of button batteries', euro coins', and disk magnets' radiographic characteristics and the implications for the differential diagnosis of round radiopaque foreign bodies in the esophagus. International Journal of Pediatric Otorhinolaryngology. 132:109917, 2020 May.Int J Pediatr Otorhinolaryngol. 132:109917, 2020 May. |
Review/Other-Dx |
NA |
Button battery (BB) ingestion can cause life-threatening complications such as esophageal perforation, and mediastinitis. Chest radiography is the method of choice to diagnose BB ingestion. Therefore, an adequate interpretation of X-ray imaging by physicians is mandatory. The study aimed to analyze relevant diagnostic aspects of BB X-ray imaging, and retrospective analysis of the imaging of radiopaque foreign bodies. |
Only BBs with a diameter of at least 20 mm had a reliable positive double rim sign at scan angles of 90°, and 45°. The step-off effect was visible in all BBs regardless of the diameter. DMs and ECs presented a homogeneous X-ray weakening at all investigated scan angles. In the retrospective analysis all five cases of BB ingestion showed a double rim sign, all fifteen cases of coin ingestion a homogeneous X-ray weakening. A corrugated margin was detected for 10 cent, 20 cent and 50 cent coins. |
4 |
| 45. Bolton SM, Saker M, Bass LM. Button battery and magnet ingestions in the pediatric patient. [Review]. Current Opinion in Pediatrics. 30(5):653-659, 2018 10.Curr Opin Pediatr. 30(5):653-659, 2018 10. |
Review/Other-Dx |
NA |
This review highlights the latest findings regarding the patients at risk for button battery and magnet ingestions, the symptoms of presentation, and complications of these objects in contributing to long-standing gastrointestinal injury. |
Button batteries may lead to esophageal injury within a few hours. Batteries retained in the esophagus are larger in diameter on average and size is associated with esophageal impaction as well as higher grade esophageal injury. Magnet ingestions, when multiple or with another metallic object, are often initially asymptomatic but may have acute worsening, and therefore warrant close monitoring. |
4 |
| 46. Dedhia K, Chang YF, Leonardis R, Chi DH. Is There a Need for Repeat Radiologic Examination of Children with Esophageal Coin Foreign Body?. Otolaryngology - Head & Neck Surgery. 156(1):173-179, 2017 01.Otolaryngol Head Neck Surg. 156(1):173-179, 2017 01. |
Review/Other-Dx |
406 children |
To determine factors associated with the passage of coins. To determine the need for repeat preoperative chest x-ray (CXR) for esophageal coin foreign body. Setting Academic tertiary care center. Design Case series with chart review. |
A total of 406 patients met inclusion criteria. The average age was 47 months (range, 1.8-194 months). On preoperative CXR, the position changed in 29 patients (7%). Age, type of coin, and location of coin were all statistically significant factors affecting the passage of the coin ( P < .0001). Coins in the distal esophagus were 9.3 times more likely to pass than coins in the proximal esophagus. The longer the object was in the esophagus, the less likely it was to pass. |
4 |
| 47. Torrecillas V, Meier JD. History and radiographic findings as predictors for esophageal coins versus button batteries. International Journal of Pediatric Otorhinolaryngology. 137:110208, 2020 Oct.Int J Pediatr Otorhinolaryngol. 137:110208, 2020 Oct. |
Observational-Dx |
139 patients with suspected coin or button battery esophageal foreign body ingestion |
To determine if clinical history and radiographic findings are reliable predictors for coin versus button battery in children presenting with esophageal foreign bodies to accurately guide decision making regarding the urgency of removal. |
139 patients met inclusion criteria for the study. Of 5 patients who had esophageal button batteries removed, clinical history was concerning for button battery in 2; accuracy of 12.35%. However, radiology reports suggested a battery in all 5. The negative predictive value for radiology alone for diagnosis of button battery was 97% with 81% accuracy. The clinical history for coin foreign body was accurate in 85.28% while radiography was 87% accurate. Wait time on average for all coin foreign body cases was 6.3 h. Day cases waited on average 5.5 h while after-hours cases waited a statistically significantly longer 7.5 h (p = 0.006). |
4 |
| 48. Brown JC, Chapman T, Klein EJ, et al. The utility of adding expiratory or decubitus chest radiographs to the radiographic evaluation of suspected pediatric airway foreign bodies. Annals of Emergency Medicine. 61(1):19-26, 2013 Jan.Ann Emerg Med. 61(1):19-26, 2013 Jan. |
Observational-Dx |
328 patients |
To compare test characteristics of standard (lateral and posteroanterior or anteroposterior) chest radiographs with and without special views (expiratory or bilateral decubitus) in the emergency department evaluation of children with suspected airway foreign bodies. |
Nine upper airway and 70 tracheobronchial airway foreign bodies were identified by direct visualization or bronchoscopy, and the remainder were ruled out by bronchoscopy (50 patients) or clinically (199 patients). The sensitivity and specificity of the radiographs were, respectively, decubitus cohort, standard views, 56% and 79% and standard+decubitus views, 56% and 64%; expiratory radiograph cohort, standard views, 33% and 70% and standard+expiratory views, 62% and 72%. For standard plus decubitus views versus standard views alone, the relative sensitivity was 1.0 (0.56/0.56; 95% confidence interval [CI] 0.81 to 1.23) and the relative 1-specificity was 1.76 (0.36/0.21; 95% CI 1.3 to 2.37). For standard plus expiratory views versus standard views alone, the relative sensitivity was 1.87 (0.62/0.33; 95% CI 1.23 to 2.83) and the relative 1-specificity was 0.93 (0.28/0.3; 95% CI 0.6 to 1.44). |
2 |
| 49. Haegen TW, Wojtczak HA, Tomita SS. Chronic inspiratory stridor secondary to a retained penetrating radiolucent esophageal foreign body. J Pediatr Surg 2003;38:e6. |
Review/Other-Dx |
N/A |
To present a 17-month-old girl with chronic inspiratory stridor secondary to tracheal compression from a chronic retained penetrating radiolucent esophageal FB. |
No results stated in abstract. |
4 |
| 50. Kim N, Atkinson N, Manicone P. Esophageal foreign body: a case of a neonate with stridor. Pediatr Emerg Care 2008;24:849-51. |
Review/Other-Dx |
N/A |
To present a case of a 7-week-old female with a 3-week history of progressively worsening stridor who was admitted to rule out a congenital anomaly in the airway or vasculature. |
No results stated in abstract. |
4 |
| 51. Valdez AL, Casavant MJ, Spiller HA, Chounthirath T, Xiang H, Smith GA. Pediatric exposure to laundry detergent pods. Pediatrics 2014;134:1127-35. |
Review/Other-Dx |
17,230 |
To investigate the epidemiologic characteristics and outcomes of laundry detergent pod exposures among young children in the United States. |
There were 17 230 children younger than 6 years exposed to laundry detergent pods in 2012-2013. From March 2012 to April 2013, the monthly number of exposures increased by 645.3%, followed by a 25.1% decrease from April to December 2013. Children younger than 3 years accounted for 73.5% of cases. The major route of exposure was ingestion, accounting for 79.7% of cases. Among exposed children, 4.4% were hospitalized and 7.5% experienced a moderate or major medical outcome. A spectrum of clinical effects from minor to serious was seen with ingestion and ocular exposures. There were 102 patients (0.6%) exposed to a detergent pod via ingestion, aspiration, or a combination of routes, including ingestion, who required tracheal intubation. There was 1 confirmed death. |
4 |
| 52. Stromberg PE, Burt MH, Rose SR, Cumpston KL, Emswiler MP, Wills BK. Airway compromise in children exposed to single-use laundry detergent pods: a poison center observational case series. Am J Emerg Med 33:349-51, 2015 Mar. |
Observational-Dx |
131 patients |
To summarize clinical effects from unintentional LDP exposures reported to a single poison center over 15 months. |
We identified 131 cases between January 2012 and April 2013. Median (interquartile range [IQR]) age was 2.0 (1.5) years, with 4 adult cases; all were coded as unintentional. The most common route was ingestion (120) followed by ocular (14) and dermal (6). Some patients had multiple routes of exposure. Of ingestion exposures, 79 (66%) were managed at home; and 41 (34%) were evaluated in a hospital, of which 9 were admitted. The median (IQR) age of admitted patients was 1.4 (1.1) years. Relevant findings in the 9 hospitalized children included emesis (7/9, 78%), CNS depression (2/9, 22%), upper airway effects (5/9, 56%), lower respiratory symptoms (3/9, 33%), seizure (1/9, 11%), and intubation (6/9, 67%). One child with emesis initially managed at home was subsequently intubated for respiratory distress. |
4 |
| 53. Truong B, Luu K. Diagnostic clues for the identification of pediatric foreign body aspirations and consideration of novel imaging techniques. American Journal of Otolaryngology. 44(4):103919, 2023 Jul-Aug.Am J Otolaryngol. 44(4):103919, 2023 Jul-Aug. |
Observational-Dx |
518 |
To better understand the diagnosis of foreign body aspiration by elucidating key components of its clinical presentation. |
518 pediatric patients presented with 75.2 % presenting within one day of the inciting event. Identified history findings included wheeze (OR: 5.83, p < 0.0001) and multiple encounters (OR: 5.46, p < 0.0001). Oxygen saturation was lower in patients with foreign body aspiration (97.3 %, p < 0.001). Identified physical exam findings included wheeze (OR: 7.38, p < 0.001) and asymmetric breath sounds (OR: 5.48, p < 0.0001). The sensitivity and specificity of history findings was 86.7 % and 23.1 %, physical exam was 60.8 % and 88.4 %, and chest radiographs was 45.3 % and 88.0 %. 25 CT scans were performed with a sensitivity and specificity of 100 % and 85.7 %. Combining two components of the diagnostic algorithm yielded a high sensitivity and moderate specificity; the best combination was the history and physical exam. 186 rigid bronchoscopies were performed with 65.6 % positive for foreign body aspiration. |
3 |
| 54. Mortellaro VE, Iqbal C, Fu R, Curtis H, Fike FB, St Peter SD. Predictors of radiolucent foreign body aspiration. Journal of Pediatric Surgery. 48(9):1867-70, 2013 Sep.J Pediatr Surg. 48(9):1867-70, 2013 Sep. |
Review/Other-Dx |
138 patients |
Predictors of radiolucent foreign body aspiration. |
138 patients, mean age 2.6 years, mean weight 15.6 kg, 68% male. Event symptoms: 81% witnessed events, 64% wheezing, 43% coughing, 39% choking, 6% stridor, and 0.7% lethargy. Hospital presentation: 70% persistent symptoms, wheezing 56%, coughing 15%, desaturations 11%, stridor 7%, choking 4%, and lethargy 1%. 92% of patients had a chest x-ray; air trapping found in 38%, and lung collapse in 21%. 2 patients received CT scans; 1 had lung collapse. Bronchoscopy identified foreign bodies in 93% of patients: food 68%, plastic 18%, non-descript 11%, rocks 3%. No correlations between event symptoms, hospital presentation, radiographs and foreign body presence. |
4 |
| 55. Assefa D, Amin N, Stringel G, Dozor AJ. Use of decubitus radiographs in the diagnosis of foreign body aspiration in young children. Pediatric Emergency Care. 23(3):154-7, 2007 Mar.Pediatr Emerg Care. 23(3):154-7, 2007 Mar. |
Review/Other-Dx |
41 children |
To assess the value of decubitus radiographs in detecting foreign body aspiration in young children and compare their value to history and physical examination. |
Twenty-eight of 41 children who underwent bronchoscopy for possible foreign body aspiration had decubitus radiographs. Foreign bodies were identified in 22 patients (79%). A total of 27% of children with foreign body aspiration and 33% of children without a foreign body had suggestive decubitus radiographs (P = not significant). As a measure of detecting foreign body aspiration, positive decubitus radiographs had a sensitivity of 27%, a specificity of 67%, a positive predictive value of 75%, and a negative predictive value of 20%. The odds ratio of finding a foreign body with suggestive decubitus radiographs was 0.75 (95% confidence interval [CI], 0.1-5.2; P = 0.57). Foreign body aspiration was confirmed in 94% of children if there was both a sudden onset of symptoms and a witnessed choking episode (odds ratio, 13.3; 95% confidence interval, 1.3-138.9; P = 0.02). |
4 |
| 56. Black RE, Johnson DG, Matlak ME. Bronchoscopic removal of aspirated foreign bodies in children. Journal of Pediatric Surgery. 29(5):682-4, 1994 May.J Pediatr Surg. 29(5):682-4, 1994 May. |
Review/Other-Dx |
548 children |
A review of the records of 548 children (aged 4 months to 18 years) was undertaken to identify factors important in diagnosis, to illustrate the effectiveness of current endoscopic techniques and equipment, and to evaluate the results and complications of management. |
Coughing, choking, and wheezing were the presenting symptoms seen for 95% of the patients. Results of inspiratory and expiratory chest radiographs were positive in 83% of the 440 children who had foreign bodies removed. Fluoroscopy findings were positive for 67 patients, 90% of whom had foreign bodies removed. Foreign bodies were successfully identified and removed in 440 patients (80%). A wide variety of objects was recovered, the most common being peanuts, organic material, other nuts, popcorn, seeds, plastic objects, and pins. The foreign bodies were in the right bronchus in 49%, the left in 44%, and the trachea and hypopharynx in 4%. Two thirds of the objects were lodged in the mainstem bronchi, on either side, and the remainder were in the distal bronchi. Bronchoscopy is required for treatment, and with experience this procedure can be simple and safe. Ninety-nine percent of the foreign bodies identified during bronchoscopy were removed successfully. Minor complications occurred in 5%, and there were no deaths. |
4 |
| 57. Burton EM, Brick WG, Hall JD, Riggs W Jr, Houston CS. Tracheobronchial foreign body aspiration in children. Southern Medical Journal. 89(2):195-8, 1996 Feb.South Med J. 89(2):195-8, 1996 Feb. |
Review/Other-Dx |
155 children |
We reviewed the demographic and radiographic findings of 155 children with bronchoscopy-proven tracheobronchial foreign body aspiration (FBA). |
An aspirated peanut accounted for one third of all cases. Foreign body location was distributed nearly evenly to the right and left primary bronchi; tracheal foreign body was noted in 16 patients. The most frequent symptoms of FBA were cough (85 patients) and wheezing (60 patients). Although most patients were seen within 1 day of aspiration, 30 patients had symptoms that lasted at least 1 week before diagnosis. The most common radiographic findings were unilateral or segmental hyperlucency (59) or atelectasis (38). The trachea was the site of the foreign body in one half of children with a normal chest radiograph and FBA. |
4 |
| 58. Eren S, Balci AE, Dikici B, Doblan M, Eren MN. Foreign body aspiration in children: experience of 1160 cases. Annals of Tropical Paediatrics. 23(1):31-7, 2003 Mar.Ann Trop Paediatr. 23(1):31-7, 2003 Mar. |
Review/Other-Dx |
1160 children |
Hospital records of 1160 children <or=15 years old referred for suspected foreign body aspiration were reviewed. |
Bronchoscopy under general anaesthesia was performed on all patients. Foreign bodies were successfully removed in 1068 (92%) children. The majority, 885 (76.3%), presented with a definite history of foreign body aspiration. Bronchoscopy was negative in 85 (7.3%) children. Watermelon seeds, found in 414 (38.7%) children, were the most commonly aspirated foreign bodies. Open surgical procedures were required for 21 (1.8%) children. Bronchial rupture related to bronchoscopy occurred in four children, two of whom died post-operatively. The overall mortality rate was 0.8%. |
4 |
| 59. Xin Y, Jia LQ, Dong YW, Wang Y, Hu YX, Wang XM. Application of high-frequency ultrasound in the diagnosis of gastrointestinal magnet ingestion in children. Front Pediatr 2022;10:988596. |
Observational-Dx |
112 patients |
To investigate the performance of ultrasound in diagnosing gastrointestinal magnet ingestion in children. |
Of 112 patients, 107 had a magnetic foreign body and 5 did not. Magnets were correctly detected by ultrasound in 97 patients, with an observed sensitivity of 90.65% and specificity of 100%. Satisfactory sensitivity was obtained for ultrasound localization of gastric magnets (96.30%) and small intestinal magnets (100.00%), but sensitivity for ultrasound localization of colonic magnets was relatively poor (73.33%). The discrimination of wall entrapment by ultrasound was good (AUC = 0.93), with an observed sensitivity and specificity of 92.00% and 93.62%, respectively. |
3 |
| 60. Buonsenso D, Chiaretti A, Curatola A, Morello R, Giacalone M, Parri N. Pediatrician performed point-of-care ultrasound for the detection of ingested foreign bodies: case series and review of the literature. Journal of Ultrasound. 24(1):107-114, 2021 Mar.J. ultrasound. 24(1):107-114, 2021 Mar. |
Review/Other-Dx |
8 patients |
The main objective of this paper is to illustrate the use of point-of-care ultrasound (POCUS) to detect ingested foreign bodies and the secondary objective is to describe a limited training, necessary for emergency pediatricians, to obtain this skill. |
POCUS, performed by emergency pediatricians who participated to a limited training, allowed to always identify the foreign bodies ingested. |
4 |
| 61. Cairns R, Brown JA, Buckley NA. Dangerous toys: the expanding problem of water-absorbing beads. Med J Aust 2016;205:528. |
Review/Other-Dx |
N/A |
The expanding problem of water-absorbing beads |
No abstract available. |
4 |
| 62. Zamora IJ, Vu LT, Larimer EL, Olutoye OO. Water-absorbing balls: a "growing" problem. Pediatrics 130:e1011-4, 2012 Oct. |
Review/Other-Dx |
1 case |
No objective stated in abstract |
No result stated in abstract |
4 |
| 63. Kim HB, Kim YB, Ko Y, Choi YJ, Lee J, Kim JH. A case of ingested water beads diagnosed with point-of-care ultrasound. Clin Exp Emerg Med 7:330-333, 2020 Dec. |
Review/Other-Dx |
1 case |
No objective stated in abstract. |
No result stated in abstract. |
4 |
| 64. Awolaran O, Brennan K, Yardley I, Thakkar H. Water beads ingestion presenting with repeated bowel obstruction in an infant. BMJ Case Rep 2024;17. |
Review/Other-Dx |
1 case |
This case highlights the challenges involved in the diagnosis and management of water bead ingestion in children. Children under 2 years are at a higher risk of complications and most require intervention. Palpation alone can miss residual water beads at surgery. Endoscopy including intraoperative enteroscopy could be a useful adjunct. |
No results stated in abstract. |
4 |
| 65. Measuring Sex, Gender Identity, and Sexual Orientation. |
Review/Other-Dx |
N/A |
Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. |
No abstract available. |
4 |
| 66. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Appropriateness-Criteria/ACR-Appropriateness-Criteria-Radiation-Dose-Assessment-Introduction.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
