Lateral soft tissue neck X-rays: are they useful in management of upper aero-digestive tract foreign bodies?

Abstract

A lateral soft tissue neck X-ray is a helpful tool in the management of patients presenting with upper aero-digestive tract foreign bodies. Junior doctors need better radiology training.

A Radiolucent Foreign Body Ingestion as a Cause of Acute Dysphagia

“…Clinical history, physical examination and radiographs are hallmark in decision making 4 . About 80% or more of FB cases will pass spontaneously without need for further surgical intervention 2 .…”

“…Lateral soft tissue neck radiographs are essential in all 21 patients with radiopaque FBs even though those with negative plain radiographs are included 4 . In total of 32 patients (51.6 per cent), lateral soft tissue neck radiographs were considered useful in managing the cases 4 . Plain radiographs give useful information which would have helped in the clinical management of more than half these patients.…”

“…Plain radiographs give useful information which would have helped in the clinical management of more than half these patients. However, by the poor radiology interpretation skills of junior doctors, the usefulness of plain radiographs was limited 4 . Persistent esophageal symptoms in the patient with suspected FB ingestion should be evaluated by endoscopy even though with negative radiographic evaluation.…”

Analysing lateral soft tissue neck radiographs

“…A thorough history and examination remains the cornerstone to managing the patient appropriately. A lateral soft tissue neck radiograph is a cheap, readily available investigation tool that is of clinical value in assessing patients with potential pathology of the upper aerodigestive tract [1,2,[6][7][8][9][10][11][12][13].…”

“…In the emergency department, these radiographs are useful in the assessment of foreign bodies in the hypopharynx and upper cervical oesophagus with some series elucidating sensitivities of over 80% [6][7][8][9][10][11][12][13]. They have no clinical value for foreign bodies in the oral cavity or oropharynx [11].…”