Pediatrician performed point-of-care ultrasound for the detection of ingested foreign bodies: case series and review of the literature

Buonsenso, Danilo; Chiaretti, Antonio; Curatola, Antonietta; Morello, Rosa; Giacalone, Martina; Parri, Niccolò

doi:10.1007/s40477-020-00452-z

Cited by 18 publications

(21 citation statements)

References 25 publications

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“…Recent studies have shown that US can be useful even for evaluating foreign bodies (FBs) in the gastrointestinal tract and identifying associated complications [14][15][16]. The role of pediatric Point-Of-Care Ultrasound (POCUS) for detection of FBs (mainly esophageal and gastric) in the emergency departments is becoming more and more relevant as it may assist clinicians integrating the clinical examination with real-time images before using more time-and resource-consuming techniques [17]. In 2013, Jeckovic et al reported using a water-filled stomach in the diagnostic workup of gastric FBs [18].…”

Section: Discussionmentioning

confidence: 99%

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

et al. 2022

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Ingestion of magnetic foreign bodies in pediatric settings has become more common in the last years due to the marketing of various toys containing small magnetic parts. Most magnets, especially if a single element is ingested, usually pass through the gastrointestinal tract without complications. However, ingestion of multiple magnets or magnets and small metallic components may require a prompt intervention due to the risk of attraction across bowel layers, leading to pressure necrosis, perforation, and even death. Routinely, serial radiological evaluations are needed to follow the progression of magnets through the intestine, while the role of small bowel ultrasound is regarded as marginal. Here we report a case of a 5-years old boy who ingested 8 magnets and in which small bowel ultrasound was pivotal for the correct assessment of magnets location to correct address the surgical approach.

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Section: Discussionmentioning

confidence: 99%

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

et al. 2022

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“…Subsequently, the exact location of the foreign body was detected using US, and thereafter, it was removed using simple laparoscopic appendectomy without additional procedures of C-arm fluoroscopy or magnets. The second patient had swallowed three round magnetic beads, which are commonly reported to spark problems [ 1 2 ]. Furthermore, if multiple magnets are swallowed at different times, they can move to different locations in the gastrointestinal (GI) tract causing challenges of sticking to each other at different positions.…”

Section: Discussionmentioning

confidence: 99%

“…Although previous studies have not recommended US for detecting ingested foreign bodies due to lack of sufficient evidence [ 3 4 5 ], several studies have reported its usefulness in assessing foreign bodies located in the GI tract [ 2 6 7 ]. US provides real-time imaging with superior temporal and spatial resolutions compared to plain radiography and CT with the precision of the ingested foreign body localization, particularly in young children with small body habitus.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Nonmigrating Metallic Foreign Bodies in the Abdomen Using Ultrasound: An Alternative Approach Using a Traditional Method

Pak

Lee

Hwang

2022

Pediatr Gastroenterol Hepatol Nutr

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Ingestion of foreign bodies (FBs) is a common phenomenon among young children. Plain radiography is the first step diagnostic modality to detect the radio-opaque FBs. And computed tomography has been recommended by several guidelines as useful modalities for diagnosing ingested FBs. However, there is a risk of radiation exposure, making it burdensome to use in asymptomatic patients. Ultrasound (US) is not a commonly used technique for diagnosing ingested foreign bodies. However, US can provide real-time imaging with good resolutions without radiation exposure in pediatric patients. Herein, we report two pediatric cases of metallic foreign body ingestion that were successfully diagnosed using US for localizing foreign bodies. This study indicates that US may be used as an alternative method for detecting the localization of metallic foreign bodies in the gastrointestinal tract without exposure of radiation, particularly in pediatric patients.

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“…A recent study suggested point of care ultrasound as an adjuvant to the standard assessment of suspected FBA in the emergency department. Neck examination using point of care ultrasound may detect foreign bodies outside the airways and it can reduce the time of bronchoscopy if needed [ 20 ], and it can explore indirect effects of lung inflammation as in aspiration pneumoniae [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

A new scoring system and clinical algorithm for the management of suspected foreign body aspiration in children: a retrospective cohort study

et al. 2021

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Background Cases of foreign body aspiration in children may be encountered in emergency departments. A suggestive history is important in diagnosing aspirated foreign body owing to the difficulty in making a diagnosis on the basis of an abnormal physical examination or chest radiography alone. The aim of this study was to examine the sensitivity and specificity of the presenting symptoms, physical examination, and radiologic findings as predictors of foreign body aspiration in children. In addition, a feasible simple algorithm with a scoring system was generated to indicate bronchoscopic investigation. Methods In a retrospective cohort, medical records of patients aged less than 16 years with suspected foreign body aspiration who underwent flexible or rigid bronchoscopy were included. Data including age, sex, symptoms, physical examination findings, radiological features, nature and location of the foreign body, and outcome of the bronchoscopy were collected, and multivariable binary logistic regression analysis was employed for prediction of foreign body aspiration. Results A total of 203 children were included, and the model showed excellent discrimination power for positive foreign body aspiration (area under the curve = 0.911) with an accuracy, sensitivity, and specificity of 86.2, 90.6, and 76.6%, respectively. The total weighted risk score at a cut-off > 2 showed a significant good power of discrimination (area under the curve = 0.879), with a sensitivity of 79.9% and specificity of 84.4%. Accordingly, a clinical algorithm was recommended. Conclusions The proposed scoring system and clinical algorithm might help in decision making with regard to the need and type of bronchoscopy in children presenting with potential foreign body aspiration. However, further prospective multicenter studies should be conducted to validate this scoring system.

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Pediatrician performed point-of-care ultrasound for the detection of ingested foreign bodies: case series and review of the literature

Cited by 18 publications

References 25 publications

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

Diagnosis of Nonmigrating Metallic Foreign Bodies in the Abdomen Using Ultrasound: An Alternative Approach Using a Traditional Method

A new scoring system and clinical algorithm for the management of suspected foreign body aspiration in children: a retrospective cohort study

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