The lateral neck radiograph in suspected impacted fish bones — Does it have a role?

Evans, R. W.; Ahuja, Anil T.; Williams, Stuart; Hasselt, C. Andrew van

doi:10.1016/s0009-9260(05)80316-2

Cited by 76 publications

(70 citation statements)

References 6 publications

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“…In this study 20% cases had given false positive result. (16) Another study by Evans (1992) gave 86% specificity for plain X-ray. In this study the specificity was 79%.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

P¹,

Sabin²,

S³

2015

jebmh

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INTRODUCTION:A foreign body is an endogenous or exogenous substance incongruous with the anatomy of the site where it is found. Foreign body ingestion can affect persons of any age. Despite major advances in diagnostic and therapeutic modalities, foreign body ingestion still causes significant dilemmas in the diagnosis and treatment. Multiple factors play role in the lodgment of these foreign bodies in the food passage. They are diet factor, dental factor, and inebriation and age factors to name a few. Preexisting strictures of esophagus is another local cause of impaction of F.B. The signs and symptoms of foreign body ingestion are quite diverse and often very non-specific. They include complete esophageal obstruction with overflow of secretions and aspiration, to mild odynophagia or dysphagia. Esophageal foreign bodies are most frequently located at the narrowest portion of the esophagus, the level of the crico-Pharynx sphincter. Rarely serious complications of such as mediastinitis, Pneumothorax, plural effusion, lung or mediastinal abscess, or massive hemorrhage due to a vascular fistula may occur before a thorough investigation is launched. Digital X-rays in two dimensions are useful in the diagnosis. CT scanning and MRI are rarely used in the evaluation of foreign bodies in the aero digestive tract, but are indicated in the event that the object is not found during endoscopic examination and migration from the airway or esophagus is suspected. In 1936 Chevalier Jackson described endoscopic techniques for the removal of foreign bodies. Since then this has remained the safest and most trusted method of treatment. Techniques for foreign body removal employing fiber optic endoscopes have been described. The treatment of choice for foreign bodies of the upper aero digestive tract is reasonably prompt endoscopic retrieval in the operating suite under anesthesia. Endoscopy is performed as an emergency in case ingestion of disc batteries with esophageal lodging and signs or symptoms of esophageal perforation to avoid further complications and strictures. AIM: To evaluate the sensitivity and specificity of digital Xray in detecting all foreign bodies impacted in throat and esophagus. To assess the factors leading to false positive findings in Digital X-rays in the study subjects; to evaluate the role of digital X-ray in detecting complications. MATERIALS AND MEHODS: 208 patients attending Government Hospital of Kozhikode with history of foreign body ingestion are included in the study. Thorough history taking, clinical examination followed by radiography with the help of Digital X-rays to locate the foreign body is done. Fish bones being common in this part of Kerala, emphasize is made to find the specificity and sensitivity of using digital X-rays in locating fish bones in food passage. Conservative management in patients showing minimal symptoms is studied. The incidence of Complications among the patients is studied. OBSERVATIONS: The sensitivity of digital X-ray in detecting fish bone foreign bodies i...

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“…In this study 20% cases had given false positive result. (16) Another study by Evans (1992) gave 86% specificity for plain X-ray. In this study the specificity was 79%.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

P¹,

Sabin²,

S³

2015

jebmh

View full text Add to dashboard Cite

show abstract

“…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].…”

Section: Introductionmentioning

confidence: 99%

“…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].…”

Section: Introductionmentioning

confidence: 99%

Analysing lateral soft tissue neck radiographs

et al. 2012

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“…It is here that a radiologically assisted diagnosis is required early in order to avoid potentially fatal complications such as oesophageal perforation, retropharyngeal abscess formation, peri-oesophagitis, mediastinitis or vascular fistula formation [1]. Evans et al called for the complete abandonment of the lateral neck radiograph in assessing for the presence of impacted fish bones [6]. Using phantoms of approximately equivalent soft tissue densities to the cervical region and standard exposure factors for a lateral neck radiograph they found a large proportion of fish bones to be of insufficient radio-density to be easily visible [6].…”

Section: Introductionmentioning

confidence: 99%

“…Evans et al called for the complete abandonment of the lateral neck radiograph in assessing for the presence of impacted fish bones [6]. Using phantoms of approximately equivalent soft tissue densities to the cervical region and standard exposure factors for a lateral neck radiograph they found a large proportion of fish bones to be of insufficient radio-density to be easily visible [6]. It is worth reiterating that the above study was performed using plain film radiography, whose image quality and spatial resolution might have a bearing on interpretation, not to mention that interpretation was performed without the use of modern-day visualization techniques that allows the radiologist to window images.…”

Section: Introductionmentioning

confidence: 99%

The lateral neck radiograph for an impacted fish bone in the aero-digestive tract: Going back to basics

Shetty¹,

Gay²

2012

JBiSE

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Aim: To evaluate the radio-opacity of fish bones from a number of species using digital radiography in order to establish whether advances in acquisition and interpretative techniques have affected the radiologist's ability to detect impacted fish bones. Methods: The bones from six species of fish commonly consumed in the United Kingdom were radiographed using a soft tissue neck phantom by means of a digital radiographic X-ray tube. The images were looked at by 15 radiology consultants and registrars who determined whether the bones were visible or not using General Electric (GE) PACS workstations. Results: The radiographed bones from all six species of fish were visible by all 15 (100%) radiology registrars and consultants. Conclusion: Digital radiogramphy and modern PACS workstations have meant that fish bones can be visualized irrespective of species. The lateral neck radiograph therefore may still have an important role in the investigation of impacted fish bones in the aerodigestive tract.

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The lateral neck radiograph in suspected impacted fish bones — Does it have a role?

Cited by 76 publications

References 6 publications

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

A Clinical Study of Foreign Bodies of Oesophagus and Their Management

Analysing lateral soft tissue neck radiographs

The lateral neck radiograph for an impacted fish bone in the aero-digestive tract: Going back to basics

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