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CT imaging of esophageal foreign bodies in children: a pictorial essay

  • Pictorial Essay
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Abstract

Foreign body (FB) ingestion is common in children, particularly from 6 months to 3 years of age. As young children may be unable to provide a clinical history and the ingestion is often unwitnessed, imaging plays an important role in diagnosis, predicting outcomes and detecting complications that require surgical intervention. Since 2015, our institution’s diagnostic algorithm for suspected airway foreign bodies has included a noncontrast airway FB CT (FB-CT) with the z-axis coverage spanning from the larynx to the proximal segmental bronchi of the lower lung zones. The effective dose of radiation from this FB-CT airway protocol is typically less than 1 mSv, compared to an effective dose of just under 1 mSv to up to 3 mSv for a fluoroscopic esophagram in children under 10 years of age and 1–3 mSv for a routine pediatric CT chest. In using the FB-CT airway protocol at our institution, we observed that esophageal rather than airway FBs were sometimes encountered on these exams. However, the confidence among radiologists for definitively diagnosing an esophageal foreign body on noncontrast CT was variable. Consequently, we created a teaching module of positive cases for our group of 21 pediatric body radiologists to increase their diagnostic confidence. This pictorial essay illustrates our institutional experience and can help others to confidently diagnose esophageal foreign bodies using a dedicated CT foreign body imaging protocol. At a similar radiation dose to a fluoroscopic esophagram, CT provides the additional advantage of an expedited diagnosis without the need for a radiologist on site.

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Change history

  • 21 February 2024

    In the original version of this article, the given and family names of J. Herman Kan were incorrectly structured. The correct given name is J. Herman and family name is Kan.

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Authors and Affiliations

  1. Singleton Department of Pediatric Radiology, Texas Children’s Hospital, 6701 Fannin Street, Houston, TX, 77030, USA

    Victor J. Seghers, J. Herman Kan, Ray Somcio, Andrew C. Sher, R. Paul Guillerman & Marla B. K. Sammer

  2. Department of Radiology, Baylor College of Medicine, Houston, TX, USA

    Victor J. Seghers, J. Herman Kan, Ray Somcio, Andrew C. Sher, R. Paul Guillerman & Marla B. K. Sammer

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  1. Victor J. Seghers
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  2. J. Herman Kan
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Correspondence to Victor J. Seghers.

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None. The authors have no conflicts of interest in regards to the content in this manuscript. All authors have contributed meaningfully to the creation of this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Seghers, V.J., Kan, J.H., Somcio, R. et al. CT imaging of esophageal foreign bodies in children: a pictorial essay. Jpn J Radiol 40, 262–270 (2022). https://doi.org/10.1007/s11604-021-01201-w

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  • DOI: https://doi.org/10.1007/s11604-021-01201-w

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