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The role and value of low-dose computed tomography scan compared to esophagoscopy in the diagnosis of foreign body ingestion in adults

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Abstract

Background

Information regarding computed tomography (CT) scan as a first-line screening tool for diagnosis of foreign body (FB) ingestion is limited to a few studies. This study aimed to discuss the role of low-dose CT scan in diagnosing FB ingestion and its complications in adults, along with its diagnostic values compared to X-ray and esophagoscopy.

Materials and methods

In this retrospective, cross-sectional study, all hospital records of adult patients diagnosed with foreign body ingestion from March 2014 to February 2019 were reviewed.

Results

Among a total of 114 patients, 41 (36.0%) and 86 patients (85.1%) had positive findings in favor of FB in chest radiographs and CT scans, respectively. Esophagoscopy showed the presence of a foreign body in a total of 95 (83.3%) cases, perforation in 14 cases (12.3%), and laceration in nine cases (7.9%). Also, 12 patients (10.5%) had no findings in their esophagoscopy. The sensitivity, specificity, positive predictive value, and negative predictive value of chest X-ray were 39.2%, 91.7%, 97.6%, and 15.1%, respectively. The sensitivity and specificity of CT were reported to be 96.62% and 100%, respectively. The positive predictive value of the CT method was 100%, and its negative predictive value was 80.0%.

Conclusion

CT scan can be the preliminary tool for the diagnosis of FB ingestion. It can decrease hospital stay and hospital costs by avoiding unnecessary endoscopy. Due to the insufficiency of X-ray, low-dose CT can be used as a first-line diagnostic tool, especially in cases with ingestion of radiolucent FBs.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, 71936-13311, Iran

    Parviz Mardani, Reza Shahriarirad, Hamidreza Malekhosseini, Armin Amirian & Hooman Kamran

  2. Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran

    Parviz Mardani, Hamidreza Malekhosseini & Armin Amirian

  3. Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

    Reza Shahriarirad, Fateme Khosravi & Hooman Kamran

  4. MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Fateme Khosravi

Authors
  1. Parviz Mardani
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  2. Reza Shahriarirad
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  4. Hamidreza Malekhosseini
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  5. Armin Amirian
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Corresponding author

Correspondence to Hooman Kamran.

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Ethical approval

In all phases of the study, the researchers adhered to the Declaration of Helsinki (set of ethical principles regarding human experimentation developed for the medical community) and maintained patient privacy and confidentiality. This paper has been adapted from a research project approved by The Vice Chancellors of Shiraz University of Medical Sciences, which was also ethically approved by this university’s Ethics Committee (recognized by IR.SUMS.MED.REC.1398.617).

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The aim of the study was explained to the patients, and informed consent was provided regarding participation and publication of the results of the study.

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Mardani, P., Shahriarirad, R., Khosravi, F. et al. The role and value of low-dose computed tomography scan compared to esophagoscopy in the diagnosis of foreign body ingestion in adults. Gen Thorac Cardiovasc Surg 71, 198–204 (2023). https://doi.org/10.1007/s11748-022-01880-w

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  • DOI: https://doi.org/10.1007/s11748-022-01880-w

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