E3327. Tiny Trespassers: Foreign Bodies Within Pediatric Aerodigestive System
Authors
Norianne Martinez-Viota;
San Juan Bautista School of Medicine
Nicole Monroig-Sanchez;
San Juan Bautista School of Medicine
Andrea Robles-Bocanegra;
San Juan Bautista School of Medicine
Lyan Cabello-Ballester;
San Juan Bautista School of Medicine
Alicia Roman-Colon;
Baylor College of Medicine; Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital
Background
Pediatric foreign-body ingestion (FBI) and foreign-body aspiration (FBA) have been well-described, but the rate of FBIs has increased since 1995, at an annual rate of 18 FBIs per 10,000 children (< 6 years of age). Further education and focus on this issue is needed, with radiologists serving a critical role in diagnosis and aid in management. FBA resulting in suffocation is the fourth most common cause of unintentional-injury pediatric mortality in the United States and is the leading cause of unintentional-injury mortality in children younger than 1 year of age. This exhibit aims to review both common and rare FBIs/FBAs in conjunction with multimodality imaging from a high-volume tertiary referral center and to demonstrate the appearance of each condition with mention of pitfalls in diagnosis and potential complications. Review of pertinent anatomy will highlight both, etiologies of retained objection locations, as well as locations for radiologists and clinicians to perform a focused search during imaging review.
Educational Goals / Teaching Points
Review the imaging findings of foreign bodies in the aerodigestive system in the pediatric population. Provide examples of appearance of typical foreign bodies that can be encountered in the GI and airway. Discuss imaging modalities used for diagnosis of suspected foreign bodies.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Description of common locations where the foreign bodies can be found depending on the type of foreign body. Review the typical imaging findings of particular foreign bodies. Familiarize radiologists and clinicians with the use of low-dose CT for detection of foreign bodies and potential complications, and as an alternative for quick and reliable diagnosis when fluoroscopic studies are not readily available.
Conclusion
Commonly ingested FBs in children include peanuts, button batteries, magnets, and fish bones, whereas food items are the most commonly aspirated FBs. Imaging modalities to diagnose radiolucent objects most commonly include CT and fluoroscopy esophagram. FBI in children may lead to severe complications such as perforation, obstruction, fistulas, and sepsis. Herein, we described advanced multidisciplinary approaches to each scenario with focus on newer techniques such as low-dose chest CT protocols using state of the art image noise reduction, in lieu of conventional esophagram. In conclusion, improved knowledge of demographics, classic imaging appearances, updated imaging techniques, potential complications, and treatments of FBIs/FBAs will aid in the multidisciplinary care of pediatric patients.
