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Foreign body ingestion: comparison of diagnostic accuracy of computed tomography versus endoscopy

Published online by Cambridge University Press:  27 November 2008

W-H Luk*
Affiliation:
Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, Hong Kong SAR
W C Fan
Affiliation:
Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, Hong Kong SAR
R Y Y Chan
Affiliation:
Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, Hong Kong SAR
S W W Chan
Affiliation:
Department of Surgery, United Christian Hospital, Hong Kong SAR
K H Tse
Affiliation:
Department of Surgery, United Christian Hospital, Hong Kong SAR
J C S Chan
Affiliation:
Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, Hong Kong SAR
*
Address for correspondence: Dr Wing-Hang Luk, Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong SAR. Fax: 852 35135637 E-mail: [email protected]

Abstract

Purpose:

To investigate and compare the sensitivity and specificity of computed tomography and of endoscopy, as diagnostic tests for foreign body ingestion.

Materials and methods:

Over a two-year period, Asian patients with suspected foreign body ingestion were studied. The clinical findings, computed tomography images, endoscopic results, treatment and outcomes were prospectively analysed.

Results:

Over the study period, 193 patients were admitted for foreign body ingestion, complaining of a persistent foreign body sensation in the neck. The sensitivity and specificity of computed tomography were 78 and 96 per cent, respectively; the positive predictive value was 75 per cent and the negative predictive value 97 per cent. The diagnostic accuracy of computed tomography was 94 per cent.

Conclusion:

Our study showed that computed tomography had high negative predictive value and accuracy in the diagnosis of foreign body ingestion. It was useful if endoscopy showed negative findings but the patient still had persistent symptoms of foreign body ingestion.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Ginsberg, GG. Management of ingested foreign objects and food bolus impactions. Gastrointest Endosc 1995;41:33–8CrossRefGoogle ScholarPubMed
2 Eisen, GM, Baron, TH, Dominitz, JA, Faigel, DO, Goldstein, JL, Johanson, JF et al. Guideline for management of ingested foreign bodies. Gastrointest Endosc 2002;55:802–6CrossRefGoogle ScholarPubMed
3 Jones, RJ, Samson, PC. Esophageal injury. Ann Thoracic Surg 1975;19:216–30CrossRefGoogle ScholarPubMed
4 Lai, AT, Chow, TL, Lee, DT, Kwok, SP. Risk factors predicting the development of complications after foreign body ingestion. Br J Surg 2003;90:1531–5CrossRefGoogle ScholarPubMed
5 Watanabe, K, Kikuchi, T, Katori, Y, Fujiwara, H, Sugita, R, Takasaka, T et al. The usefulness of computed tomography in the diagnosis of impacted fish bones in the oesophagus. J Laryngol Otol 1998;112:360–4CrossRefGoogle ScholarPubMed
6 Braverman, I, Gomori, JM, Polv, O, Saah, D. The role of CT imaging in the evaluation of cervical esophageal foreign bodies. J Otolaryngol 1993;22:311–14Google ScholarPubMed
7 Ngan, JH, Fok, PJ, Lai, EC, Branick, FJ, Wong, J. A prospective study on fish bone ingestion. Experience of 358 patients. Ann Surg 1990;211:459–62CrossRefGoogle ScholarPubMed
8 Gonsalves, HJ. Foreign body in the throat. J Accid Emerg Med 1999;16:462–3CrossRefGoogle ScholarPubMed
9 Eliashar, R, Dano, I, Dangoor, E, Braverman, I, Sichel, J-Y. Computed tomography diagnosis of esophageal bone impaction: a prospective study. Ann Otol Rhino Laryngol 1999;108:708–10CrossRefGoogle ScholarPubMed
10 Debasis, Das, Gabby, May. Is CT effective in cases of upper oesophageal fish bone ingestion? Emerg Med J 2007;24:48–9Google Scholar
11 Nandi, P, Ong, GB. Foreign bodies in the oesophagus: review of 2394 cases. Br J Surg 1978;65:59CrossRefGoogle ScholarPubMed
12 Teo, DT, Loy, AH, Goh, YH, Chan, YM. Head and neck cancer after foreign body ingestion. Ann Acad Med Singapore 2004;33:379–81CrossRefGoogle ScholarPubMed
13 Lewis, MA. Multislice CT: opportunities and challenges. Br J Radiol 2001;74:779–81CrossRefGoogle ScholarPubMed