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Intestinal foreign bodies: diagnosis
Last reviewed: 23.04.2024
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Large metal foreign bodies with fluoroscopy are detected well, less contrasting foreign bodies, especially splinters of meat and fish bones, plastic objects, needles, thin nails are more difficult, the smaller their size. For detection, an overview radiograph of the abdomen is required, preferably not only in the frontal, but also in oblique projections. If a change in the survey radiograph is found that is suspicious of the foreign body of the intestine, in order to exclude the artifact, several x-rays must additionally be made to make sure that this dubious "shadow" is present on the other X-rays in the same place. Contrast X-ray examination should be used when indicating the ingestion of fairly large radiopaque objects. Sometimes a contrasting radiographic examination reveals a foreign body of large dimensions, than on the survey radiographs of the abdomen. X-ray examination with the use of contrast mass allows you to accurately determine the localization of a foreign body, determine its relationship with the intestinal wall.
In recent years, for the detection of radiopaque bodies of the stomach and intestines, echography and computed tomography have been used successfully.
In all cases, when a patient reports that he has swallowed a foreign body, even in the absence of clinical and radiological symptoms, he should continue to monitor the patient for several days in order not to miss the complication. When there are any symptoms or the absence of a foreign body in the feces, it is necessary to repeatedly examine the patient.
In comparatively rare cases, the foreign body is found accidentally, most often with X-ray examination of the intestine or with a survey radiograph of the abdomen, conducted on a different occasion (to identify petrifications in the abdominal cavity, kidney stone disease). In this case, more often accidentally reveal metallic foreign bodies, which patients are informed about by purposeful careful collection of anamnesis. Metal foreign bodies, swallowed meat or chicken bones can be found by chance during echography. In these cases, additional irrigoscopy and colonoscopy are performed if a foreign body in the large intestine is suspected, or other necessary studies are prescribed.
If a foreign body that has penetrated into the intestinal wall is kept in the intestine for a long time, infiltrates of considerable size may be formed, mistakenly mistaken for a malignant tumor.
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