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Intestinal foreign bodies - Diagnosis
Last reviewed: 06.07.2025
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Large metallic foreign bodies are easily detected by fluoroscopy, while less contrasting foreign bodies, especially fragments of meat and fish bones, plastic objects, needles, and thin nails, are more difficult to detect the smaller their size. A general abdominal radiograph is required for detection, preferably not only in the frontal but also in the oblique projections. If a change suspicious of a foreign body in the intestine is found on a general radiograph, several radiographs must be taken to rule out an artifact in order to verify the presence of this dubious "shadow" on other radiographs in the same place. Contrast radiographic examination should be used if there is evidence of swallowing fairly large radiopaque objects. Sometimes, a contrast radiographic examination reveals a foreign body of a larger size than on general abdominal radiographs. A radiographic examination using a contrast mass allows one to accurately determine the localization of the foreign body and determine its relationship with the intestinal wall.
In recent years, echography and computed tomography have been successfully used to detect radiopaque bodies in the stomach and intestines.
In all cases, when a patient reports that he/she has swallowed a foreign body, even in the absence of clinical and radiographic symptoms, the patient should be monitored for several days to avoid missing a complication. If any symptoms appear or if there is no foreign body in the faeces, the patient should be re-examined.
In relatively rare cases, a foreign body is found by chance, most often during an X-ray examination of the intestine or during a general X-ray of the abdomen, performed for another reason (to detect petrification in the abdominal cavity, nephrolithiasis). In this case, metallic foreign bodies are most often found by chance, which patients report during a targeted, thorough collection of anamnesis. Metallic foreign bodies, swallowed meat or chicken bones can be found by chance during echography. In these cases, an irrigoscopy and colonoscopy are additionally performed if the presence of a foreign body in the large intestine is suspected, or other necessary studies are prescribed.
If a foreign body that has penetrated the intestinal wall remains in the intestine for a long time, large infiltrates may form, which are mistakenly taken for a malignant tumor.
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