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Acta Radiol. 2004 Jul;45(4):369-74.

Value of helical computed tomography in the management of upper esophageal foreign bodies.

Author information

1
Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Av. Valdecilla s/n, Santander 39008, Cantabria, Spain. emarco@seram.org

Abstract

PURPOSE:

To analyze the utility of helical computed tomography (CT) in the diagnosis of suspected upper esophageal foreign bodies.

MATERIAL AND METHODS:

A prospective study was performed on 36 patients (26 F, 10 M, mean age 70 years) with a history of foreign body impaction. All had negative findings at indirect laryngoscopy. Radiologic assessment included unenhanced helical CT and a barium contrast study. Patients with positive findings were taken to esophagoscopy. All patients had a posterior clinical surveillance.

RESULTS:

Twenty patients had both normal CT and barium study and satisfactory clinical outcome. In 12 patients a foreign body was noted in the cervical esophagus by CT, barium study, and endoscopy. In one patient a fish bone was detected by CT (and not by barium) confirmed with esophagoscopy. Another patient had a fish bone esophageal perforation which was observed only by CT and confirmed at surgery. Two patients with normal barium and endoscopy presented a false-positive CT result.

CONCLUSION:

Barium swallow is currently the first radiologic study, but may involve a risk of aspiration and can impede a subsequent esophagoscopy. Esophagoscopy is an invasive technique with a certain risk of serious complications that can be avoided with a satisfactory radiologic assessment. CT is easy, fast, has 100% sensitivity and is therefore the first choice technique for diagnosing suspected upper esophageal foreign bodies not expected to be visible on plain radiographs.

PMID:
15323387
[Indexed for MEDLINE]

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