PICTORIAL ESSAY   

Il Giornale Italiano di Radiologia Medica 2019 Novembre-Dicembre;6(6):547-62

DOI: 10.23736/S2283-8376.19.00241-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Foreign bodies in emergency radiology: tips and tricks

Mariangela DIMARCO, Dario GIAMBELLUCA ✉, Roberto CANNELLA, Giovanni CARUANA, Giuseppe SALVAGGIO, Massimo MIDIRI

Section of Radiological Sciences, Bi.N.D., University of Palermo, Palermo, Italy

Foreign bodies may be frequently encountered on different imaging modalities performed in emergency setting. Their visualization by different imaging techniques strictly depends on the composition or density of the objects. Metallic objects are typically radiopaque, as well as foreign bodies made of glasses or most animal bones, while most of plastic and wooden foreign bodies and fish bones are not radiopaque, so that their visualization may be quite challenging. It is not uncommon that a foreign body could not be visualized with a technique and successfully detected with another. An exhaustive and complete patients’ clinical history is crucial to understand their origin and to select the most appropriate modalities for the correct diagnosis. The aim of this essay is to describe the imaging characteristics and pitfalls of unexpected foreign bodies in emergency radiology by reviewing the most common presentations with different imaging techniques (conventional radiography, US, CT, and MRI). The authors also present the most common locations of foreign bodies in patients imaged in emergency department (upper airways in case of aspiration, gastrointestinal tract in case of ingestion, rectal/vaginal site and soft tissues), with some tips and tricks for making a successful imaging diagnosis. Moreover, surgical retained foreign bodies are also mentioned. Radiologists play an important role for the diagnosis of foreign bodies in emergency department and they should be aware of the possible risk of complications requiring urgent treatment.

KEY WORDS: Foreign bodies; Radiography; Ultrasonography; Tomography, X-ray computed; Magnetic resonance imaging