Identification and topographic localization of metallic foreign bodies by metal detector
Section snippets
Materials and methods
Patients who presented to our emergency department after an alleged or witnessed ingestion of a metal foreign object were prospectively and consecutively enrolled. Exclusion criteria were respiratory compromise, presence of metallic hardware, or previous diagnostic imaging for the current FB ingestion. Informed consent was obtained from the accompanying parent or guardian for participation in the study. Figure 1 schematically demonstrates the principles of how an MTD works.
The pediatric
Results
A total of 70 MTD examinations were performed on 65 patients (age 6 months to 16 years, mean 4.1 years) over a period of 20 months; 5 patients were scanned twice on different days of presentation by different individuals. One patient’s family refused to participate in the study because of “lack of time.” The majority of objects reported by the caregiver to have been potentially or actually swallowed were coins and button batteries followed by other items including jewelry, tools, needles, and
Discussion
Lewis7 described the first clinical application of metal detection to identify a swallowed coin in 1980. Since then, MTDs have been used by otolaryngologists,8 radiologists before MRI studies9 and forensic experts and trauma surgeons to look for bullets and missile shrapnel.10, 11, 12
Several controlled studies using an MTD to identify swallowed metal objects have been performed in the pediatric population, with reported sensitivities exceeding 96% and specificities above 81%.2, 3, 6, 13, 14
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Cited by (29)
Esophageal Foreign Bodies and Obstruction in the Emergency Department Setting: An Evidence-Based Review
2019, Journal of Emergency MedicineCitation Excerpt :Sensitivity increases when CT is combined with esophagography with water-soluble contrast material, which has greater sensitivity for small perforations (83,85,86). In pediatric patients, a handheld metal detector (HHMD) has been used successfully to localize and track metallic objects (89–91). One systematic review found a sensitivity and accuracy > 99% for coin detection and localization compared with chest radiograph, though sensitivity approaches 70% for other metallic foreign bodies.
Utilization of a handheld metal detector protocol to reduce radiation exposure in pediatric patients with esophageal coins
2018, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :As a result, we have now purchased 4 of these devices in an effort to make the HHMD more easily available for residents. Some argue that the use of a HHMD may require extensive training; however, several studies have demonstrated that even individuals with minimal HHMD instruction are able to correctly detect and localize ingested metallic foreign bodies [10,20,21]. The model of HHMD used in this study was less visually intimidating given slimmer design, simple to use, on/off and vibrate vs. audible noise alarm.
Just How Good Are Handheld Metal Detectors for Ingested Foreign Bodies?
2017, Annals of Emergency MedicineThe utility of a handheld metal detector in detection and localization of pediatric metallic foreign body ingestion
2017, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :One of those was identified by the HHMD and the other was not. In the literature, 16 false positives for an ingested MFB have been reported in 3 studies combined [1,21,22]. Eight of those false positives were eliminated though when a surrounding metallic object was identified, removed, and the patient was rescanned.
A case report of successful removal of multiples sewing needles in the gastrointestinal tract and pancreas using intraoperative C-arm fluoroscopy
2016, International Journal of Surgery Case ReportsCitation Excerpt :Nevertheless, it is difficult to localize intraoperatively when they are disseminating throughout the digestive tract and when they are too thin and short to be palpated. A metal detector may facilitate exact localization to guide accurate treatment [10], but this instrument is not available in many institutions. Herein, we present a case of a mental retardation patient with a history of multiple laparotomies due to past foreign body ingestions who presented with peritonitis after swallowing multiple sewing needles.
Paediatric GI emergencies
2013, Best Practice and Research: Clinical Gastroenterology