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Background <p>Current clinical guidelines offer limited recommendations on the timing and role of computed tomography (CT) and fluoroscopic esophagography during inpatient management of esophageal foreign bodies, especially in relation to foreign body detection, complication assessment, and post-removal follow-up.</p> Methods <p>We retrospectively reviewed 241 inpatient cases with sharp esophageal foreign bodies admitted to our institution over the past decade, aiming to evaluate the diagnostic value of CT and esophagography in clinical management.</p> Results <p>A total of 241 inpatients with sharp esophageal foreign body ingestion were included. CT achieved a 100% detection rate, successfully identifying all foreign bodies, including 14 cases (6.97%) that were missed by initial endoscopy, as well as 155 cases of perforation (64.32%). During post-removal follow-up, persistent perforation was observed in 12 patients (7.74%), of whom 2 (16.67%) showed no contrast extravasation on initial fluoroscopic esophagography, leading to delayed diagnosis and prolonged disease course.</p> Conclusion <p>CT demonstrates clear advantages in detecting both retained foreign bodies and associated complications, and should be considered the first-line screening tool, particularly to facilitate early triage of emergency patients. Fluoroscopic esophagography remains the primary modality for post-removal perforation follow-up; however, persistent fever or signs of infection warrant additional CT or CT esophagography.</p>

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Utilizing CT and fluoroscopic esophagography in inpatients with esophageal foreign bodies: a decade's experience

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Luwen Hao,
  • Xin Chen,
  • Xuemei Hu,
  • Daoyu Hu,
  • Zhen Li,
  • Yaqi Shen

摘要

Background

Current clinical guidelines offer limited recommendations on the timing and role of computed tomography (CT) and fluoroscopic esophagography during inpatient management of esophageal foreign bodies, especially in relation to foreign body detection, complication assessment, and post-removal follow-up.

Methods

We retrospectively reviewed 241 inpatient cases with sharp esophageal foreign bodies admitted to our institution over the past decade, aiming to evaluate the diagnostic value of CT and esophagography in clinical management.

Results

A total of 241 inpatients with sharp esophageal foreign body ingestion were included. CT achieved a 100% detection rate, successfully identifying all foreign bodies, including 14 cases (6.97%) that were missed by initial endoscopy, as well as 155 cases of perforation (64.32%). During post-removal follow-up, persistent perforation was observed in 12 patients (7.74%), of whom 2 (16.67%) showed no contrast extravasation on initial fluoroscopic esophagography, leading to delayed diagnosis and prolonged disease course.

Conclusion

CT demonstrates clear advantages in detecting both retained foreign bodies and associated complications, and should be considered the first-line screening tool, particularly to facilitate early triage of emergency patients. Fluoroscopic esophagography remains the primary modality for post-removal perforation follow-up; however, persistent fever or signs of infection warrant additional CT or CT esophagography.