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- Do foreign bodies look the same in fluid or gas on radiographs
Franco Yuen DVM and Sophie Dennison BVMS, DACVR
Background
The study, conducted by Franco Yuen and Sophie Dennison, focuses on the challenge of radiographically identifying gastrointestinal tract foreign bodies in small animals. Given the prevalence of small animals ingesting non-digestible objects, which often complicate veterinary diagnosis and treatment, the research aims to enhance the radiographic identification process by exploring how the appearance of these objects varies when surrounded by different media (air vs. water).
Methods
The study utilized an online survey, completed by 368 veterinarians from a private, veterinarian-based social media group. The survey ran from June 18, 2023, to July 2, 2023. Commonly ingested foreign bodies were radiographed in both air and water environments to simulate conditions within the gastrointestinal tract. Two examiners then evaluated the radiographs to determine the opacity and visibility of the objects in these different settings.
Results
Out of the 3,900 members in the social media group, 362 veterinarians responded, identifying 123 different foreign objects that did not cause mechanical obstruction at initial presentation. A total of 68 foreign bodies were reported five or more times and included various items such as toys, household objects, and food remnants. In the radiographic analysis, 98.5% of objects were clearly visible in air, but 23.5% became obscured in water, and 39.7% showed an inversion in opacity when compared to their appearance in air.
Limitations
The study acknowledges limitations including the inability to account for how the ingestion and subsequent digestion processes might alter the appearance of foreign bodies. The research was restricted to objects in their intact form, which does not fully simulate clinical scenarios where objects might be fragmented or altered by digestive processes.
Conclusions
The findings indicate that the radiographic appearance of foreign objects can significantly vary depending on the medium surrounding them. This variability can affect the detection and diagnosis of foreign bodies in veterinary practice. By understanding these variations, veterinarians can improve diagnostic accuracy, particularly in cases where conventional radiography might fail to detect non-metallic or radiolucent objects. The study suggests that using both air and water radiographs can enhance the assessment and identification of ingested foreign objects, thus improving clinical outcomes and client communications in veterinary practice.
Radiographic images of a rubber key chain fob surrounded by air (A) versus water (B), as 1 representative gastrointestinal foreign body among 68 commonly reported foreign bodies in cats and dogs as reported in an online survey with 362 US veterinarian respondents between June 18, 2023, and July 2, 2023. The window level and width were adjusted to optimize each radiograph for evaluation. This is an example of materials that are radiopaque relative to air and water. Other objects that exhibit similar characteristics include tennis ball, gold ball, glass marble, wall of ping pong ball, olive pit, stone fruit pit, candy, hair ties, rope, suction cup, pacifier nipple, bottle nipple, yoga mat, rubber bands, toy wheel, toy dinosaur, button, glass ornament, and ceramic ornament.
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