Lee Sang Min, Baek Song-Ee, Lee Choong Wook, Kim Young Chul, Kim Min-Jeong
Department of Radiology, CHA University, CHA Gangnam Medical Center, Seoul, Republic of Korea.
Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea.
Korean J Radiol. 2025 Jul;26(7):638-649. doi: 10.3348/kjr.2025.0118.
Foreign body ingestion and sensation are common clinical conditions encountered in emergency and outpatient settings. True foreign body ingestion typically involves a history of swallowing a foreign object and is often confirmed by radiographic findings. The management of foreign body ingestion depends on the type, size, and location of the object, as well as the patient's symptoms. High-risk objects, such as button/disk batteries, multiple magnets, and sharp objects, often require urgent or emergent endoscopic removal to prevent severe complications such as perforation, obstruction, and fistula formation. Imaging is crucial for diagnosis and management, with radiographs being the first-line modality and CT offering superior sensitivity for detecting radiolucent objects and complications. Mimickers of foreign body ingestion and sensations, even without the presence of an actual foreign body, arise from motility disorders (e.g., achalasia), structural or mucosal abnormalities (e.g., Zenker's diverticulum, reflux esophagitis, and esophageal strictures), and extrinsic compression. Although these mimickers produce similar symptoms, they require different diagnostic approaches. This review highlights the radiological findings, management strategies for various foreign bodies, and the distinguishing features of their mimickers, emphasizing the importance of timely and accurate differentiation to guide appropriate interventions and improve patient outcomes.
异物吞食和异物感是急诊和门诊常见的临床情况。真正的异物吞食通常有吞食异物的病史，且常通过影像学检查结果得以证实。异物吞食的处理取决于异物的类型、大小和位置，以及患者的症状。高风险异物，如纽扣/盘状电池、多个磁铁和尖锐物体，通常需要紧急或急诊内镜取出，以防止诸如穿孔、梗阻和瘘管形成等严重并发症。影像学检查对诊断和处理至关重要，X线平片是一线检查方法，而CT对检测透X线物体和并发症具有更高的敏感性。即使没有实际异物存在，异物吞食和异物感的模仿者也源于动力障碍（如贲门失弛缓症）、结构或黏膜异常（如Zenker憩室、反流性食管炎和食管狭窄）以及外部压迫。尽管这些模仿者会产生相似的症状，但它们需要不同的诊断方法。本综述重点介绍了各种异物的影像学表现、处理策略及其模仿者的鉴别特征，强调了及时准确鉴别以指导适当干预并改善患者预后的重要性。
