Imamura Shun, Ishimaru Soichiro, Maejima Hikaru, Hirai Masayuki, Kisohara Satoru
Department of Pediatrics, Kariya Toyota General Hospital, Kariya, JPN.
Cureus. 2025 Jul 31;17(7):e89144. doi: 10.7759/cureus.89144. eCollection 2025 Jul.
Foreign body ingestion is a common pediatric emergency, and plastic objects are particularly difficult to detect on imaging due to their radiolucency. This can lead to delayed diagnosis and serious complications, especially when the ingestion is unwitnessed or the child is asymptomatic. We report a case of a four years and five months old girl who claimed to have accidentally swallowed a 4.6 cm tapered plastic food pick. She was asymptomatic on initial presentation, and neither X-rays nor CT scans revealed the foreign body. She was initially discharged. However, upon reevaluation of the history and characteristics of the object, a senior physician suspected the presence of a retained elongated object and advised re-presentation. Under general anesthesia, upper gastrointestinal endoscopy was performed, and the pick was safely retrieved from the stomach without complications. This case highlights the clinical significance of recognizing the potential danger posed by radiolucent, tapered plastic foreign bodies, even in asymptomatic patients. Clinical decisions should not rely solely on imaging but incorporate the history and nature of the object. This case emphasizes the importance of flexible clinical judgment and early intervention in managing radiolucent foreign body ingestion.
异物摄入是常见的儿科急症，塑料物品因其透光性在影像学检查中特别难以检测到。这可能导致诊断延迟和严重并发症，尤其是在无人目睹摄入过程或儿童无症状的情况下。我们报告一例4岁5个月大的女孩，她声称意外吞下了一根4.6厘米长的锥形塑料食品签。她初诊时无症状，X线和CT扫描均未发现异物。她最初被出院。然而，在重新评估异物的病史和特征后，一位主任医师怀疑存在残留的细长异物，并建议再次就诊。在全身麻醉下进行了上消化道内镜检查，食品签从胃中安全取出，无并发症发生。本病例强调了认识到透光性、锥形塑料异物所构成潜在危险的临床意义，即使在无症状患者中也是如此。临床决策不应仅依赖影像学检查，还应结合异物的病史和性质。本病例强调了灵活的临床判断和早期干预在处理透光性异物摄入中的重要性。
