Spectrum of imaging findings in trans-gastric migration of accidently ingested metallic foreign bodies

Arshed Hussain Parry, Mohammad Saleem Dar, Abdul Haseeb Wani, Tariq Ahmad Gojwari, Irfan Robbani


Background: An accidently ingested foreign body may get lodged within the lumen of gastrointestinal tract, pass uneventfully with feces or may migrate extraluminally into the surrounding tissues in which case it may lead to suppurative or vascular complications. The aim of the endeavor was to study the spectrum of imaging findings in patients with accidental ingestion of foreign bodies with trans-gastric migration of metallic foreign bodies.

Methods: Total 33 patients with history of accidental ingestion of foreign bodies were subjected to preliminary radiograph of neck, chest and abdomen followed by upper gastrointestinal endoscopy. Failure to retrieve/ localize foreign body endoscopically from upper gastrointestinal tract with check radiograph reiterating the presence of foreign body in upper abdomen were subjected to computed tomography of abdomen.

Results: A total of 33 patients comprising of 27 females and 6 males with mean age of 23.76 years with history of foreign body ingestion were studied. Ingested foreign bodies were lodged in pharynx (n=7), esophagus (n=3), stomach (n=13) or duodenum (n=3).  In 7 patients in whom endoscopy failed to locate and/or retrieve foreign body, computed tomography confirmed the presence of trans-gastrically migrated foreign body in the surrounding structures. The location of migrated foreign bodies was in lesser sac (n = 2), greater omentum (n = 3), lesser omentum (n = 1) and transmural (n = 1). Two patients had evidence of collection formation around the migrated foreign bodies.

Conclusions: Sharp or pointed metallic foreign bodies may migrate trans-luminally with various implications. Though radiography is the preliminary workhorse for the confirmation of ingested foreign bodies, computed tomography owing to its volumetric data acquisition helps in exact localization of migrated foreign bodies and should precede any therapeutic intervention for retrieval of migrated foreign bodies.


Computed tomography, Metal foreign body, Radio-opacity, Radiographic visibility, Trans-gastric migration

Full Text:



Verma RK, Panda NK. Metallic foreign body migrating into prevertebral muscles: how we did it? Oman Med J. 2014;29(1):64.

Vamanshankar H, Nair AB, Rajan N. Metallic foreign body penetrating the carotid sheath: a case report. Malaysian J Med Sci. 2011 Jan;18(1):72.

Landis BN, Giger R. An unusual foreign body migrating through time and tissues. Head face Med. 2006 Dec;2(1):30.

Remsen K, Biller HF, Lawson W, Som ML. Unusual presentations of penetrating foreign bodies of the upper aerodigestive tract. Ann Otol Rhinol Laryngol. 1983;92(4_suppl):32-44.

Rahalkar MD, Pai B, Kukade G, Al Busaidi SS. Sewing needles as foreign bodies in the liver and pancreas. Clinical Radiol. 2003;58(1):84-6.

Halverson M, Servaes S. Foreign bodies: radiopaque compared to what? Pediatr Radiol. 2013;43:1103-7.

Ingraham CR, Mannelli L, Robinson JD, Linnau KF. Radiology of foreign bodies: how do we image them?. Emergency Radiol. 2015;22(4):425-30.

Horton LK, Jacobson JA, Powell A, Fessell DP, Hayes CW. Sonography and radiography of soft-tissue foreign bodies. Am J Roentgenol. 2001;176(5):1155-9.

Adesanya OO, Dawkins DM. Intraorbital wooden foreign body (IOFB): mimicking air on CT. Emerg Radiol. 2007;14:45-9.

Bolliger SA, Oesterhelweg L, Spendlove D, Ross S, Thali MJ. Is differentiation of frequently encountered foreign bodies in corpses possible by Hounsfield density measurement?. J Forensic Sci. 2009;54(5):1119-22.

Hunter TB, Taljanovic MS. Foreign bodies. Radiographics. 2003;23(3):731-57.

American Society for Gastrointestinal Endoscopy (ASGE) Standard of Practice Committee, Ikenberry SO, Jue TL, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011;73:1085-91.

Jayachandra S, Eslick GD. A systematic review of paediatric foreign body ingestion: presentation, complications, and management. Int J Pediatr Otorhinolaryngol. 2013;77(3):311-7.

Meæinã CI, Vîlcea DI, Paæalega M. Problems of diagnosis and treatment caused by ingested foreign bodies. Chirurgia (Bucur). 2013;108:400-6.

Tang AP, Kong AB, Walsh D, Verma R. Small bowel perforation due to a plastic bread bag clip: the case for clip redesign. ANZ J Surg. 2005 May;75(5):360-2.

Hariga I, Khamassi K, Zribi S, Amor MB, Gamra OB, Mbarek C, et al. Management of foreign bodies in the aerodigestive tract. Indian Journal of Otolaryngology and Head Neck Surg. 2014;66(1):220-4.

Rodríguez H, Passali GC, Gregori D, Chinski A, Tiscornia C, Botto H, et al. Management of foreign bodies in the airway and oesophagus. Int J Pediatr Otorhinolaryngol. 2012;76:S84-91.

Weiland ST, Schurr MJ. Conservative management of ingested foreign bodies. J Gastrointest Surg. 2002;6(3):496-500.