Dennison Chelsea B,  Onnis Carlotta,  Ali Sumera,  Huang Hui,  Jergel Andrew,  Alazraki Adina,  Parikh Ashishkumar

Final Pr. ID: Poster #: SCI-072

Foreign body (FB) aspiration is a common medical emergency in children, which can be fatal. Prompt diagnosis is crucial to avoid complication. Bronchoscopy represents the gold standard for diagnosis; however, false negatives can lead to unnecessary invasive testing and exposes children to procedural risks. While lateral decubitus radiographs can assess for air trapping, this exam has low sensitivity for detecting airway foreign bodies. Thus, there is a need for a sensitive and specific diagnostic imaging test in the detection of airway FB. We developed and implemented a FB chest CT protocol that is characterized by low-dose relative to a standard chest CT and no intravenous contrast. We hypothesize that low-dose chest CT is a sensitive and specific modality for detection of airway FB in the pediatric population that may ultimately decrease the negative bronchoscopy rate. Read More

Authors:  Dennison Chelsea B , Onnis Carlotta , Ali Sumera , Huang Hui , Jergel Andrew , Alazraki Adina , Parikh Ashishkumar

Keywords:  Chest Computed Tomography (CT), Foreign Body Ingestion, Low Dose Protocol

Rafferty Bridget,  Thakrar Pooja

Final Pr. ID: Poster #: CR-010

Orbeez Water Beads, marketed as "nontoxic sensory toys for kids ages 5 and up," arrive as pinhead-sized microbeads ("seeds") which must be soaked in water for several hours to achieve full size of 7-8 mm (1,2,4). The water beads and other similar products, such as gel beads, water orbs, and gel balls, are available in multiple colors and finishes, including "shimmer" and glow in the dark (1). Their small size and bright colors give these water beads the appearance of candy, and they are easily ingested. If ingested as seeds, the beads will expand in the gastrointestinal tract, where they have been found to grow well beyond their purported full size of 8 mm to as much as 40 mm, causing bowel obstruction (3).
Detecting water beads on imaging is a challenge for the pediatric radiologist, but localization of the beads before intervention can aid the surgeon or gastroenterologist in their retrieval attempts. Radiographs are poor detectors of their thin membranes and majority fluid composition. If there is a high index of suspicion for ingestion, CT is often second-line for detection of the fluid-filled orbs and evaluation of intestinal obstruction. However, in the pediatric population, in whom keeping radiation exposure to the lowest reasonably achievable levels is paramount, ultrasound (US) is a valuable tool for diagnosis of bowel obstruction. US demonstrates equal sensitivity and increased specificity in comparison to radiography. In addition, US is an excellent tool for identifying the beads themselves, which appear as well-circumscribed, rounded, anechoic structures within the bowel lumen. Importantly, US is readily available, is easy to use, and obviates exposure to radiation in young children.
We present a case of ingested water beads diagnosed by US to demonstrate the utility of US in identifying both the beads and potential bowel obstruction in young children.
References:
1. https://www.spinmaster.com/en-US/brands/orbeez/
2. https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Water-Beads-Harmful.aspx
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808832/
4. https://www.amazon.com/Blaster-Splatter-Electric-Automatic-Manual/dp/B09YBYR2T7 Read More

Authors:  Rafferty Bridget , Thakrar Pooja

Keywords:  ultrasound, ingestion, obstruction

Patel Khushbu,  Sher Andrew,  Kan J.

Final Pr. ID: Poster #: SCI-041

Ingested foreign bodies (FB) are frequently encountered in the pediatric population, whether accidental or deliberate and may lodge in the airways or esophagus. Metallic FB (e.g., coins, button batteries, magnets) are radio-opaque and easily detected on radiographs, conversely non-metallic objects (e.g., plastic toys, food) are radiolucent and often require CT, leading to diagnostic delays. The purpose of this study is to assess sensitivity for chest radiography and chest CT for endoscopically proven airway and esophageal food and non-food FBs. Read More

Authors:  Patel Khushbu , Sher Andrew , Kan J.

Keywords:  Foreign Body Ingestion, Approach, Diagnostic