Unexpected radiographic findings related to foreign bodies

In two asymptomatic patients, routine preoperative radiographs revealed three pennies in the esophagus in one patient and a spring from a toy in another patient. In contrast two symptomatic patients, one with a flip-top cap from a beer can in the esophagus and the other with a piece of photographic film in the larynx, had negative findings on their radiographs. Salient points of the cases are that diagnosis can be delayed by inadequate history, misinterpretation of signs and symptoms, and unexpected radiographic findings. Special attention should be focused on the flip-top cap ingestion case. Sixty-five percent of 677 people polled have placed flip-top caps into full cans. Fifty-two people almost swallowed a flip-top cap. Otolaryngologists should be alerted about the radiolucency of this metallic foreign body, and the general population should be discouraged from this dangerous practice.