Foreign Body Ingestion: Radiologic Evaluation, Findings, and Management

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.