POCUS for Detection of Esophageal and Gastric Foreign Bodies

Foreign body ingestion is a common and challenging complaint for physicians in the emergency department (ED). Although most foreign bodies pass naturally without surgical intervention, about 10-20% require removal based on their size, shape, and location within the gastrointestinal tract. X-rays and computed tomography (CT) scans are frequently used for evaluation. However, x-rays cannot detect radiolucent foreign bodies, both modalities emit ionizing radiation, and CT scans are notably expensive. Point of care ultrasound (POCUS) offers a valuable alternative for detecting foreign bodies, as it avoids radiation exposure, reduces costs, and is readily accessible.

We present a case series involving three distinct instances of foreign body ingestion, where POCUS enhanced patient outcomes and disposition. This series includes evidence on use of POCUS for an obstructed esophageal foreign body and two gastric foreign bodies in a stable patient and unstable altered patient suspected of medication overdose.

POCUS is an effective tool for identifying foreign bodies in the upper gastrointestinal tract, especially when x-rays fail to visualize non-radiopaque materials or when attempting to minimize radiation from CT scans. It allows emergency physicians to quickly confirm the presence and precise location of foreign bodies in the gastrointestinal tract, leading to faster clinical decision making and reduced risk of complications, such as perforation or obstruction.