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Ingesting or aspirating aluminum beverage can pull tabs can cause severe complications in children, including death. Medical evaluation is crucial for toddlers with feeding or respiratory issues, as these tabs are difficult to detect on X-rays.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Toxicology
Background:
- Aluminum beverage can pull tabs pose a risk of ingestion or aspiration in children.
- Complications can be severe and life-threatening.
Observation:
- Seven children were treated over 3.5 years for pull tab ingestion/aspiration complications.
- One child died from an aortoesophageal fistula.
- Two children had esophageal perforations and abscesses.
Findings:
- Aluminum pull tabs are radiolucent, making them difficult to visualize on standard X-rays, especially when superimposed on vertebral bodies.
- Diagnosis requires a high index of suspicion in symptomatic children.
Implications:
- Early recognition and evaluation are critical for children with unexplained feeding or respiratory symptoms.
- Consider pull tab aspiration/ingestion in the differential diagnosis.
- Improved diagnostic methods may be needed for radiolucent foreign bodies.
Abstract:
In a 3 1/2- year period, seven children have been treated for complications of ingestion or aspiration of pull tabs from aluminum beverage cans. One child died from a fistula between the esophagus and a branch of the aortic arch, and two children suffered esophageal perforation with local abscess formation. Since aluminum absorbs x-rays poorly, the pull tabs cannot be seen in frontal projection if they overlie vertebral bodies. Any toddler with unexplained alteration of feeding habits or persistent respiratory symptoms requires evaluation for an aspirated or ingested foreign body.