- Most gastrointestinal foreign bodies are radiopaque
- Need to distinguish gastrointestinal foreign bodies that can cause medical emergencies (button battery and rare earth magnets) from those that will most likely pass through the gastrointestinal tract without incident
Approach to the differential diagnosis of gastrointestinal foreign body appearance acutely:
- Obtain CXR AP (to include nasopharynx) and AXR AP and then obtain lateral radiograph of wherever foreign body is
- Need to make accurate diagnosis of ingested button battery (which has on AP view a beveled edge or halo of lucency or double rim and on lateral view has a step off) which requires immediate endoscopic removal
- Note: Two stacked coins can mimic a button battery
- Need to make accurate diagnosis of multiple rare-earth magnets which require immediate endoscopic removal
- If there is a concern for an impacted radiolucent foreign body in the esophagus, an upper GI may be of use