I read with interest the article by Vötsch et al. In cases of the presence of a radio-opaque foreign body in the chest X-ray, we should localize it either in the pleura, mediastinum, airway, eosophagus or parieties. Treatment depends on the exact site of the foreign body.
The main problem comes from misinterpreting the site of the foreign body. Proper localization of the foreign body in the chest requires not only a detailed and thorough history-taking from the victim and/or family, but also chest X-rays, at posteroanterior and lateral views with clothes off to overcome malingering psychotic patients. Not infrequently, 24 to 48 hours of observation may help to localize the chest foreign body properly - whether ingested, inhaled, self-inflicted or even forgotten intraoperatively. It may save some unnecessary scopies and/or explorations. The reported case [1] and a case of mine [2] are good examples that reiterate these rules.
Conflict of interest: none declared.
References
- 1.Vötsch A, Beran E, Zirngast B, Müchler H. Re- sternotomy as an unwelcome side-effect of unknown effervescent tablet intake? Interact CardioVasc Thorac Surg 2012;15:558–9 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Sersar SI. A self-introduced sharp metallic foreign body migrating transcutaneously to the interventricular septum, mistaken as an inhaled pin. Thorac Cardiovasc Surg 2011;141:603–604. [DOI] [PubMed] [Google Scholar]