Conventional Radiology and Foreign Bodies: Their Current Role

Background: Intra-digestive foreign bodies are common and can vary in nature, shape, and number. Complications—especially perforation and superinfection—make them a medical emergency. Abdominal radiography without preparation (plain abdominal X-ray) is commonly prescribed in various situations and remains the first-line imaging method for detecting foreign bodies due to its simplicity and rapid access, providing valuable guidance for therapeutic management. Objectives: To describe the prevalence and radiographic appearance of digestive tract foreign bodies and assess the current role of conventional radiology in their detection. Methods: A single-center, descriptive retrospective study conducted over a two-year period in the Radiology Department of the Eaubonne Montmorency Hospital Group, Paris, France. The study included all patients who underwent a plain abdominal X-ray following the ingestion or insertion of a foreign body. Results: A total of 62 cases of digestive tract foreign bodies were identified on plain abdominal radiographs out of 1977 examinations (3.14%). Males predominated with a sex ratio of 2. Pediatric patients under 10 years of age were the most affected group, with ages ranging from 9 months to 82 years. In 95.2% of cases, the event occurred accidentally, while 4.8% had a history of psychosis. In over 98% of cases, the entry route was ingestion; one case involved anal insertion. Reported symptoms included abdominal pain, vomiting, and odynophagia. All detected foreign bodies were radiopaque and ranged in size from 5 mm to 10 cm. On imaging, most objects appeared rounded, resembling coins (53.2%). The most frequent location was the umbilical region (40.3%). Complications were generally minor, including fecal stasis (69.2%) and aerocolia (69.7%). Spontaneous evacuation through natural routes occurred in 93.5% of patients. Conclusion: Foreign bodies in the digestive tract are frequently detected by conventional radiography, particularly in the pediatric population, with boys affected twice as often as girls. Clinical manifestations depend on the location of the object in the digestive tract, and complications vary according to the foreign body’s shape, size, and number. Conventional radiography plays a key role in diagnosis by identifying the foreign body’s presence, location, and morphology, assessing complications, and guiding treatment decisions.