Author:Otto Louis-Jacques, MDPediatric Specialists of Virginia, Fairfax, Virginia

Citation:Louis-Jacques O.Foreign body ingestion of a beverage can tab.

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Consultant. 2018;58(2):92-94.

A14-year-old boy presented to an outside urgent care facility after having accidentally swallowed part of the metallic opening mechanism of an aluminum beverage can. The patient was in the habit of separating the 2 parts of the metallic opener from the can, namely the pull-tab and the flat, circular, scored part of the lid that folds inside the can as one lifts the tab. After doing so, he had placed the pull-tab inside his mouth and had placed the circular part around his lower lip.

As he laughed, he had accidentally choked on the pieces of the soda can tab. He had been able to cough up the pull-tab but felt the other part go down his throat. He subsequently had felt pain in the throat and a persistent foreign body sensation, and he had been taken to the urgent care facility.

While there, he had eaten part of a sandwich, after which the pain in his throat and the foreign body sensation had resolved. He had no vomiting, hematemesis, difficulty breathing, or cough, and he denied having abdominal pain. His vital signs and physical examination findings were normal. Radiographs of the neck, chest, and abdomen were obtained at the urgent care facility and did not show any foreign body (Figure 1).

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The clinicians at the urgent care facility consulted with a pediatric gastroenterologist at our facility. Because the patient’s history was clearly indicative of foreign body ingestion, and because aluminum soda can tabs are not always visible on plain radiographs because of their low density, we advised that the patient be transferred to our institution.

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An abdominal radiography series was performed at our institution 5 hours after the initial radiographs had been taken at the urgent care facility. The new films showed a 2.5-cm linear metallic density projecting over the left aspect of the L3 vertebral body, suspicious for a foreign body (Figure 2). Because of the potential for injury to the gastrointestinal tract mucosa from the sharp edges of the soda can tab, the patient underwent urgent endoscopy, and the metallic object was found in the proximal part of the stomach (Figure 3). It was removed uneventfully via endoscopy, and the patient subsequently was discharged home.