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2016 ; 95
(35
): e4701
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A computed tomography phantom study of foam earplugs: Uncommon but potentially
hazardous foreign body ingestion in children
#MMPMID27583901
Hsu LS
; Yen JB
; Wang SS
; Liao CL
Medicine (Baltimore)
2016[Aug]; 95
(35
): e4701
PMID27583901
show ga
Ingestion of a foreign body is common among children. However, ingestion of foam
earplugs (FEPs) has not been reported previously. A 7-month-old female infant
presented with small bowel obstruction, which was finally proved to be a case of
FEP ingestion.Computed tomography (CT) phantom study was performed to examine the
imaging features of FEPs. We studied the following dry and fully wet FEPs, FEPs
squeezed in pure water to varying degrees, and FEPs with different degrees of
compression in the dry and wet states from day 0 to 6 and all scanned with a CT
scanner.The density of a dry FEP is -843.5?±?4.5 Hounsfield units (HU) and it
increases to 0.76?±?9.3?HU when fully wet. The densities of FEPs ranged from
-844.2 to 1.0?HU with different water/air ratios, and some showed a heterogeneous
geographic pattern. The densities of FEPs increase due to compression and gradual
water absorption.FEPs can be potentially hazardous objects to children. Owing to
the special foam structure of the FEP, it can mimic a fatty lesion if the density
ranges from -100 to -50?HU; moreover, it can hide in the water if fully wet.
However, it should not be mistaken as air, as the density of a dry FEP is
-843.5?HU, and the contour can be observed if the window level is set
appropriately. Because of its soft texture, the surgeon should be careful not to
miss an FEP during the operation. Moreover, radiologists should be familiar with
the CT features of FEPs so that they can be identified before surgery.
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