technetium-tc-99m-sulfur-colloid and Foreign-Bodies

Pulmonary aspiration was assessed using a scintigraphic swallowing procedure in 14 dysphagics in whom penetration of the larynx had been previously diagnosed. No patient had recent evidence of aspiration pneumonia. Imaging was performed during and following ingestion of a cupful of thin liquid admixed with between 1-2 mCi of Tc-99m sulfur colloid. Follow-up scans were obtained several hours later as needed to assess airway clearance. Five of the fourteen (36%) showed penetration distal to the trachea. Seven (50%) were indeterminate for aspiration, as isotope localized to the neck could not be clearly designated as being in either airway or foodway. Two subjects had negative studies. Of patients with subtracheal penetration, (1) fractions of the ingested material which were aspirated ranged from < 1%-25%, and (2) elimination from airways was complete or near-complete by 3 hours. The presence of an immediate or delayed cough was noted but did not correlate with subtracheal aspiration. Based on the results of scintigraphy, 8 of 9 patients on some form of liquid restriction at the time of testing were allowed to ease restrictions. Five patients without prior liquid restriction were allowed to continue to drink. We propose that scintigraphy provides important data on airway penetration and clearance that is useful in the dietary management of dysphagic patients.

Topics: Adult; Aged; Cough; Deglutition; Deglutition Disorders; Foreign Bodies; Humans; Inhalation; Larynx; Middle Aged; Mucociliary Clearance; Radionuclide Imaging; Severity of Illness Index; Technetium Tc 99m Sulfur Colloid; Trachea

Topics: Abdomen; Foreign Bodies; Humans; Male; Middle Aged; Radionuclide Imaging; Surgical Sponges; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Sulfur Colloid; Time Factors

The development of a pseudo defect in the spleen secondary to perforation of the bowel by a 17 cm lead pencil is described. The approach to diagnosis of a foreign body in the abdominal cavity is discussed.

Topics: Adolescent; Colon; Fever of Unknown Origin; Foreign Bodies; Gallium Radioisotopes; Humans; Intestinal Perforation; Male; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed