To understand radiographic and CT images of Press-Through-Package (PTP) of different materials under various conditions.
PTP is one of the most common ingested foreign bodies in patients with dementia or mental retardation and may cause intestinal perforation or obstructive ileus (1-4). As clinical information is often not obtained, diagnostic images will play important roles.Recently, the majority of material of PTP has been changed from polyvinyl chloride (PVC) to polypropylene (PP) for the environmental reason. The problem with polypropylene is that it is radiolucent on radiograph and even difficult to be confirmed on CT (Figure). It is imperative that radiologist be...
Imaging findings OR Procedure details
A. PTP made by polyvinyl chloride (PVC) with and without tablet.
(Non Steroidal Anti-Inflammatory Drugs, Loxoprofen sodium)(Figure)
B. PTP polypropylene (PP) with and without tablet.
(Iron medicine, Sodium Ferrous citrate)(Figure)
Radiography of PTP
PTPs with and without a tablet attached to thin wooden bars were placed between acryl phantoms in the air. (Figure)
1) 100kV, 200mA, 10ms, Acryl phantom:10cm (5cm+5cm)
2) 60kV, 200mA, 125ms, Acryl phantom:10cm (5cm+5cm)
3) 100kV, 200mA, 125ms, Acryl phantom:20cm (10cm+10cm)
4) 60kV, 200mA, 125ms, Acryl phantom:20cm (10cm+10cm)
Radiography in head...
The images of PTP are different by the material and conditions.When accidental ingestion of PTP is suspected, it is necessary to confirm the material of PTP, use the appropriate imaging technique and review carefully.
S. Kamei, T. Ishiguchi, N. Shimizu, M. Yamauchi, R. Sano, Y. Kondo, T. Watanabe, A. Kitagawa, M. Hagihara; Aichi-gun/JPAichi Medical UniversityAichi-gun/JPkamei@aichi-med-u.ac.jp
Sakakura A, Yamamoto Y, Terada M, et al. Clinical study of esophageal foreign bodies attributable to PTP material. Auris Nasus Larynx 24: 411-416, 1997.Yamaguchi H, Yamashita H, Yamauchi H, et al. Intestinal perforation caused by stagnated press-through packages. Surgery: 661-663, 2005.Imaizumi H, Yamauchi M, Namiki A, et al . Obstructive ileus caused by swallowed foreign body (a “Press-Through-Package”) and preexisting adhesions. Am J Emerg Med 15: 52-53, 1997.Takada M, Kashiwagi R, Sakane M, et al. 3D-CT diagnosis for ingested foreign bodies. Am J Emerg Med...