Radiopaque Esophageal Foreign Body (chewing gum)

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Clinical Presentation: 35 y.o. woman

History

35 y.o. mother presents to the pulmonary clinic for follow up of mild cough and dyspnea. She reports that she had some candy from her son's Trick-or-Treat bag. She has a past history of asthma, dyspnea on exertion, and sarcoidosis of the eye.

Physical Examination and Laboratory

A high resolution CT scan of the chest was performed

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Esophageal Foreign Body (radiopaque)

Radiopaque Esophageal Foreign Body

Esophageal Foreign Body (radiopaque)

Happy Halloween!

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Summary of Findings & Images

Normal appearing lung parenchyma. An irregular heterogeneously dense structure was noted in the mid esophagus measuring 1.9x0.5cm. The structure was of approximately 390 Hounsfield units.

Differential Diagnosis

â€¢ Foreign body- pill, chewing gum, food
â€¢ Calcified mass

Diagnosis: Radiopaque Esophageal Foreign Body (chewing gum)

Diagnosis Confirmed by: History (see below)

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Treatment and Followup

Tx and Followup:
She confirmed chewing and swallowing TridentÂ® Cinnamon flavor during the scan. (see Discussion) No treatment was necessary.

Additional Discussion:
The patient was questioned regarding food, pills, and other potential foreign bodies. She reported chewing gum while in the CT scanner and she swallowed her gum during the scan. The gum was TridentÂ® Cinnamon flavor.

Foreign bodies have the potential for diagnostic confusion. Chewing gum in particular is not frequently thought of when an irregular heterogeneously mass of calcium density is identified. Chewing gum has been reported simulating abdominal calcifications, bezoars, and tumors. Intraoral chewing gum on CT has been described previously1. With a comparison of various brands of gum and their associated hounsfeld units. The densest flavor was cinnamon flavor TridentÂ®, with a reported Hounsfield units of 418. [1]

References:
1. Towbin, A (2008) The CT appearance of intraoral chewing gum; Pediatric Radiology 38:1350-1352

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Contributor Credits

Submitted by: Aaron McAllister -
Case/Image Editor: Patricia Stoltzfus -

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