Ingested foreign body mimic - hair tie

Case contributed by MD Jaclyn Kappico

Presentation

Three days of fever, cough and tachycardia.

Patient Data

Age: 3 years
Gender: Female

Density in the shape of a coil seen projecting over the superior mediastinum/lower neck on the AP view, and overlying the upper back on the lateral view consistent with a hair tie.

Case Discussion

A chest x-ray was requested to rule out pneumonic process versus foreign body aspiration.

Hair elastics/ties/bands can pose a clinical challenge when discerning whether or not they have been ingested. The key on this x-ray is that the hair tie extends out from the borders of the mediastinum on the frontal radiograph, with its position confirmed on the lateral exam. To truly rule out a radiolucent foreign body, both lateral decubitus views would be useful in identifying air trapping within the affected lung.

Differential diagnosis includes:

  1. artifact
  2. foreign body ingestion vs aspiration

This case was submitted with supervision and input from:

Soni C Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center

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