title: The utility of handheld metal detector in confirming metallic foreign body ingestion in the pediatric emergency department.
abstract: OBJECTIVE
  We aimed to identify the presence of ingested metallic foreign bodies with handheld metal detector in the pediatric population.
  
  
  METHODS
  All children (n=40) known or suspected to have ingested a MFB and who presented to the Emergency Department of the Children's Hospital of Ege University were prospectively ascertained. All patients underwent both radiographic evaluation and handheld metal detector scanning of the chest and abdomen on their presentation. In the present prospective study, we compared handheld metal detector scanning with plain radiography.
  
  
  RESULTS
  The end point of the study compared metallic foreign body findings with handheld metal detector vs radiological findings during an eight-month period. Forty subjects with possible metallic foreign body ingestion were enrolled into the study. The principle investigator scanned all subjects. Disease was defined by the presence of a foreign body in the gastrointestinal tract on radiograph. Radiographically, 35 foreign bodies were found, and handheld metal detector revealed 31 of them. The sensitivity of handheld metal detector was 88.6% (95% confidence interval [CI]: 72.1%-96.5%), specificity 100% (95% CI: 61.8%-100%), positive predictive value (PPV) 100% (95% CI: 85.8%-100%), and negative predictive value 55.5% (95% CI: 34.3%-84.6%). Handheld metal detector revealed that 2 metallic foreign bodies (1 pushpin, 1 coin) were localized to the chest, which was confirmed by radiography, and urgent removal was performed with endoscopy.
  
  
  CONCLUSIONS
  Handheld metal detector scanning is an accurate, inexpensive, radiation-free screening tool and should be used for evaluation of patients suspected of ingesting metallic foreign bodies.
authors.affiliation: Department of Emergency Medicine, Ege University School of Medicine, Children's Hospital, Izmir. ulas.saz@ege.edu.tr
authors.forename: Eylem Ulaş
authors.initials: EU
authors.lastname: Saz
authors.forename: Ciğdem
authors.initials: C
authors.lastname: Arikan
authors.forename: Funda
authors.initials: F
authors.lastname: Ozgenç
authors.forename: Muhterem
authors.initials: M
authors.lastname: Duyu
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Ozananar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D004867:Equipment Design; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis*; D005762:Gastroenterology / Q000295:instrumentation; D006801:Humans; D007223:Infant; D008297:Male; D008670:Metals; D011446:Prospective Studies
chemical_list: D008670:Metals