Objectives: Aspirated objects generally represent items accessible to children. When metallic candy wrapper aspiration is questioned, radiographic studies may aid diagnosis. An infant with repeated chest radiographs negative for a metallic foreign body was found to have a multi-layer metallic candy wrapper in the left main bronchus. The purpose of this study was to determine whether conventional and dual-energy radiographic techniques exclude the presence of aspirated metallic foil wrappers.
Methods: Single-layer and multi-layer metallic candy wrappers were radiographically studied with conventional and dual-energy radiographic techniques in 3 tissue models.
Results: No single-layer metallic samples were detectable with conventional or dual-energy radiography. The multilayer samples were not detectable at less than 8 layers (pulmonary tissue model) or 16 layers (mediastinal model) by either conventional or dual-energy radiography.
Conclusions: Conventional and dual-energy chest radiographic techniques do not reliably exclude the presence of aspirated metallic foil wrappers.