Pediatric emergency medicine trisk 4527 4527
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marker is over the foreign body and the skin should be marked to identify this
optimal incision site. After appropriate anesthetic injection and incision, image
the foreign body in the long axis and use forceps or hemostats to grasp the object
under ultrasound guidance.
FIGURE 131.34 Abscess.
Pitfalls
Bone and joint surfaces appear hyperechoic with shadowing, and can be confused
with foreign bodies if one is not familiar with the local anatomy. Scar tissue can
also appear hyperechoic and must be differentiated from foreign bodies. Wooden
foreign bodies may become less echogenic over time, making them more difficult
to see. Finally, using ultrasound dynamically to remove a foreign body is
technically challenging. It requires a moderate amount of ultrasound experience
and dexterity. The novice user may have greater success in identifying the foreign
body statically in multiple planes, marking the site and attempting removal in
standard fashion.
OTHER USES OF ULTRASOUND
There are other uses of sonography that are beyond the scope of this chapter. We
touch upon them briefly here to introduce the concepts. The interested reader
should consult a textbook of ultrasonography.
