NAKAMURA Shinichi    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor
Article types	Case report
Language	English
Peer review	Non peer reviewed
Title	Two cases of accidental ingestion of a press-through package (PTP) sheet, diagnosed by tomosynthesis prior to endoscopy.
Journal	Formal name：Clinical journal of gastroenterology Abbreviation：Clin J Gastroenterol ISSN code：18657265/18657265
Domestic / Foregin	Domestic
Volume, Issue, Page	13(6),pp.1057-1061
Author and coauthor	SASAKI Yu, OMORI Teppei, NITTA Hiroki, KURE Rie, KOBAYASHI Ayako, YAMAMOTO Kana, KISHINO Maiko, NAKAMURA Shinichi, TOKUSHIGE Katsutoshi
Publication date	2020/12
Summary	The accidental ingestion of a press-through package (PTP) sheet is associated with the risk of gastrointestinal injury and puncture. When pain occurs in the laryngeal pharynx, the PTP may already be stuck in the upper esophageal region, and urgent endoscopic treatment is necessary. A plain chest X-ray image should be performed first to identify the ingested PTP, but this was not successful in the present two patients. As a next step, a CT scan (which involves high radiation exposure) is commonly used. In our patients (a 76-year-old woman and a 59-year-old man), tomosynthesis was used to confirm the presence and location of a PTP sheet as a pre-endoscopic diagnosis. With tomosynthesis, the level of radiation exposure was reduced to approx. 1/10 of that of simple CT; the imaging time is also shorter at ~ 5 s. Tomosynthesis can be performed at approx. 1/3-1/4 the cost of simple CT. The usefulness of tomosynthesis as a pre-endoscopic diagnostic tool was demonstrated in our patients, and its further utilization is expected.
DOI	10.1007/s12328-020-01185-6
PMID	32712843