Mickey Mouse Sign

mickey mouse oesophageal foreign body

A 7 year old girl presented to ED after swallowing a foreign body. Initial CXR shows a foreign body at the level of T8. There was no change in the position of the Mickey Mouse key ring after 8 hours. No pneumomediastinum or pneumothorax. The airway is patent. It was finally retrieved with oesophagoscopy.

Foreign body ingestion in children is a common ED presentation. If not removed, metallic/caustic material (eg, battery) can erode into oesophagus, causing ulceration or even perforation.

If passed into stomach, most round FBs cause little problem. The most common locations for FBs to lodge in the oesophagus are: (a) cricopharyngeal muscle, (b) aortic knob or (c) gastroesophageal junction. Follow up examinations to look for passage of FBs are essential, especially if they are pointed, long, irregular or jagged.

Reference: Swischuk, L. Emergency Radiology of the Acutely Ill or Injured Child, 2nd edition 1986. Chapter 2 “Abdomen” p283-289.

Credit: Dr Lily Wang