Lane F. Donnelly MD, Presenter: Nothing to Disclose

Related to a 1975 JAMA article by Rogers and Igini that pointed out the hazards of inadvertent ingestion of detachable beverage-can pull-tabs, the can industry changed the construction to the stay-tabs (remain attached to can after opening) used today. However, these stay-tabs can easily be removed from the can, particularly by fiddling children. Our purpose is to identify the number of inadvertent ingestions of beverage can stay-tabs by children seen at our institution. We also review the radio-opacity of these aluminum stay-tabs and mean age of children who swallowed them. We suspect that inadvertent ingestion is more common than suspected, that older children ingest them (rather than those typical infant or toddlers that ingest foreign bodies), and that the aluminum tabs are difficult to detect radiographically.

The medical information system of a large children’s hospital was search with key terms to identify cases body in the past 10 years in which a witnessed or self-reported inadvertent ingestion of a beverage can stay-tab resulted in a radiographic series (chest, abdomen and lateral neck) to rule out foreign. Identified radiographs and reports were reviewed for patient demographics, whether the stay-tab was visible radiographically and - if so - the location of the stay-tab, and other radiographic abnormalities.

19 cases of stay-tab ingestion were identified. Mean age of ingesters was 8.5 years with the majority being teenagers and 15 (79%) > 5 years of age. The stay-tab could be seen radiographically only in 4 (21%) cases – all with the stay-tab identified in stomach.

The identification of 19 inadvertently ingested beverage-can stay-tabs at a single children’s hospital suggests that such occurrences are not uncommon and raises the possibility that the 1970s re-design of beverage tabs may not have reduced the number of ingestions, as was intended. Radiologists should be aware that stay-tabs are radiographically visible in the minority (21%) of cases and that these events occur more typically in older children, as compared to the typical age (infants and toddlers) of most pediatric foreign body ingestions.

The 1970s re-design of beverage tabs may not have reduced the number of ingestions as was intended. Ingested stay-tabs typically occur in teenagers and are not seen radiographically in most cases.

Donnelly, L, Did the Introduction of the Beverage Can Stay-Tab in the Mid-1970s Fail to Reduce the Number of Inadvertent Ingestions as Compared to the Previous Detachable Pull Tabs?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8003888.html