Lost in the Woods: Pediatric Wooden Foreign Body Revealed by Ultrasound
Document Type
Conference Proceeding - Restricted Access
Publication Date
5-8-2026
Abstract
Retained foreign bodies are a common yet often missed complication of traumatic soft tissue injuries, particularly when the material is radiolucent. Wooden foreign bodies are difficult to visualize on plain radiographs and CT, whereas ultrasound is well-suited to detect them and should be considered early when injuries involve wooden objects. This case describes a pediatric wooden puncture injury in which CT was negative, but a repeat ultrasound ultimately revealed the retained fragment and guided definitive management.
A 5-year-old previously healthy male presented to a community emergency department after jumping from a tree and sustaining a right thigh puncture wound from a tree branch. Vital signs were normal, with an abrasion and a small puncture wound and a nearby 1 cm right inguinal lymph node thought unrelated. Radiographs were negative for foreign body, and CT showed subcutaneous air in the right inguinal region without a described retained object; the wound was explored, irrigated, and the patient was discharged on Augmentin. Eight days later, he returned to a children's emergency department with worsening pain, erythema, induration tracking to the inguinal region, and purulent drainage despite antibiotics, though without leukocytosis.
This case highlights the limited sensitivity of radiography and CT for radiolucent wooden foreign bodies and supports ultrasound as a key first-line modality in suspected organic puncture injuries. When the mechanism and clinical course suggest retained material despite negative initial imaging, clinicians should maintain a high index of suspicion, involve surgical consultants early, and obtain a targeted or repeat ultrasound to reduce complications and operative burden.
Recommended Citation
Eswine S, Chassee T, Benner C. Lost in the woods: Pediatric wooden foreign body revealed by ultrasound. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.
Comments
2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1947