peak age of coin ingestion is 1-3 years, 60% being males
CXR is recommended, and if in esophagus the flat surface of coin is seen on the AP view with the edge seen on the lateral view
if in the stomach, expectant observation (3-4 days) in the absence of abdominal pain and vomiting
20% of coins will lodge in the esoophagus at the level of the cricopharyngeus muscle, aortic arch, and lower esophageal sphincter
the change in composition of pennies from cooper to zinc in recent years has increased the potential for mucosal corrosion
all coins lodged in the proximal esophagus should be removed endoscoopically as soon as possible
coins in the mid- to lower esophagus may be observed for 12-24 hours if asymptomatic, but should undergo endoscopy if the coin fails to pass in that time period
References
Conners GP, Chamberlain JM, Ochsenschlager DW. Symptoms and spontaneous passage of esophageal coins. Arch Pediatr Adolesc Med. 1995;149:36-39
Macpherson RI, Hill JG, Otherson HB, Tagge EP, Smith CD. Esophageal foreign bodies in children: diagnosis, treatment, and complications. AJR Am J Roentgenol. 1996;166:919-924
