UMEM Educational Pearls

Category: Pediatrics

Title: Swallowed Coins

Posted: 8/1/2009 by Rose Chasm, MD (Updated: 10/21/2021)
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  • 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