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Pediatric coin ingestion: an unusual presentation
A F Brayer1, M Sciera, G P Conners
1Department of Emergency Medicine, University of Rochester Medical Center, Box 492, 601 Elmwood Avenue, NY, Rochester, USA. anne_brayer@urmc.rochester.edu
International Journal of Pediatric Otorhinolaryngology
|October 18, 2000
Summary
A child swallowed a coin, but initial exams missed it. A careful physical exam later found the coin lodged in the palate, highlighting the need for thorough examination in pediatric emergencies.
Area of Science:
- Pediatric Emergency Medicine
- Foreign Body Ingestion
- Diagnostic Challenges
Background:
- Coin ingestion is common in young children.
- Initial diagnostic workup often includes physical and radiographic examinations.
- Delayed diagnosis can occur due to atypical presentations.
Observation:
- A 35-month-old child presented with suspected coin ingestion.
- Initial physical and radiographic exams were negative for foreign body.
- The child refused oral intake, prompting further examination.
Findings:
- A coin was discovered lodged on the hard palate, behind the upper incisors.
- Visualization required full neck extension, indicating an unusual lodging location.
- This case highlights limitations of standard imaging and the importance of clinical suspicion.
Implications:
- Emphasizes the critical role of meticulous physical examination in pediatric cases.
- Underscores the need for reevaluation when clinical findings contradict initial assessments.
- Suggests considering less common locations for foreign bodies even with negative initial imaging.