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Predicting outcome in pediatric coin ingestion.
M R Amin1, F J Buchinsky, J P Gaughan
1Department of Otolaryngology, MCP/Hahnemann School of Medicine, 2 Logan Square, Suite 1810, Philadelphia, PA 19103, USA. mamin@drexel.edu
Summary
Pediatric coin ingestion is often successfully diagnosed via X-ray. Older children and coins at the gastroesophageal junction are more likely to pass spontaneously.
Area of Science:
- Pediatric Gastroenterology
- Radiology
- Emergency Medicine
Background:
- Pediatric coin ingestion is a common emergency.
- Determining factors for spontaneous coin passage is crucial for clinical management.
Purpose of the Study:
- To investigate the relationship between coin characteristics, patient factors, and esophageal coin passage.
- To evaluate the accuracy of radiographic assessment for determining coin denomination.
Main Methods:
- Retrospective review of pediatric coin ingestion cases over 25 months.
- Analysis of factors including coin size, location, patient age, and weight.
- Assessment of radiographic appearance for coin denomination identification.
Main Results:
- Nineteen percent of ingested coins passed spontaneously.
- Radiographic assessment accurately determined coin denomination.
- Older patient age and gastroesophageal junction coin location correlated with higher passage rates.
- Coin size did not predict passage.
Conclusions:
- Radiographic assessment is reliable for identifying coin denomination.
- Patient age and coin location at the gastroesophageal junction are significant predictors of spontaneous esophageal coin passage.