Esophageal coin with an unusual radiographic appearance

Esophageal coins are typically seen as radiopaque disks on anteroposterior chest radiographs. This radiographic finding is generally considered classic for identifying "swallowed" coins as being in the esophagus. We report the case of an 11-year-old girl with an esophageal coin seen end-on on an anteroposterior chest radiograph and as a disk consistent with a coin in the lateral view. These findings are typically associated with coin aspiration. Clinicians should be wary of making the diagnosis of foreign body aspiration of coins by relying on single-view radiographic findings alone. When clinically reasonable, we suggest additional imaging to help further localize swallowed coins.