Child with esophageal coin and atypical radiograph

Aspirated or swallowed coins are a common phenomenon resulting in a pediatric patient presenting to the Emergency Department. The location of the coin (trachea vs. esophagus) is commonly determined by the alignment of the coin on radiographic studies. We present a child who had an esophageal coin but radiographic findings that supported a coin located in the trachea. Our case illustrates the importance of performing radiographic studies that include both anteroposterior and lateral neck/chest views in patients who aspirate or swallow coins.