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Epidemiology and management of oesophageal coin impaction in children

Matthew B McNeill1, Sarah L W Sperry, Seth D Crockett

  • 1Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|February 11, 2012
PubMed

Insights

Oesophageal coin impaction commonly affects young children, with pennies being the most frequent foreign body. Extraction is often necessary, but coin type does not predict impaction location.

Area of Science:

  • Pediatric Gastroenterology
  • Otolaryngology
  • Emergency Medicine

Background:

  • Oesophageal coin impaction is a common pediatric emergency.
  • Epidemiological data and management strategies require further elucidation.

Purpose of the Study:

  • To characterize patients with oesophageal coin impaction.
  • To identify predictors of coin type and impaction location.
  • To evaluate management strategies for paediatric coin ingestion.

Main Methods:

  • Retrospective chart review of 113 children with oesophageal coin impaction (2002-2009).
  • Data extracted from tertiary care center databases using ICD-9 code 935.1.
  • Analysis of patient demographics, coin type, impaction site, and procedural outcomes.

Main Results:

  • The mean age of affected children was 2.9 years, with pennies being the most common coin (58%).
  • Most impactions occurred in the proximal oesophagus (80%), requiring procedural extraction (91%).
  • Otolaryngologists managed proximally impacted coins more frequently (99%) than gastroenterologists (49%).

Conclusions:

  • Oesophageal coin impaction predominantly affects young children, necessitating frequent endoscopic or surgical removal.
  • While pennies are the most common impacted coin, coin type does not reliably predict impaction location.
  • Management strategies may differ based on the impacted coin's location and the managing specialist.
Abstract

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