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Published on: September 11, 2018

Management of oesophageal coins in children

O Nafousi1, Richard Pertwee, Damian Roland

  • 1Paediatric Emergency Department, Leicester Royal Infirmary, Leicester, UK.

Emergency Medicine Journal : EMJ
|March 17, 2012
PubMed

Insights

A watch and wait approach is safe for asymptomatic children with oesophageal coins. Most coins pass spontaneously within 18 hours, avoiding complications and the need for general anesthesia (GA).

Area of Science:

  • Pediatric Emergency Medicine
  • Radiology
  • Gastroenterology

Background:

  • Esophageal foreign body ingestion is common in children.
  • Radiographic confirmation of an esophageal coin necessitates a management decision.

Purpose of the Study:

  • To evaluate the safety and efficacy of a 'watch and wait' approach for asymptomatic children with esophageal coins.

Main Methods:

  • Retrospective case note review of children under 16 years.
  • Analysis of data over a 7-year period (2004-2010).
  • Inclusion criteria: confirmed esophageal coin on X-ray.

Main Results:

  • 89% of asymptomatic children managed conservatively had spontaneous coin passage within 18 hours.
  • No complications were observed in conservatively managed children.
  • No patient with a middle or lower esophageal coin required general anesthesia (GA).

Conclusions:

  • A period of observation up to 18 hours is safe for asymptomatic children with esophageal coins in the UK.
  • Conservative management can be safely performed at home with follow-up X-ray.
  • This approach avoids unnecessary interventions like GA.
Abstract

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