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Symptoms and spontaneous passage of esophageal coins

G P Conners1, J M Chamberlain, D W Ochsenschlager

  • 1Emergency Medical Trauma Center, Children's National Medical Center, Washington, DC.

Archives of Pediatrics & Adolescent Medicine
|January 1, 1995
PubMed

Insights

Coins in the upper esophagus require immediate removal. Distal esophageal coins in children have a high chance of spontaneous passage, warranting observation before intervention. Esophageal coin ingestion necessitates imaging for all cases.

Area of Science:

  • Pediatric Gastroenterology
  • Emergency Medicine
  • Radiology

Background:

  • Esophageal coin ingestion is common in children.
  • Location of esophageal coins may influence spontaneous clearance.
  • Asymptomatic coin ingestion occurs in a subset of pediatric patients.

Purpose of the Study:

  • To compare spontaneous clearance rates of esophageal coins based on location.
  • To determine the frequency of asymptomatic esophageal coin ingestion in children.

Main Methods:

  • Retrospective case review of 73 children with esophageal coins.
  • Analysis of coin location (proximal, middle, distal esophagus) via roentgenography.
  • Review of medical records for symptoms and removal procedures.

Main Results:

  • All proximal and middle esophageal coins (58 children) required invasive removal.
  • 60% of distal esophageal coins (9/15 children) cleared spontaneously.
  • 7% of children (5/73) with esophageal coins were asymptomatic.

Conclusions:

  • Prompt removal of proximal and middle esophageal coins is recommended.
  • Observation for up to 24 hours is suggested for distal esophageal coins due to high spontaneous clearance rates.
  • All children with suspected coin ingestion should undergo roentgenographic evaluation due to potential asymptomatic presentation.
Abstract

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