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Keep the change, doc!: coins in the upper GI tract of children
1Department of Pediatrics, Marshall University School of Medicine, Huntington.
Insights
Foreign body ingestion in children, especially coins, presents a common ER dilemma. Most ingested foreign bodies lodge in the esophagus, necessitating careful management protocols for pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Endoscopy
Background:
- Swallowing foreign bodies (FBs) is a frequent cause for pediatric emergency room visits.
- Coins are the most common type of ingested FB in children.
- Deciding between removal and natural passage of FBs poses a clinical challenge.
Purpose of the Study:
- To review clinical and endoscopic findings in pediatric patients undergoing FB retrieval.
- To discuss management strategies for ingested coins in children.
- To propose a medical protocol for managing coin ingestions.
Main Methods:
- Retrospective review of pediatric patients treated for FB retrieval.
- Analysis of clinical presentations and endoscopic findings.
- Literature review on FB ingestion and coin management.
Main Results:
- The study included retrieval of coins, food particles, and toy parts.
- 82% of swallowed FBs were located in the esophagus.
- Clinical and endoscopic data were analyzed to inform management.
Conclusions:
- Esophageal FB impaction is common in children.
- A standardized protocol is beneficial for managing coin ingestions.
- Effective FB retrieval and management are crucial in pediatric care.
Abstract:
Many children are brought to the Emergency Room each year because they have swallowed foreign bodies (FBs), particularly coins. Whether to remove these foreign bodies or let them pass through naturally is a constant dilemma for ER physicians. This article reviews our experiences in treating pediatric patients who underwent FB retrieval for coins, food particles and toy parts, and discusses their clinical and endoscopic findings. The vast majority (82%) of the swallowed FBs were lodged in the esophagus. A review of the literature and a suggested medical protocol to manage patients who have swallowed coins are also discussed in this article.