Spontaneous passage of coins lodged in the upper esophagus

Coin ingestion with subsequent esophageal coin impaction is common in children. Although spontaneous passage to the stomach of coins at the gastroesophageal sphincter is fairly common, spontaneous passage of coins from the upper or mid-esophagus has only rarely been reported. Thus, in an effort at cost savings, an endoscopist might forego obtaining a second set of radiographs prior to removal of an esophageal coin. We present two cases of spontaneous passage of coins from the upper esophagus, both of which occurred hours after coin ingestion. These cases suggest that spontaneous passage of proximal esophageal coins does, in fact, occur in some children. A second set of radiographs, therefore, may identify these children, and prevent unnecessary invasive removal procedures.