Acute esophageal coin ingestions: is immediate removal necessary?

Abstract

Patients with acute esophageal coin ingestions may experience spontaneous coin passage and therefore, patients with coins located below the thoracic inlet with minor symptoms may be candidates for next-day follow-up. If repeat radiographs reveal a persistent esophageal coin, then the coin should be immediately removed. Furthermore, asymptomatic patients with coins above the thoracic inlet should undergo repeat radiographs in 2-5 h, as spontaneous coin passage may occur. Our protocol may also be more convenient and cost-effective as patients can be observed at home.

Multiple Foreign Bodies in GIT in a Child Managed by Conservative Approach

“…Once these foreign bodies pass beyond pylorus and ileocaecal valve, they easily pass out of the lumen per rectum spontaneously. Losanof et al operated all cases since the foreign bodies have pointed and sharp edges 1,7 . Our pa ent was managed conserva vely and monitored as an inpa ent.…”

Esophageal coin removal by emergency physicians: a continuous quality improvement project incorporating rapid sequence intubation

“…1 Fortunately, many swallowed coins will traverse the entire digestive tract and pass without complication. [2][3][4] However, some coins become lodged in the esophagus, 5,6 causing throat irritation, gagging, and vomiting. 2,7 Life-threatening complications are rare, but esophageal perforation, extraluminal coin migration, tracheoesophageal fistula, and fatal aortoesophageal fistula have been reported.…”

“…8,9 Esophageal coins can be removed with Magill forceps, a Foley catheter, endoscopy, and airway bougienage to advance the coin into the stomach, where subsequent spontaneous passage is the expected outcome. [3][4][5][6][7][10][11][12][13] Historically, at our institution, pediatric surgeons, otolaryngologists, and pediatric gastroenterologists have performed the removal of esophageal coins. In mid-2003, our group of general and pediatric emergency physicians expressed interest in removing these coins in the emergency department (ED).…”

Ingestão acidental de moedas por crianças: atuação do Setor de Otorrinolaringologia do Hospital João XXIII

“…This study recommends that the asymptomatic cases of coins lodged in the middle and distal thirds may be observed at home for a period of 24 hours, however if they remain in the esophagus they should be removed. Home watch have a better cost-benefit ratio than hospital stay for observation 8 . In cases of coins located at the cricopharynx, watching alone does not bear good results 2 .…”

“…Complications occur mainly because of invasive removal attempts. 1.8% of the patients who undergo Foley catheter removal attempt present some complications (epistaxis, vomits and transitory respiratory failure) 8 . Esophageal perforations have not been described in the cases in which the Magill forceps was used.…”