Coin Ingestion

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A 7-year-old girl was brought to the emergency department because of moderate pain on swallowing and mild upper abdominal discomfort. A few hours earlier, she had been given a piggy bank in order to save money for a family trip planned for the next day. On shaking the piggy bank upside down above her head, a few coins fell out. The child admitted to swallowing a coin.

Physical examination findings were unremarkable. A plain abdominal radiograph showed what appeared to be 1 coin in the stomach (A). Because the child and her family were travelling the next day, the decision was made to retrieve the foreign body. During an upper endoscopy, 2 coins were located in the body of the stomach (B). They were retrieved with a Roth net, without complication.

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Most coin ingestions occur in children between 6 months and 3 years of age.¹ Once the coins pass the gastroesophageal junction, they usually progress through the remainder of the GI tract without difficulty in children with normal anatomy.² If more than 1 coin or any other foreign body is suspected, a lateral abdominal radiograph may be obtained as well.

References:

REFERENCES:

1

. Metzl K. Question from the clinician: coin ingestion.

Pediatr Rev

. 2003;24:395.

2

. Conners GP. Management of asymptomatic coin ingestion.

Pediatrics

. 2005;116:752-753.