Predicting outcome in pediatric coin ingestion

Milan R. Amin, Farrel J. Buchinsky, John P. Gaughan, Wasyl Szeremeta

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Objective: To determine the relationship between coin size, coin location, patient age, and patient weight and likelihood of coin passage through the esophagus following pediatric coin ingestion. A secondary objective is to test the hypothesis that coin denomination can be determined based on radiographic appearance. Methods: A retrospective review was performed of all children seen and evaluated for coin ingestion at a single institution over a 25-month period. Outcome measures included the number of coins that were retained in the esophagus, and the number that passed. Various factors were assessed for their predictive value in judging outcome in coin ingestion cases. Results: Nineteen percent of patients (15/79) in the study passed their ingested coins. Coin denomination could be accurately determined on every patient that had a standard AP or lateral X-ray film. These findings were marked when compared with the lack of reliability of history in determining coin denomination. Patients who passed coins were as a group older (4.6 vs. 3.2 year, P=0.04), but did not differ significantly by weight (19.5 vs. 15.4 kg, P=0.07) from those that retained the coins. Coins located at the gastroesophageal junction had a significantly higher passage rate than coins located elsewhere in the esophagus (89 vs. 8.2%, P<0.01). Coin size was not predictive of coin passage (P=0.7 by χ2). Conclusions: Radiographic assessment of coin denomination is reliable, but in this study could not be used to predict coin passage. Patient age and coin location at the gastroesophageal junction, however, do correlate with this event.

Original languageEnglish (US)
Pages (from-to)201-206
Number of pages6
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume59
Issue number3
DOIs
StatePublished - Jul 2 2001
Externally publishedYes

Keywords

  • Coin ingestion
  • Esophagus
  • X-ray

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

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