Mythbuster: Pediatric coin ingestion vs aspiration?

Sep 28, 12
Mythbuster: Pediatric coin ingestion vs aspiration?

220px-2006_Quarter_Proof

Is this coin in the esophagus or the trachea? 
The classic teaching for the Boards exam is:

  • Esophageal coins appear in the coronal plane, as shown above.
  • Tracheal coins appear in the sagittal plane because of the cartilaginous tracheal rings.

 

PediatricEsophCoin

Mythbuster: Pediatric Coin Ingestion vs Aspiration?

A case series of 8 pediatric patients were documented with coins positioned in a sagittal plane were actually in the esophagus! This data was collected over 15 years.

  • Age range 3-17 years old
  • Location of coin: 7/8 at level of aortic notch and 1/8 at distal esophagus 

The classic teaching likely still holds true most of the time (sagittal coin = tracheal foreign body), but don’t rush to immediate judgment. Take a look at the lateral view, and see where the coin is located with respect to the trachea and airway. It may be more posterior, in which case, it’s in the esophagus.

Thanks to Dr. Matt Anderson (Resident at Univ. of Wisconsin EM program) for the tip!

Reference

Schlesinger AE, Crowe JE. Sagittal orientation of ingested coins in the esophagus in children. AJR Am J Roentgenol. 2011 Mar;196(3):670-2. Pubmed .

 

Author information

Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

The post Mythbuster: Pediatric coin ingestion vs aspiration? appeared first on ALiEM.

Leave a Comment

Like articles like this one?

Join our Email List and get the latest TCCC/TECC/TEMS news bulletins, articles, product releases, and more!

Free Delivery

On all orders over $99 within CONUS and to APO/FPO

Easy Returns

We're here to help! Satisfaction Guaranteed

Knowledgeable Staff

Ready to assist you at a moment's notice

Safe& Secure Checkout

World’s most advanced and secure website encryption.