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Signs and symptoms of oesophageal coins
  1. Vincent Choudhery,
  2. Sue Maurice
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

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    Report by Vincent Choudhery, Specialist Registrar Search checked by Sue Maurice Consultant

    Clinical scenario

    A 3 year old boy is brought into the emergency department by his mother. She says that he swallowed a coin two hours earlier. The boy is asymptomatic. You wonder whether any investigation needs to be done to exclude oesophageal impaction.

    Three part question

    In [children who have swallowed coins] is [history and examination] accurate at [ruling out oesophageal impaction]?

    Search strategy

    Medline 1966 to 12/99 using the OVID interface. ({exp numismatics OR coin$.mp OR exp foreign bodies OR foreign body.mp OR foreign bodies.mp} AND {exp pediatrics OR pediatric$.mp OR paediatric$.mp OR child$.mp} AND {ingest$.mp OR swallow$.mp OR exp esophagus OR esophagus.mp OR esophageal.mp OR oesophagus.mp OR oesophageal.mp}) LIMIT to human AND english.

    Search outcome

    Altogether 435 papers were found of which 428 were irrelevant or of insufficient quality. The remaining seven papers are shown in table 1.

    Table 1

    Comments

    All studies show that a significant number of children with oesophageal coins are asymptomatic.

    Clinical bottom line

    All children with a history of coin ingestionshould have further investigation to exclude oesophageal impaction.

    Report by Vincent Choudhery, Specialist Registrar Search checked by Sue Maurice Consultant

    References

    View Abstract

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