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Ingested coins and metal detection
  1. Sue Maurice,
  2. Kevin Mackway-Jones
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

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    Report by Sue Maurice, Consultant Search checked by Kevin Mackway-Jones, 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 know it is important to rule out oesophageal impaction and wonder whether a metal detector can accurately show whether the coin is above or below the diaphragm.

    Three part question

    In [children who have swallowed coins] is [a metal detector] accurate at [ruling out oesophageal impaction]?

    Search strategy

    Medline 1966–03/00 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 433 were irrelevant or of insufficient quality. The remaining two papers are shown in table 1.

    Table 1

    Comments

    These studies are small scale and apply only to children. The accuracy in obese children is not established.

    Clinical bottom line

    Hand held metal detectors are sensitive enough to be used to SnNout the presence of oesophageal metallic foreign bodies in children.

    Report by Sue Maurice, Consultant Search checked by Kevin Mackway-Jones, Consultant

    References

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