Management of asymptomatic children with a history of coin ingestion

Report by: Elizabeth Cervi, F2 Doctor

Search checked by: Dr J Crawfurd, Consultant in Emergency Medicine

Institution: James Paget Hospital, Great Yarmouth, Norfolk, UK.

Three-part question

In [asymptomatic children who have a swallowed coin lodged in the oesophagus] is [watchful waiting better than early active removal] at [achieving safe coin passage]?

Clinical scenario

A child presents to the Emergency Department with a history of witnessed coin ingestion in the last 24 h. He is asymptomatic and clinical examination is unremarkable. Chest x-ray reveals a coin lodged in the oesophagus. You wonder whether to observe the child, hoping for spontaneous passage into the stomach or to refer him for removal/assisted advancement of the coin.

Search strategy

Ovid MEDLINE(R) …