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Management of oesophageal coins in children
  1. O Nafousi1,
  2. Richard Pertwee2,
  3. Damian Roland3,
  4. Jonathan Acheson3
  1. 1Paediatric Emergency Department, Leicester Royal Infirmary, Leicester, UK
  2. 2Children's Hospital, Leicester Royal Infirmary, Leicester, UK
  3. 3Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Royal Infirmary, Leicester, UK
  1. Correspondence to Dr Jonathan Acheson, Paediatric Emergency Department, Leicester Royal Infirmary, Leicester, Leicestershire LE1 5WW, UK; jonathan.acheson{at}uhl-tr.nhs.uk

Abstract

Objective Is a watch and wait approach safe in asymptomatic patients presenting to the emergency department with a confirmed oesophageal coin on x-ray?

Methods A retrospective case note review for children <16 years attending with a confirmed oesophageal coin on x-ray over a 7-year period (1 January 2004 to 31 December 2010).

Results 89% (33/37) of coins in asymptomatic patients, who were conservatively managed, had passed spontaneously on repeat chest x-ray up to 18 h later. No patient who was discharged with a middle or lower oesophageal coin required a GA and no child who was treated conservatively developed any complications.

Conclusion In the UK asymptomatic children, with no history of tracheal or oesophageal disease and a confirmed oesophageal coin on x-ray should undergo a period of observation up to 18 h. This can be safely undertaken at home, followed by a repeat x-ray in the emergency department.

  • Paediatric emergency med
  • paediatrics
  • paediatric emergency medicine
  • teaching
  • admission avoidance
  • clinical assessment
  • education
  • research
  • clinical
  • acute medicine-other
  • accident prevention
  • alcohol abuse
  • anaesthesia

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Footnotes

  • Funding DR has received funds under the terms of a doctoral research training fellowship issued by the National Institute of Health Research (NIHR). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, NIHR or the Department of Health.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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