UMEM Educational Pearls

Category: Visual Diagnosis

Title: What's the Diagnosis? Case by Dr. Kathleen Stephanos

Posted: 10/12/2015 by Haney Mallemat, MD
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5 year-old boy who presents with sudden onset hoarse voice, and drooling without a fever.

Coin lodged in the esophagus

Coin ingestions

More than 100,000 foreign body ingestions are reported in children each year; coins are #1 cause
Although not always 100% true, coins typically appear circular on an AP Xray of the neck when in the esophagus and linear when in the trachea
Coins usually pass without issue, but warning signs are drooling, dysphagia, hoarse voice, wheezing, or stridor
10-20% require endoscopy for removal and 1% require surgery
Objects lodged in the middle esophagus should raise concern for underlying pathology such as strictures, masses, or webs

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