Research Article

Rationalising the management of swallowed coins in children.

BMJ 1991; 302 doi: https://doi.org/10.1136/bmj.302.6788.1321 (Published 01 June 1991) Cite this as: BMJ 1991;302:1321
  1. M D Stringer,
  2. S N Capps
  1. Department of Paediatric Surgery, Queen Mary's Hospital for Children, Carshalton, Surrey.

    Abstract

    OBJECTIVE--To assess the management of swallowed coins in children and identify aspects that could be improved. DESIGN--Study of records of three hospital departments for 1986-90. SETTING--Accident and emergency, radiology, and operating theatre departments in a children's hospital. SUBJECTS--50 children reported to have ingested coins. MAIN OUTCOME MEASURES--Radiological investigations performed, position of coin, symptoms of child, and surgical intervention. RESULTS--50 children were recorded to have swallowed coins during 1986-90. Five children had only chest radiography, five only abdominal radiography, and 40 had both. A coin was detected in the oesophagus in 15 children, six of whom had symptoms, and below the cardia in 26, none of whom had symptoms; no coin was seen in nine children. Eleven children had further abdominal radiographs despite the absence of gastrointestinal symptoms; one child had a coin removed from the stomach. CONCLUSIONS--Children are being unnecessarily exposed to radiation and surgical intervention, and a consensus on management of swallowed coins is needed. Most children require only a single chest and neck radiograph.