Ingested foreign body - coin

Case contributed by Leonardo Lustosa
Diagnosis certain

Presentation

Ingested a coin a couple of hours ago.

Patient Data

Age: 7 years
Gender: Male
x-ray

Radiographs revealed a round metallic density object in keeping with a coin projecting over the esophagus. The lateral view allows for the visualization that the foreign body is posterior to the trachea and therefore is within the esophagus.

No signs of obstruction or perforation.

Photo

1 Brazilian real coin (R$1).

Original file: https://commons.wikimedia.org/wiki/File:Brasil_coin_1_real-2.jpg

Case Discussion

The history of coin ingestion was corroborated by the radiographs.

In some instances, it might be necessary to recognize whether the foreign object is within the esophagus or the trachea. In this case, the lateral radiograph was performed and allowed for clear visualization of the coin within the esophagus.

Ingested foreign body management usually depends on its location. Foreign bodies within the esophagus are usually subjected to endoscopic removal, which can be either urgent or done within the next 24 hours.

Curiosity addendum: the 1 Brazilian real coin is made of two alloys, sometimes this is noticeable on radiographs. In this case, not only the two distinct alloys are noticed, but the Effigy of the Republic is also noted on the frontal radiograph.

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