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Although coins are the foreign objects most frequently swallowed by children, there are no empirically well- grounded guidelines for managing this situation. Standard texts recommend an initial x-ray of the esophagus and abdomen with serial abdominal films after the coin has entered the stomach.
To develop rational guidelines, these authors reviewed the cases of 50 children reported to have ingested a coin. Five children had only a chest film, 5 had only an abdominal film, and 40 had both. A coin was detected in the esophagus in 15 children, 6 of whom had symptoms (e.g., choking or epigastric discomfort), and below the gastric cardia in 26 children, none of whom had symptoms. No coin was seen in 9 children. Five of the 15 esophageal coins an…