Unusual radiological finding in foreign bodies ingestion: three esophageal coins
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Case description:
A 5-year-old girl presented to the emergency department with a history of foreign body ingestion. A cervico-thoracoabdominal radiograph demonstrate a foreign body in the esophagus, which seemed to show a double rim sign suspecting a button battery. After an emetic episode and expelling a coin, the child became asymptomatic. Close inspection of the X-ray demonstrated that the image was formed by superimposition of 3 circumferential objects of different sizes. Another X-ray observed the persistence of two superimposed objects.
Clinical findings:
The girl presented with sialorrhea, odynophagia, and nausea. Vital signs and physical examination were normal. There was no significant medical history.
Treatment and Outcome:
With the suspicion of multiple impacted esophageal objects, the patient was then taken to the operating room. During the flexible esophagoscopy 2 coins were found in the esophagus, both were removed without difficulty. The patient had an uneventful postoperative recovery and there have been no long-term complications.
Clinical relevance:
Unusual radiographic findings regarding esophageal foreign bodies have been reported, however, we describe the first case of a child with 3 coins impacted in the esophagus and a new radiological finding in foreign bodies ingestions that allow to avoid misdiagnosis and improve outcomes.
- radiography
- foreign bodies
- impaction
- esophagus
- coin
Julio César Moreno Alfonso, Hospital Universitario de Navarra. Servicio de Cirugía Pediátrica. Pamplona, España
Servicio de Cirugía Pediátrica. Hospital Universitario de Navarra. Pamplona, España.
Especialización en Epidemiología. Universidad Autónoma de Bucaramanga. Bucaramanga, Colombia.
Doctorando en Medicina y Cirugía. Universidad Pública de Navarra. Pamplona, España.
https://orcid.org/0000-0002-0414-2888
Ada Yessenia Molina Caballero, Hospital Universitario de Navarra. Servicio de Cirugía Pediátrica. Pamplona, España.
https://orcid.org/0000-0002-2269-0116
Néstor Busto Aguirreurreta, Hospital Universitario de Navarra. Servicio de Anestesiología Pediátrica. Pamplona, España
https://orcid.org/0000-0001-9311-7336
Concepción Goñi-Orayen, Hospital Universitario de Navarra. Servicio de Pediatría. Pamplona, España
https://orcid.org/0000-0002-9648-2272
Heinzerling NP, Christensen MA, Swedler R, Cassidy LD, Calkins CM, Sato TT. Safe and effective management of esophageal coins in children with bougienage. Surg (United States) 2015;158:1065-1072. https://doi.org/10.1016/j.surg.2015.06.025 DOI: https://doi.org/10.1016/j.surg.2015.06.025
McNeill MB, Sperry SLW, Crockett SD, Miller CB, Shaheen NJ, Dellon ES. Epidemiology and management of oesophageal coin impaction in children. Dig Liver Dis. 2012;44:482-486. https://doi.org/10.1016/j.dld.2012.01.001 DOI: https://doi.org/10.1016/j.dld.2012.01.001
Dedhia K, Chang YF, Leonardis R, Chi DH. Is there a need for repeat radiologic examination of children with esophageal coin foreign body. Otolaryngol - Head Neck Surg (United States) 2017;156(1):173-179. https://doi.org/10.1177/0194599816667039 DOI: https://doi.org/10.1177/0194599816667039
Pérez A, Molina AY, Goñi C. Impaction of button batteries in the esophagus a potentially fatal surgical emergency in infancy. An Sist Sanit Navar. 2020;43:255-260. https://doi.org/10.23938/ASSN.0874 DOI: https://doi.org/10.23938/ASSN.0874
Nafousi O, Pertwee R, Roland D, Acheson J. Management of oesophageal coins in children. Emerg Med J. 2013;30(2):157-158. doi: 10.1136/emermed-2011-200958. https://doi.org/10.1136/emermed-2011-200958 DOI: https://doi.org/10.1136/emermed-2011-200958
Ormeño A. Inusual hallazgo de dos monedas juntas en esófago de pacientes pediátricos Reporte de dos casos. Rev Gastroenterol Peru. 2016;36(4):373-375
Shatani N, Alshaibani S, Potts J, Phillips B, Bray H. Chest radiograph alone is sufficient as the foreign body survey for children presenting with coin ingestion. Pediatr Emerg Care. 2021;37(9):e524-e527. https://doi.org/10.1097/PEC.0000000000001688 DOI: https://doi.org/10.1097/PEC.0000000000001688
Huyett P, Shaffer A, Flom L, Simons JP, Jabbour N. Accuracy of chest X-Ray measurements of pediatric esophageal coins. Int J Pediatr Otorhinolaryngol. 2018;113:1-3. https://doi.org/10.1016/j.ijporl.2018.07.011 DOI: https://doi.org/10.1016/j.ijporl.2018.07.011
Raney LH, Losek JD. Child with esophageal coin and atypical radiograph. J Emerg Med. 2008;34:63-66 https://doi.org/10.1016/j.jemermed.2007.03.004 DOI: https://doi.org/10.1016/j.jemermed.2007.03.004
Schlesinger AE, Crowe JE. Sagittal orientation of ingested coins in the esophagus in children. Am J Roentgenol. 2011;196(3):670-672. https://doi.org/10.2214/AJR.10.5386 DOI: https://doi.org/10.2214/AJR.10.5386
Ángel ALA, León SLP, Martínez GDC, Jurado GM. Cuerpo extraño incidental en tracto gastrointestinal Reporte de tres casos y revisión de la literatura. Rev Colomb Gastroenterol. 2011;26(4):316-327.
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