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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.

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.


Ada Yessenia Molina Caballero, Hospital Universitario de Navarra. Servicio de Cirugía Pediátrica. Pamplona, España.


Néstor Busto Aguirreurreta, Hospital Universitario de Navarra. Servicio de Anestesiología Pediátrica. Pamplona, España


Concepción Goñi-Orayen, Hospital Universitario de Navarra. Servicio de Pediatría. Pamplona, España

Moreno Alfonso, J. C., Pérez Martínez, A., Molina Caballero, A. Y., Busto Aguirreurreta, N., Goñi-Orayen, C., Gil Sáenz, F. J., & Elcano Sarasibar, L. (2023). Unusual radiological finding in foreign bodies ingestion: three esophageal coins. Colombia Medica, 52(4), e5005016. (Original work published February 14, 2022)

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Received 2021-08-28
Accepted 2022-01-25
Published 2023-05-04