Question
5 year-old boy who presents with sudden onset hoarse voice, and drooling without a fever.
Answer
Coin lodged in the esophagus
Coin ingestions
- More than 100,000 foreign body ingestions are reported in children each year; coins are #1 cause
- Although not always 100% true, coins typically appear circular on an AP Xray of the neck when in the esophagus and linear when in the trachea
- Coins usually pass without issue, but warning signs are drooling, dysphagia, hoarse voice, wheezing, or stridor
- 10-20% require endoscopy for removal and 1% require surgery
- Objects lodged in the middle esophagus should raise concern for underlying pathology such as strictures, masses, or webs
References
Follow me on Twitter (@criticalcarenow)