Sir.—We noted the occurrence of altered consciousness as a presenting symptom in three patients with lodged foreign bodies. When a patient with altered consciousness presents, a lodged esophageal foreign body should be considered.
Patient Reports.—Patient 1.—An 8-month-old male infant presented with a choking episode that was immediately followed by 15 minutes of unresponsiveness. Paramedics found the infant unresponsive and limp. Pulse rate was 126 beats per minute, and respirations were 44/min. During transport, the patient choked, coughed up a large amount of sputum, and became more responsive.
On physical examination, the infant preferred to sleep but was easily aroused. Pulse rate was 160 beats per minute, respirations were 20/min, blood pressure was 90/54 mm Hg, and rectal temperature was 37.3°C. The remainder of examination yielded normal results.
A lateral neck roentgenogram revealed a coin-shaped foreign body in the cervical esophagus. A penny was removed by rigid endoscopy
MELZER-LANGE M, VAN HOWE R, LOSEK JD. Esophageal Foreign Body Presenting With Altered Consciousness. Am J Dis Child. 1988;142(9):915-916. doi:10.1001/archpedi.1988.02150090013005