Sir.—I read with interest, in the May 1989 issue of AJDC, the conflicting conclusions by different authors from the same university regarding the question of routine chest roentgenography in the evaluation of esophageal foreign bodies in children.1,2 Schunk et al1 recommended that all such children be evaluated, as previously suggested by Hodge et al.3 Caravati et al,2 however, concluded that evaluating asymptomatic children is unnecessary provided the enteral administration of liquids is tolerated and telephone follow-up is available. The latter conclusion is incredible considering the report of esophageal perforation by a coin in a 3½-year-old child who had been asymptomatic for 6 months following the ingestion.4 The definitive thoracotomy would have been avoided if the parents had sought medical attention initially, a chest roentgenogram had been performed, and the coin had subsequently been removed.
An 11-month-old male infant with a similar history was referred
FOSTER DL. Pediatric Coin Ingestion. Am J Dis Child. 1990;144(4):450–451. doi:10.1001/archpedi.1990.02150280072006
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