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April 1994

Radiological Cases of the MonthCase 2

Arch Pediatr Adolesc Med. 1994;148(4):423-424. doi:10.1001/archpedi.1994.02170040089016

A PREVIOUSLY healthy 9-year-old boy presented for removal of a coin believed to be in his airway. He was transferred from an outlying hospital where he presented several hours after swallowing a quarter at church. There was no report of choking or cyanosis at the time the coin was swallowed. He did not complain of difficulty in breathing at any time.

On presentation to the emergency department he was cooperative and in no respiratory distress; his lungs were clear with symmetric respiratory sounds. The remainder of his physical examination was also unremarkable. His vital signs included temperature (oral), 37°C; respiratory rate, 20 beats/min; pulse rate, 88/min; and blood pressure, 120/58 mm Hg.

Frontal and lateral chest roentgenograms were obtained (Figure 1 and Figure 2).

Denouement and Discussion 

Esophageal Coins  The patient was taken to the radiology department, where the coin (one quarter) was easily extracted from the esophagus with fluoroscopic