Objective: To assess the management of swallowed coins in children and identify aspects that could be improved.
Design: Study of records of three hospital departments for 1986-90.
Setting: Accident and emergency, radiology, and operating theatre departments in a children's hospital.
Subjects: 50 children reported to have ingested coins.
Main Outcome Measures: Radiological investigations performed, position of coin, symptoms of child, and surgical intervention.
Results: 50 children were recorded to have swallowed coins during 1986-90. Five children had only chest radiography, five only abdominal radiography, and 40 had both. A coin was detected in the oesophagus in 15 children, six of whom had symptoms, and below the cardia in 26, none of whom had symptoms; no coin was seen in nine children. Eleven children had further abdominal radiographs despite the absence of gastrointestinal symptoms; one child had a coin removed from the stomach.
Conclusions: Children are being unnecessarily exposed to radiation and surgical intervention, and a consensus on management of swallowed coins is needed. Most children require only a single chest and neck radiograph.
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| http://dx.doi.org/10.1136/bmj.302.6788.1321 | DOI Listing |
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