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Symptoms and Spontaneous Passage of Esophageal Coins

Paul R. Joseph, MD
Arch Pediatr Adolesc Med. 1995;149(11):1286. doi:10.1001/archpedi.1995.02170240103025.
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I found the article by Conners et al1 in the January issue of the Archives very interesting. However, the data in their paper do not support one of their conclusions that coins lodged in the proximal or middle esophagus for more than 24 hours do not pass into the stomach and should be removed. If the authors had waited longer than 24 hours, it is certainly possible that more, most, or all the coins would have passed into the stomach.

A 1985 telephone survey2 in Salt Lake City, Utah, of 65 practicing pediatricians revealed that 77% would not obtain a radiograph of an asymtomatic child who swallowed a coin. It is also likely that a large number of coin ingestions never come to the attention of the parent or the physician. In spite of the large number of coin ingestions, many of which undoubtedly include coins lodged in


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