Children, for whatever reason, have a predilection for swallowing coins. Perhaps it’s the taste or that they’re using their stomach as a piggy bank. When these young patients present to the emergency department with a coin lodged in their esophagus, what options do we have? We could call gastroenterology or try to take it out ourselves. One option with few complications is bougienage, where we manually advance the coin into the stomach classically using a Hurst dilator and allow it to pass naturally.
In 2012, there were approximately 93,000 cases of foreign-body ingestions, nearly 4,000 of which were coins.1 While the feared button-battery ingestion can cause esophageal necrosis in as little as two hours, impacted coins can also cause perforation, obstruction, or fistulas if left untreated.2,3