A Retrospective Review of the Management of Impacted Coin Ingested in Children.

Abstract

Introduction: Accidental coin ingestion is a common presentation amongst paediatric patients in emergency departments (ED) worldwide, necessitating prompt management to prevent complications.

Objectives: This study aimed to describe the clinical features of paediatric patients with impacted oesophageal coins at Dr. George Mukhari Academic Hospital ED and compare outcomes between the balloon catheter and oesophagoscopic techniques for coin extraction.

Methods: This was a retrospective review of the medical records of patients aged ≤12 years over 5 years. Data were collected from the hospital records and analysed using SAS® (SAS Institute Inc, Cary, NC), Release 9.3, running under Microsoft Windows.

Results: The analysis included 95 patients (51 females, 44 males) with a median age of 3 years, ranging from 0.70 to 10 years. Coins were predominantly located in the upper oesophagus (71.6%). Thirty-five (36%) children presented 8 h after the ingestion of the coin. At presentation, 82 (86.3%) patients were asymptomatic. The most observed symptoms were hypersalivation in 17 (17.9%) patients and vomiting in eight (8.4%) patients. Of the 62 patients for whom the balloon catheter was solely used, it was successful in 77.4% of the cases. Rigid oesophagoscopy was used in 33 patients as the first procedure (34.7%), and its overall success rate was 100% (44 patients).

Conclusions: This study contributes valuable insights into the management of oesophageal coin ingestion in a resource-constrained setting, emphasising the safety and efficacy of the balloon catheter and the role of rigid oesophagoscopy in cases of failure or delayed presentation.