Role of Point-of-Care ultrasound as a Bridge Investigation for Management of Upper Oesophageal Coins in Children.

Abstract

Coins are commonly ingested foreign body (FB) in children, particularly the area just below the cricopharyngeus muscle, being the most common site of lodgement. The aim of the present study was to evaluate the effectiveness of point-of-care ultrasound (POCUS) of the upper airway as an investigation arm to guide and assist the clinical management of foreign body coin in children with expectant management for spontaneous passage. A total of 50 children with coin in upper oesophagus were chosen and POCUS was done in the preoperative area. Those in whom coin was visualised on POCUS were taken for retrieval under general anaesthesia and in whom coin was not visualised were taken for 2 nd X-ray to confirm passage. In 50 children with a coin in upper oesophagus, point-of-care ultrasound (POCUS) showed the presence of coin in 44 children (confirmed on esophagoscopy) and spontaneous passage in 6 children (confirmed on 2 nd X-ray), thus resulting in the reduction of approximately 88% of 2 nd check X-ray to demonstrate the position of coin.