C. Kunze, R. Mund, Carsten Bock (Halle)  

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GI-Stomach  

physical  

According to the statements of the mother, the child swallowed a coin, probably 10-cent piece. Confirmation? Position of the coin?  

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<- view X-Ray 1

X-Ray 1: X-ray of the thoracic and abdominal regions with proof of a metal, round foreign body in the area of the stomach. The rough edges of the coin can be seen. It seems it is somewhat larger than a 10 cent coin, but smaller than a 50 cent coin.




<- view Ultrasound 1

Ultrasound 1: The stomach is not empty: within the echogenic stomach contents an image of a linear echogenic structure of about 15 mm with a hint of dorsal increase of sound, most likely the coin.




<- view Ultrasound 2

Ultrasound 2: Sonographic image of a 10 cent coin shown transversally. The highly echogenic surface (about 20 mm) is smooth. Dorsally, there is on the one hand a typical repeating echo between the transducer and coin as well as a dorsal increase of sound through resonance phenonema. The size of the coin: 19.75mm (see literature).




<- view Ultrasound 3

Ultrasound 3: 10-Cent tangential:highly echogenic round structure with rough edges of the coin.




<- view Ultrasound 4

Ultrasound 4: 2-Euro tangential front: The "2" can be seen and the border between gold and silver can be seen as well.




<- view Ultrasound 5

Ultrasound 5: 2 Euro tangential opposite side: The eagle can be seen









<- view Ultrasound 6

Ultrasound 6: 50-Cent tangential (opposite side):
The "Brandenburg Gate" can be seen







<- view Ultrasound 7

Ultrasound 7: Diagonal coin surface in the area of the antrum.




<- view Ultrasound 8

Ultrasound 8: Control to see where the coin is located on the following day after n.p.o (stomach filled with tea): smooth surface with linear, echogenic structure of about 20 mm diameter with dorsal increase in sound, changes on position -- it's the coin.

 

Imaging including endoscopy  

Other swallowed foreign bodies, in this specific case however, a quite reliable diagnosis of ingestion of a 10-cent piece possible.  

Since after the 3rd day, the coin was still in the stomach, an endoscopic removal of the coin was made.
According to the Muensters regarding the acid-stability of the new Euro coins, these can be left up to a week to wait for a spontaneous voiding. (see literature)  

As a follow-up,. if the roentgenologically and sonographically foreign object was still in the stomach, a sonograph was performed with filling the stomach with tea (echoless fluid), to avoid further roentgenological examinations after a spontaneous voiding could not be proven. The primary x-ray to localize the foreign object is, however, not renounceable.  

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Dtsch Ärzteblatt 2002; 99: A 2106-2110 (Heft 31-32)  

ingestion, metal, money, coin ingestion, foreign body, foreign body ingestion, child, childhood, pediatric radiology  

C Kunze, R Mund, Carsten Bock. Coin Ingestion. PedRad [serial online] vol 2, no. 8.
URL: www.PedRad.info/?search=20020822153232