title: Localizing ingested coins with a metal detector.
abstract: This study was conducted to determine the utility of metal detection in coin localization by inexperienced operators, and determine the rate of spontaneous passage of asymptomatic esophageal coins. All children who presented to the emergency department of an urban children's hospital with a suspected coin ingestion were eligible. Coin location was predicted from metal detector results, while radiographs confirmed location. Asymptomatic patients with esophageal coins were observed for spontaneous passage. Ninety-one children (ages 9 months to 17 years) were prospectively enrolled. The metal detector had a sensitivity of 98% (53/54) in coin detection and 98% (81/83) in determining coin location as esophageal. Symptoms were poor predictors of coin location. Six of eight asymptomatic patients with esophageal coins spontaneously passed their coins. These results show that metal detection is a good screening test for coin presence and to determine coin location as esophageal. Spontaneous passage of asymptomatic esophageal coins warrants further study.
authors.affiliation: University of Utah School of Medicine, Department of Pediatrics, Primary Children's Medical Center, Salt Lake City 84113, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Bassett
authors.forename: J E
authors.initials: JE
authors.lastname: Schunk
authors.forename: L
authors.initials: L
authors.lastname: Logan
mesh_terms: D000293:Adolescent; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D019719:Diagnostic Equipment; D004945:Esophagoscopy; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005544:Forecasting; D005547:Foreign Bodies / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D005772:Gastrointestinal Transit / Q000502:physiology; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013270:Stomach / Q000000981:diagnostic imaging / Q000473:pathology; D014504:Urban Health