title: In vitro study of ingested coins: leave them or retrieve them?
abstract: BACKGROUND
  Objects and notably coins are frequently swallowed by children 3 to 5 years old. Precisely how they should be managed after passing the gastroesophageal junction without causing symptoms remains controversial. This study was performed to assess dissolution of specific metals from coins immersed in simulated gastric juice.
  
  
  METHODS
  Four types of euro and US coins were immersed in simulated gastric juice for 4, 24, 72, and 120 hours. Six metals were evaluated by inductively coupled plasma-atomic emission spectrometry. Weight loss and corrosive behavior were also determined.
  
  
  RESULTS
  After only 4 hours, metals had dissolved from euro (Cu, 2.86-7.85 mg; Ni, 0.23-0.52 mg; Zn, 0.09-0.99 mg; Al, 0.24 mg; Sn, 0.02 mg) and US (Cu, 1.45-6.65 mg; Ni, 0-0.62 mg; Zn, 0-0.14 mg) coins. Their concentrations in simulated gastric juice peaked after 24 to 72 hours (milligrams/hours) in euro (Cu, 218/48; Ni, 82.50/72; Zn, 83.00/72; Al, 14.65/72; Sn, 0.66/72) and US (Cu, 126.50/24; Ni, 88.00/72; Zn, 149.00/24) coins. All coins underwent corrosion and weight loss (by 2.56%-4.8%).
  
  
  CONCLUSIONS
  Coins retained in the stomach will release a number of heavy metals well known to cause dose-dependent poisoning. Studies to evaluate their toxicity and absorption are needed to optimize treatment.
authors.affiliation: Division of Pediatric Surgery, Vienna Medical University, 1090 Vienna, Austria. winfried.rebhandl@meduniwien.ac.at
authors.forename: Winifred
authors.initials: W
authors.lastname: Rebhandl
authors.forename: Adrienne
authors.initials: A
authors.lastname: Milassin
authors.forename: Lukas
authors.initials: L
authors.lastname: Brunner
authors.forename: Ilse
authors.initials: I
authors.lastname: Steffan
authors.forename: Thomas
authors.initials: T
authors.lastname: Benkö
authors.forename: Marcus
authors.initials: M
authors.lastname: Hörmann
authors.forename: Judit
authors.initials: J
authors.lastname: Burtscher
mesh_terms: D000497:Alloys / Q000737:chemistry; D003300:Copper / Q000737:chemistry; D003343:Corrosion; D019468:Disease Management; D005547:Foreign Bodies; D005750:Gastric Juice; D041981:Gastrointestinal Tract; D006851:Hydrochloric Acid / Q000494:pharmacology; D066298:In Vitro Techniques; D008670:Metals / Q000737:chemistry*; D009532:Nickel / Q000737:chemistry; D009717:Numismatics; D012995:Solubility; D013997:Time Factors; D014001:Tin / Q000737:chemistry; D015032:Zinc / Q000737:chemistry
chemical_list: D000497:Alloys; D008670:Metals; D014001:Tin; D003300:Copper; D009532:Nickel; D015032:Zinc; D006851:Hydrochloric Acid