Coin stuck in 3 year old child's esophagus

Hanoi: A 2cm coin got stuck in the esophagus of a 3-year-old child after swallowing it while playing and was removed by a doctor to avoid injury.

Baby Pham Ha ( Hung Yen ) was taken to Tam Anh General Hospital in Hanoi by his family for examination on June 18. The baby's parents said that the baby suddenly cried and vomited white saliva while playing with coins. Immediately upon admission, the doctor examined the ear, nose and throat, took a chest X-ray and found a foreign object at the level of the thoracic vertebrae with a diameter of about 2 cm. The doctors performed an emergency endoscopy and used forceps to remove the foreign object through the mouth in a short time.

Dr. Bui Quang Thach (Digestive Department) said that the foreign object is located near the airway, if not treated immediately, it can fall into the airway, endangering life or fall into the stomach and small intestine, requiring surgery. Ha's case was detected early and timely intervention was performed. The foreign object was smooth, so the baby did not have any damage to the esophageal mucosa.

Gastroenterologist uses endoscopy to remove foreign object in patient's esophagus. Photo: Provided by hospital — Gastroenterologist uses endoscopy to remove foreign object in patient's esophagus. Photo: *Provided by hospital*

Doctor Thach shared that the endoscopy process for children requires the doctor's caution because the digestive tract is much smaller than that of adults. Children may be afraid and uncooperative during the preparation for the procedure. Anesthesia and resuscitation are also difficult because the child is too young. Each foreign object will have different tools to grasp such as nooses, baskets, balls... Foreign objects that can easily cause damage when removed, doctors often use a special group of tools to help protect the lining of the digestive tract such as external tubes, endoscope caps...

When choking on a foreign object, especially in young children, parents need to determine early whether it is a foreign object in the digestive tract or a foreign object in the respiratory tract. After eliminating the foreign object in the respiratory tract, the family needs to take the child to a medical facility for early intervention. Knowing the nature of the foreign object helps the doctor predict possible complications and have a suitable plan to remove the foreign object, such as choosing tools, techniques, etc.

Image of foreign object at the beginning of the esophagus on X-ray (left) and after it has been removed (right). Photo: BVCC — Image of foreign object at the beginning of the esophagus on X-ray (left) and after it was removed (right). Photo: *Provided by the hospital*

According to Dr. Thach, in the past half month, the Gastroenterology Department - Tam Anh General Hospital, Hanoi has received many cases of children with foreign bodies in the digestive tract. The main reason is that children are on summer vacation and play without the control and management of adults. Choking on foreign bodies is a common accident in young children. Adults need to be vigilant with surrounding objects, especially small, hard objects because children can easily mistake them for toys or food. Parents need to create a safe space for their children to play during the summer. If a child unfortunately chokes on a foreign body, parents need to calmly perform first aid properly and quickly take the child to the nearest medical facility.

When choking on a foreign object, the patient should not use household tools to remove it, causing injury. The patient should not try to spit or swallow food or drink with the intention of pushing the foreign object out of the stuck place. This method inadvertently causes the foreign object to be stuck deeper into the esophagus if the foreign object is swallowed with a sharp point or increases the injury while the foreign object moves through the esophagus and stomach.

Emerald

* Patient's name has been changed.

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