Coin stuck in 3 year old child's esophagus

Hanoi – A 2 cm diameter coin became lodged in the esophagus of a 3-year-old child after being swallowed while playing. Doctors removed it, preventing injury.

Pham Ha, a child from Hung Yen province , was brought to Tam Anh General Hospital in Hanoi for examination on June 18th. Her parents reported that she suddenly screamed and vomited white saliva while playing with a coin. Upon admission, doctors examined her ears, nose, and throat, and took a chest X-ray, revealing a foreign object approximately 2 cm in diameter located across her thoracic vertebrae. Emergency endoscopic surgery was performed, and the foreign object was quickly removed through her mouth using forceps.

Dr. Bui Quang Thach (Department of Gastroenterology) said that the foreign object's location near the airway meant that if not treated immediately, it could fall into the airway, posing a life-threatening risk, or fall into the stomach and small intestine, requiring surgery. In Ha's case, the foreign object was detected early and intervention was timely. Because the foreign object was smooth, there was no damage to the esophageal mucosa.

A gastroenterologist performs an endoscopic procedure to remove a foreign object from a patient's esophagus. (Photo: Provided by the hospital)

Dr. Thach shared that the endoscopy procedure for children requires careful attention from the doctor because their digestive tract is much smaller than that of adults. Children may be frightened and uncooperative during the preparation for the procedure. Anesthesia and resuscitation are also difficult because the children are so young. Different foreign objects require different tools for removal, such as snares, baskets, balloons, etc. For foreign objects that are easily damaged during removal, doctors often use special instruments to protect the mucous membrane of the digestive tract wall, such as external probes and endoscope caps.

When a child chokes on a foreign object, especially a young child, parents need to determine early on whether it's in the digestive tract or the airway. After ruling out airway obstruction, family members should take the child to a medical facility for prompt intervention. Knowing the nature of the foreign object helps doctors anticipate potential complications and plan an appropriate removal procedure, including selecting the right instruments and techniques.

X-ray images show a foreign object at the beginning of the esophagus (left) and after it has been removed (right). Photo: Provided by the hospital.

According to Dr. Thach, for the past two weeks, the Gastroenterology Department of Tam Anh General Hospital in Hanoi has received many cases of children with foreign objects in their digestive tract. The main reason is that children are on summer vacation and playing unsupervised without adult supervision. Choking on foreign objects is a common accident among young children. Adults need to be vigilant about objects around them, especially small, hard objects, as 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 object, parents need to remain calm, provide proper first aid, and quickly take the child to the nearest medical facility.

When a foreign object is lodged in the throat, patients should not use household tools to try and remove it, as this can cause injury. Patients should not attempt to cough up or swallow food or drink in an attempt to dislodge the foreign object. This can inadvertently cause the foreign object to become more deeply embedded in the esophageal wall if it is sharp, or increase damage as the foreign object moves through the esophagus and stomach.

Emerald

The patient's name has been changed.

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