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Figure 10.2
Chest films of a coin in the midesophagus.
Source: Flint et al., Figure 208-3.
2. Ingestion
a. Radiographs
i. PA and Lateral Chest Films
PA and lateral chest films from the esophageal inlet to the abdomen are
performed to evaluate the possible presence of a foreign body (Figure
10.2). If a radiopaque foreign body is found in the alimentary tract, three
factors predict spontaneous passage:
y
y
Male gender.
y
y
Older than 5 years.
y
y
Location in the distal esophagus.
An observation period of 8–16 hours is considered appropriate manage-
ment in otherwise healthy children with coin ingestion that is causing
no obvious symptoms and no distressing signs.
ii. Barium Contrast
Barium contrast for suspected radiolucent foreign bodies should be
avoided. A negative scan is not sufficient to rule out a foreign body, as
the object may be obscured by the swallowed material. Barium contrast
would also delay the time for the patient to enter the operating room for
endoscopy.