IS Case 593: Swallowed dime in esophagus

Narasimhachar G. Prativadi, MD

Imaging Sciences URMC

Imaging Sciences URMC 2010
Publication Date: 2011-11-17

History

Patient is a 3-year-old child who swallowed a dime.

Findings

AP and lateral radiographs demonstrated a disk-like opacity projecting over the upper thoracic esophagus.

Diagnosis

Swallowed dime in esophagus

Discussion

When a coin in taken into the oral cavity and lodged in the midline upper thorax in a patient who cannot verbally respond, the dilemma is often whether it is in the esophagus or in the trachea. The key is simple. If it is in the upper thoracic trachea, the coin should be in the sagittal plane since the tracheal cartilage is present in a C-shape only at the anterior aspect of the trachea. If the coin is oriented in the coronal plane, it is likely to be in the esophagus since the esophagus is pushed against the flat posterior aspect of the trachea anterior to it.

References

1. Weissleder R, Wittenberg J, Harisinghani MG. Primer of Diagnostic Imaging. Philadelphia, PA: Mosby Elsevier, 2007.