Presentation
Ingested a coin a couple of hours ago. Asymptomatic.
Patient Data
Radiograph revealed a round metallic density object in keeping with a coin projecting over the mediastinum, below the carina. This means the coin is located within the esophagus and not the trachea. No signs of obstruction or perforation.
No lateral radiographs were available.
See annotated image below.
Annotation highlights the trachea in green and shows that the coin is located below the carina.
Case Discussion
In the present case, the history of coin ingestion was corroborated by the radiograph.
In some instances, it might be necessary to recognize whether the foreign object is within the esophagus or the trachea. In this case, the foreign object was located below the carina, therefore it must be in the esophagus.
It is essential to identify the object correctly. While a coin is mostly harmless, a battery could injure the patient. These are very similar, but batteries usually have a slight step in profile and an inner ring when viewed across its diameter.