Tander Burak, Yazici Mehmet, Rizalar Riza, Ariturk Ender, Ayyildiz Suat H, Bernay Ferit
Department of Pediatric Surgery, Ondokuz Mayis University, Samsun, Turkey.
J Laparoendosc Adv Surg Tech A. 2009 Apr;19(2):241-3. doi: 10.1089/lap.2008.0206.
Because of economic inflation, different-sized coins are in circulation in our country. The coin ingestion and retention in the esophagus are common problems in childhood. We evaluated the patients with coins retained in the esophagus and the impact of the size of the coins on lodgment.
Sixty-two children with a history of coin ingestion and a chest X-ray with retained coin in the esophagus were evaluated. Patients' age, sex, type of the ingested coin, and localization of coin were recorded. The size of all coins was measured. All coins were removed either directly with a Magill forceps or with the aid of an esophagoscope from the esophagus under general anaesthesia.
There were 27 male and 35 female patients with coin lodgment (median age, 4 years; range, 1-13). Forty-five patients (73%) ingested a coin with a diameter between 23.45 and 26.00 mm. In the remaining 17 patients (27%), the coins had a diameter between 17.00 and 20.90 mm or between 26.85 and 28.00 mm. Fifty coins were at the upper esophagus, eight coins were in the middle esophagus, and 4 patients had a coin in the distal esophagus. There was a positive correlation between the diameter of coin and age of the patient (r = 0.415 and P < 0.001).
Coin ingestion is rather common among childhood and its treatment may require an endoscopic approach. Most retained coins had a diameter between 23.45 and 26.00 mm. We think we could redesign our coins so that they would either be too big to ingest or so small they would always pass spontaneously.
由于经济通胀，我国流通着不同尺寸的硬币。儿童吞食硬币并滞留于食管是常见问题。我们评估了硬币滞留于食管的患者以及硬币尺寸对其滞留的影响。
对62例有吞食硬币史且胸部X线显示硬币滞留于食管的儿童进行评估。记录患者的年龄、性别、吞食硬币的类型以及硬币的位置。测量所有硬币的尺寸。所有硬币均在全身麻醉下通过麦吉尔钳直接取出或借助食管镜从食管取出。
有27例男性和35例女性患者硬币滞留（中位年龄4岁；范围1 - 13岁）。45例患者（73%）吞食的硬币直径在23.45至26.00毫米之间。其余17例患者（27%）吞食的硬币直径在17.00至20.90毫米之间或在26.85至28.00毫米之间。50枚硬币位于食管上段，8枚硬币在食管中段，4例患者的硬币在食管下段。硬币直径与患者年龄之间存在正相关（r = 0.415，P < 0.001）。
儿童吞食硬币相当常见，其治疗可能需要内镜方法。大多数滞留的硬币直径在23.45至26.00毫米之间。我们认为可以重新设计硬币，使其要么大到无法吞食，要么小到总能自行通过。
