Endoscopic removal of a coin embedded in the esophagus of a 2-year-old male.

BACKGROUND AND AIMS: Endoscopic esophageal foreign body removal is a common procedure performed by pediatric gastroenterologists and surgeons. However, when foreign bodies are embedded in the esophageal wall, traditional treatment has instead involved surgical resection. As recently described, advanced endoscopic techniques enable endoscopic retrieval of embedded esophageal foreign bodies. METHODS: We present a case of endoscopic retrieval of a coin embedded in the esophagus of a 2-year-old male. The patient presented with wheezing and radiograph findings consistent with an esophageal foreign body. Endoscopy was performed, but the procedure was aborted after the coin was identified to be completely embedded within the mucosa of the esophageal wall. A CT scan then confirmed the embedded coin. RESULTS: A decision was made to perform a repeat endoscopy, with conversion to thoracotomy if the coin could not be successfully removed endoscopically. On repeat endoscopy, the coin was visualized, although its superior edge was surrounded by heaped-up mucosa. Mucosotomy and myotomy were necessary to fully expose the coin, which was then removed. The patient's diet was advanced postoperatively, and he was discharged after an esophagram showed no evidence of a leak. CONCLUSIONS: Providers should consider endoscopic removal of embedded esophageal foreign bodies for pediatric patients.