What's the most likely diagnosis?

• 4 year old male with drooling

1. Teratoma
2. Pneumothorax
3. Coin in the esophagus
4. Croup
5. Checker in the trachea

Additional Image - Lateral view of the neck/chest

 

Additional Image

 

Lateral view of the neck/chest (reversed)

 

Answer:

 

3. Coin in the esophagus

 

 

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Coin in the Esophagus

General Considerations

• More common in children ( < 5 years old) than adults
• Consist of either food-related impactions, or
• Ingestion of true foreign body (toy truck, marble, etc)
• True foreign bodies are more often ingested in those under 40 whereas those over 60 have food-related impactions
• Most often they impact just below cricopharyngeus at the thoracic inlet (70%)
• Another 20% impact at the level of the aortic arch
• Another 10% just above the esophagogastric junction
• Once past the esophagus, most foreign bodies will pass through the GI tract

 

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