Coin ingestion

Chest X-ray of a child who swallowed a dime.

Image from University of Rochester Medical Sciences (link)

When a coin is taken into the mouth and gets stuck 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. (adapted from Univ of Rochester Med Sciences)

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