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Case of the Month 03/09

Q: This 11-month-old female was brought to the ED by her mother for 8 days of cough, congestion and intermittent fever to 102. According to the mother, she had been tolerating liquids without difficulty but vomiting after solid food for the last 2 days.

What is wrong with this picture?

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There is a coin most likely lodged in the esophagus. The orientation of the coin in the coronal plane is strongly suggestive of location in the esophagus. (If the coin were in the trachea, we would expect the x-rays to reveal the coin in the sagittal plane.)

The patient underwent removal in the OR with rigid esophagoscopy and was discharged without complications the next day.