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Symptoms and Spontaneous Passage of EsophagealCoins-Reply

Symptoms and Spontaneous Passage of EsophagealCoins-Reply Abstract We appreciate Dr Schmitt's interest in our recent article.1 As we noted, our data were retrospectively collected from the charts of all patients seen in a pediatric emergency department over an 18-month period. As Dr Schmitt notes and Paul et al2 have shown, this is a somewhat different population from those patients managed exclusively in a primary care setting. Because of these differences, we were unable to formally assess the cost-effectiveness of obtaining a radiograph for most asymptomatic children who have swallowed a coin. However, since an asymptomatic child may have an esophageal coin, we concluded that the safest approach would be to obtain a radiograph after 24 hours, allowing the child sufficient time to possibly pass the coin while staying within the 24-hour period during which esophageal mucosal inflammation has been shown to be minimal.3 Although waiting 72 hours before ordering a radiograph to References 1. Conners GP, Chamberlain JM, Ochsenschlager DW. Symptoms and spontaneous passage of esophageal coins . Arch Pediatr Adolesc Med . 1995;149:36-39.Crossref 2. Paul RI, Christoffel KK, Binns HJ, et al. Foreign body ingestions in children: risk of complication varies with site of initial health care contact . Pediatrics . 1993;91:121-127. 3. Bonadio WA, Emslander H, Milner D, Johnson L. Esophageal mucosal changes in children with an acutely ingested coin lodged in the esophagus . Pediatr Emerg Care . 1994;10:333-334.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Symptoms and Spontaneous Passage of EsophagealCoins-Reply

Abstract

Abstract We appreciate Dr Schmitt's interest in our recent article.1 As we noted, our data were retrospectively collected from the charts of all patients seen in a pediatric emergency department over an 18-month period. As Dr Schmitt notes and Paul et al2 have shown, this is a somewhat different population from those patients managed exclusively in a primary care setting. Because of these differences, we were unable to formally assess the cost-effectiveness of obtaining a radiograph for...
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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170240105028
Publisher site
See Article on Publisher Site

Abstract

Abstract We appreciate Dr Schmitt's interest in our recent article.1 As we noted, our data were retrospectively collected from the charts of all patients seen in a pediatric emergency department over an 18-month period. As Dr Schmitt notes and Paul et al2 have shown, this is a somewhat different population from those patients managed exclusively in a primary care setting. Because of these differences, we were unable to formally assess the cost-effectiveness of obtaining a radiograph for most asymptomatic children who have swallowed a coin. However, since an asymptomatic child may have an esophageal coin, we concluded that the safest approach would be to obtain a radiograph after 24 hours, allowing the child sufficient time to possibly pass the coin while staying within the 24-hour period during which esophageal mucosal inflammation has been shown to be minimal.3 Although waiting 72 hours before ordering a radiograph to References 1. Conners GP, Chamberlain JM, Ochsenschlager DW. Symptoms and spontaneous passage of esophageal coins . Arch Pediatr Adolesc Med . 1995;149:36-39.Crossref 2. Paul RI, Christoffel KK, Binns HJ, et al. Foreign body ingestions in children: risk of complication varies with site of initial health care contact . Pediatrics . 1993;91:121-127. 3. Bonadio WA, Emslander H, Milner D, Johnson L. Esophageal mucosal changes in children with an acutely ingested coin lodged in the esophagus . Pediatr Emerg Care . 1994;10:333-334.Crossref

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Nov 1, 1995

References