From the Guidelines
If a 7-year-old has swallowed a penny, parents should first call their pediatrician or poison control (1-800-222-1222) for guidance, as most swallowed coins will pass through the digestive system naturally without treatment within 1-5 days 1.
Key Considerations
- The child can eat normally unless directed otherwise by a healthcare provider, and parents should monitor the child's stools to confirm the penny has passed.
- Medical attention is needed immediately if the child develops symptoms like difficulty swallowing, drooling, vomiting, abdominal pain, or if the penny doesn't pass within a week.
- X-rays may be needed to locate the coin, and according to the World Journal of Emergency Surgery, urgent flexible endoscopy is recommended for other esophageal foreign bodies without complete obstruction 1.
Important Distinctions
- Unlike batteries, which require emergency treatment, pennies are generally less dangerous when swallowed, but pennies minted after 1982 contain zinc, which can react with stomach acid and potentially cause problems if they remain in the stomach for extended periods 1.
- The Centers for Disease Control and Prevention report that choking rates are highest among infants, and almost one third of choking episodes occurred among infants, but the child in question is 7 years old, which reduces the risk of severe complications 1.
Recommendations
- Parents should follow the guidance of their pediatrician or poison control, and seek immediate medical attention if symptoms develop or the penny doesn't pass within a week.
- The child's condition should be monitored closely, and any changes or concerns should be reported to the healthcare provider immediately.
- According to the study published in the World Journal of Emergency Surgery, therapeutic flexible endoscopy is recommended as first-line treatment of persistent esophageal foreign bodies, and emergent flexible endoscopy is recommended for sharp-pointed objects, batteries, magnets, and for foreign bodies inducing complete esophageal obstruction 1.
From the Research
Treatment for Swallowing a Penny in a 7-Year-Old
- The treatment for a 7-year-old who has ingested a penny depends on whether the child is symptomatic or asymptomatic 2.
- If the child is symptomatic, showing signs such as cough, stridor, respiratory distress, drooling, or pain, immediate removal of the penny via endoscopy is recommended 2.
- For asymptomatic children, current data support expectant management for a period of 12-24 hours, with the hope of spontaneous passage and avoidance of general anesthesia and surgical procedures 2.
- It is worth noting that coins are the most commonly ingested foreign body in the pediatric population, and most coins that reach the stomach will pass unimpeded through the gastrointestinal tract 3.
- However, in some cases, surgical intervention may be required, such as if the coin causes an obstruction or perforation in the gastrointestinal tract 4, 5.
- The management of swallowed coins may also be influenced by the child's medical history, such as if they have previously undergone pyloromyotomy, which may affect the passage of the coin through the gastrointestinal tract 6.