A 9 year old boy swallowed a coin. Is it in the Esophagus or the Trachea? Why?

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What do you think? Post your answer and your reasoning in 50 words or less.

Best Answer wins a prize! Correct answer to be posted on 2/7/08.

coin.jpg
(Anterior/Posterior and Lateral Chest Xray)
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Answer: It’s in the Esophagus

You can answer this question just with knowledge of human anatomy.

A little known fact is that the trachea is not a full circle of cartilage. It’s a C-ring.

Now, in normal anatomy (from the chest to back), the trachea(which leads to the lungs ahhh AIR) sits on top of the esophagus (which leads to the stomach ahhh food). The open end of the C of the C-ring cartilage of the trachea faces your back. Find the C below.

So, with almost 100% certainty a large coin will follow the path of least resistance if it happens to go down your esophagus.

If it’s in the esophagus (like in this patient) the face of the coin will sit flat against the flatter C-ring portion of the abutting trachea just like below. Now, when you take an xray from the front to the back and from side to side it will look like the picture up top. If it’s in the trachea the coin in the xrays (above) will be switched. It will sit end to end on the front to back view(AP) of the chest xray.

This picture is a bird’s eye view. You are looking through a person’s body from the head to the toes. The person’s face is facing to the Left.
c-ring.jpg

Note: Not all kids that swallow a coin will come in with difficulty breathing. Parents usually bring kids in after see their kid pick up a coin and eat it. Also, in kids you can’t say that the normal physiologic swallowing mechanism will prevent a coin from going into the trachea.

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13 Responses to “A 9 year old boy swallowed a coin. Is it in the Esophagus or the Trachea? Why?”

  1. quetzalsol Says:

    THe esophagus because the epiglottis closes and allows no passage of any object to go down the trachea other than air (sometimes when things do they begin to cough up or choke)….I don’t believe he’s choking so it can’t be the trachea. What do I win? hahaha…just kidding. Thanks for e-mails. They are very helpful for my premed-self.

    A. Perez

  2. S.A.M Says:

    ABSOLUTELY! THE ESOPHAGUS. IF IT WAS IN THE TRACH, THERE WOULD BE NO TIME TO TAKE THAT X-RAY, BECAUSE THE PATIENT WOULD BE CHOKING. AND IT IS TRUE, THINGS THAT ARE SWALLOWED NORMALLY GO DOWN THE ESOPHAGUS INTO THE STOMACH, ETC. VERY COOL QUESTION!!

  3. Tania Says:

    I think it is in the esophagus. I agree with the two persons above, when I choked on a candy I coughed it out, I could not swallowed it because it was too big. Although the coin is smaller than the candy I choked on jaja.

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  5. Concerned dad Says:

    My kid just swallowed a coin and this really helped calm me down. Thanks.

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  13. mokhtar Says:

    it is in esophagus as it appears en face in anteroposterior view whears if in trachea appears en face on lateral view according to anatomt

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