A California teen became the subject of a recent medical paper after getting a metal coin vertically stuck between his vocal cords like in a slot machine.
In a medical report published in this month’s New England Journal of Medicine, a team of doctors detailed the bizarre case of a 14-year-old boy who showed up at the emergency room of a hospital with a hoarse throat and swallowing difficulties. He told the staff that he had accidentally swallowed a quarter, but reported no difficulties breathing and no drooling. However, after performing an X-ray scan of his chest and neck, doctors immediately recognized the severity of the situation, as the metal coin had become stuck in a vertical position between his vocal cords and could damage them if left there for too long.
Photo: Joshua Hoehne/Unsplash
“When aspirated into the airway by older children, foreign bodies typically lodge more distally than in this case (in the trachea or a mainstem bronchus), owing to gravity and the larger airway size,” doctors wrote, adding that in this case, things happened a bit differently.
Once the coin passed the vocal cords and the glottis, it became lodged between the teen’s cords and the trachea, in a very small space known as the subglottis. Endoscopically-taken photos show the metal object sitting in the subglottis like in a slot machine.
“Airway foreign bodies — especially those in the trachea and larynx — necessitate immediate removal to reduce the risk of respiratory compromise,” the report read, so doctors sedated the team and performed an emergency bronchoscopy using a grabbing tool.
A healthy 14yo boy presented with a 6-hour history of hoarseness & difficulty swallowing after having accidentally swallowed a coin. Bronchoscopy showed a coin situated vertically within the subglottis (shown in a video). Full clinical case: https://t.co/joKejyAfQu #MedTwitter pic.twitter.com/PCEyvyAayw
— NEJM (@NEJM) April 5, 2024
Apart from some minor ulcerations where the coin’s rimmed edge made contact with the delicate tissue, there was no damage to the boy’s throat, and his initial symptoms – hoarse throat and difficulty swallowing – improved as soon as the coin was removed. He was discharged after the coin’s removal.
Coins are the most common object swallowed by children, making up around 60% of all reported swallowed objects, although accidental ingestion usually occurs in children under the age of six.
