Naseer Ahmad, Niamatullah, Mohammad Yousaf, Javaid M, Inayat Ullah, Ihsan Ullah.
Removal of coins from upper esophgus under local anesthesia.
J Postgrad Med Inst Jan ;21(2):109-12.

Objective: To know the safety of coin extraction from upper esophagus by using Magill forceps and laryngoscope, under local anesthesia. Material and Methods: This prospective study includes four hundreds patients with coin stuck at the upper end of esophagus, referred to us` from emergency department form Jan 2004 to Dec. 2004. We used both Magill forceps and Mackintosh Laryngoscope for coin extraction. Result: A total of 400 patients were treated in one year, majority were children between 2-5 years of age. Males were 202 (50.5%) and females were 198 (49.5%). Three hundred and forty patients (85%) presented with in 24 hours while 60 patients (15%) presented after 24 hours. At presentation, 360 (90%) had difficulty in swallowing and excessive salivation while remaining 10% had vomiting and cough. Out of 400 coins, 296 (74%) were of two rupees while remaining 105 (26.3%) included one and five rupees coins. Three hundred and twenty (80%) coins were removed in first attempt while 65 (16.2%) require more than one attempt. We failed in 15 (3.75%) cases. Minor complications occurred with this method in 19 (4.75%) while one child develop neck abscess (0.25%). Conclusion: Coin extraction from upper esophagus, using Magill forceps and laryngoscope under local anesthesia is a safe and effective method.

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