Hand held metal detectors are sensitive enough to rule out oesophageal coins
Date First Published:
March 1, 2000
Last Updated:
August 20, 2001
Report by:
Sue Maurice, Consultant (Manchester Royal Infirmary)
Search checked by:
Kevin Mackway-Jones, Manchester Royal Infirmary
Three-Part Question:
In [children who have swallowed coins] is [a metal detector accurate] at [ruling out oesophageal impaction]?
Clinical Scenario:
A 3 year old boy is brought into the Emergency Department by his mother. She says that he swallowed a coin 2 hours earlier. The boy is asymptomatic. You know it is important to rule out oesophageal impaction and wonder whether a metal detector can accurately show whether the coin is above or below the diaphragm.
Search Strategy:
Medline 1966-03/00 using the OVID interface.
Search Details:
({exp numismatics OR coin$.mp OR exp foreign bodies OR foreign body.mp OR foreign bodies.mp} AND {exp pediatrics OR pediatric$.mp OR paediatric$.mp OR child$.mp} AND {ingest$.mp OR swallow$.mp OR exp esophagus OR esophagus.mp OR esophageal.mp OR oesophagus.mp OR oesophageal.mp}) LIMIT to human AND english.
Outcome:
435 papers found of which 433 were irrelevant or of insufficient quality. The remaining 2 papers are shown in the table.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Localizing ingested coins with a metal detector. Bassett KE, Schunk JE, Logan L. 1999 USA. | 176 children attending an emergency department with a known or suspected metallic foreign body. Age range 6 months to 15 years. Hand-held metal detector in experienced and inexperienced hands. X-ray gold standard | Diagnostic. | Experienced operators | Sensitivity 100% | Sample size limits power. |
| Inexperienced operators | Sensitivity 95.75% | ||||
| Handheld metal detector localization of ingested metallic foreign bodies: accurate in any hands? Seikel K, Primm PA, Elizondo BJ, Remley KL. 1999 USA. | 91 children with suspected coin ingestion. Age range 9 months to 17 years. X-ray gold standard. | Diagnostic. | Inexperienced operators | Sensitivity 100% | Sample size limits power. |
Author Commentary:
These studies are small scale and apply only to children. The accuracy in obese children is not established.
Bottom Line:
Hand-held metal detectors are sensitive enough to be used to SnNout the presence of oesophageal metalic foreign bodies in children.
References:
- Bassett KE, Schunk JE, Logan L.. Localizing ingested coins with a metal detector.
- Seikel K, Primm PA, Elizondo BJ, Remley KL.. Handheld metal detector localization of ingested metallic foreign bodies: accurate in any hands?