In vitro study of ingested coins: leave them or retrieve them?

Rebhandl, Winifred; Milassin, Adrienne; Brunner, Lukas; Steffan, Ilse; Benkö, Thomas; Hörmann, Marcus; Burtscher, Judit

doi:10.1016/j.jpedsurg.2007.05.031

« Previous Next »Journal of Pediatric Surgery
Volume 42, Issue 10 , Pages 1729-1734, October 2007

In vitro study of ingested coins: leave them or retrieve them?

Winifred Rebhandl
- Division of Pediatric Surgery, Vienna Medical University, 1090 Vienna, Austria
- Corresponding author. Tel.: +43 1 40400 6836; fax: +43 1 40400 6812.
Adrienne Milassin
- Division of Pediatric Surgery, Vienna Medical University, 1090 Vienna, Austria
Lukas Brunner
- Institute of Analytical and Food Chemistry, University of Vienna, 1090 Vienna, Austria
Ilse Steffan
- Institute of Analytical and Food Chemistry, University of Vienna, 1090 Vienna, Austria
Thomas Benkö
- Division of Pediatric Surgery, Vienna Medical University, 1090 Vienna, Austria
Marcus Hörmann
- Department of Radiology, Vienna Medical University, 1090 Vienna, Austria
Judit Burtscher
- Division of Pediatric Surgery, Vienna Medical University, 1090 Vienna, Austria

Abstract

Background

Objects and notably coins are frequently swallowed by children 3 to 5 years old. Precisely how they should be managed after passing the gastroesophageal junction without causing symptoms remains controversial. This study was performed to assess dissolution of specific metals from coins immersed in simulated gastric juice.

Methods

Four types of euro and US coins were immersed in simulated gastric juice for 4, 24, 72, and 120 hours. Six metals were evaluated by inductively coupled plasma–atomic emission spectrometry. Weight loss and corrosive behavior were also determined.

Results

After only 4 hours, metals had dissolved from euro (Cu, 2.86-7.85 mg; Ni, 0.23-0.52 mg; Zn, 0.09-0.99 mg; Al, 0.24 mg; Sn, 0.02 mg) and US (Cu, 1.45-6.65 mg; Ni, 0-0.62 mg; Zn, 0-0.14 mg) coins. Their concentrations in simulated gastric juice peaked after 24 to 72 hours (milligrams/hours) in euro (Cu, 218/48; Ni, 82.50/72; Zn, 83.00/72; Al, 14.65/72; Sn, 0.66/72) and US (Cu, 126.50/24; Ni, 88.00/72; Zn, 149.00/24) coins. All coins underwent corrosion and weight loss (by 2.56%-4.8%).

Conclusions

Coins retained in the stomach will release a number of heavy metals well known to cause dose-dependent poisoning. Studies to evaluate their toxicity and absorption are needed to optimize treatment.