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Hand held metal detectors are sensitive enough to rule out oesophageal coins

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.
({exp numismatics OR coin$.mp OR exp foreign bodies OR foreign OR foreign} AND {exp pediatrics OR pediatric$.mp OR paediatric$.mp OR child$.mp} AND {ingest$.mp OR swallow$.mp OR exp esophagus OR OR OR OR}) LIMIT to human AND english.

Search 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)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses
Bassett KE, et al.
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 standardDiagnostic.Experienced operatorsSensitivity 100%Sample size limits power.
Inexperienced operatorsSensitivity 95.75%
Seikel K, et al.
91 children with suspected coin ingestion. Age range 9 months to 17 years. X-ray gold standard.Diagnostic.Inexperienced operatorsSensitivity 100%Sample size limits power.


These studies are small scale and apply only to children. The accuracy in obese children is not established.

Clinical Bottom Line

Hand-held metal detectors are sensitive enough to be used to SnNout the presence of oesophageal metalic foreign bodies in children.


  1. Bassett KE, Schunk JE, Logan L. Localizing ingested coins with a metal detector. Am J Emerg Med 1999;17(4):338-41.
  2. Seikel K, Primm PA, Elizondo BJ, Remley KL. Handheld metal detector localization of ingested metallic foreign bodies: accurate in any hands? Arch Pediatr Adolesc Med 1999;153(8):853-7.