Hand held metal detectors are sensitive enough to rule out oesophageal coins
- Report By: Sue Maurice - Consultant
- Search checked by Kevin Mackway-Jones - Consultant
- Institution: Manchester Royal Infirmary
- Current web editor: Minnie Alexander - Senior Information Officer
- Date Submitted: 1st March 2000
- Date Completed: 25th September 2000
- Last Modified: 20th August 2001
-
Status:
Green (complete)
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$.mp OR exp foreign bodies OR foreign body.mp OR foreign bodies.mp} AND {exp pediatrics OR pediatric$.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.
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. 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% | ||||
| Seikel K, et al. 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. |
Comment(s)
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.References
- Bassett KE, Schunk JE, Logan L. Localizing ingested coins with a metal detector. Am J Emerg Med 1999;17(4):338-41.
- 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.