Conservative management of pediatric distal esophageal coins.

Management of the child with an esophageal coin has typically included an invasive coin removal procedure, usually endoscopy. Coins in the distal esophagus, however, often pass spontaneously into the stomach in the first 24 h after coin ingestion, suggesting that conservative management alone may be effective. Four children with distal esophageal coins who were successfully managed without an invasive procedure are presented. Recommendations for conservative management are given. Further study of the effectiveness of conservative management of distal esophageal coins in healthy children is warranted.