REMOVAL OF COINS FROM UPPER OESOPHGUS UNDER LOCAL ANESTHESIA

Objective: To know the safety of coin extraction from upper esophagus by using Magill forceps and laryngoscope, under local anesthesia.Material and Methods: This prospective study includes four hundreds patients with coin stuck at the upper end of esophagus, referred to us from emergency department form Jan 2004 to Dec. 2004. We used both Magill forceps and Mackintosh Laryngoscope for coin extraction.Result: A total of 400 patients were treated in one year, majority were children between 2-5 years of age. Males were 202 (50.5%) and females were 198 (49.5%). Three hundred and forty patients (85%) presented with in 24 hours while 60 patients (15%) presented after 24 hours. At presentation, 360 (90%) had difficulty in swallowing and excessive salivation while remaining 10% had vomiting and cough. Out of 400 coins, 296 (74%) were of two rupees while remaining 105 (26.3%) included one and five rupees coins. Three hundred and twenty (80%) coins were removed in first attempt while 65 (16.2%) require more than one attempt. We failed in 15 (3.75%) cases. Minor complications occurred with this method in 19 (4.75%) while one child develop neck abscess (0.25%).Conclusion: Coin extraction from upper esophagus, using Magill forceps and laryngoscope under local anesthesia is a safe and effective method.