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Aim: Because of economic inflation, different-sized coins are in circulation in our country. The coin ingestion and retention in the esophagus are common problems in childhood. We evaluated the patients with coins retained in the esophagus and the impact of the size of the coins on lodgment., Patients and Methods: Sixty-two children with a history of coin ingestion and a chest X-ray with retained coin in the esophagus were evaluated. Patients' age, sex, type of the ingested coin, and localization of coin were recorded. The size of all coins was measured. All coins were removed either directly with a Magill forceps or with the aid of an esophagoscope from the esophagus under general anaesthesia., Results: There were 27 male and 35 female patients with coin lodgment (median age, 4 years; range, 1-13). Forty-five patients (73%) ingested a coin with a diameter between 23.45 and 26.00 mm. In the remaining 17 patients (27%), the coins had a diameter between 17.00 and 20.90 mm or between 26.85 and 28.00 mm. Fifty coins were at the upper esophagus, eight coins were in the middle esophagus, and 4 patients had a coin in the distal esophagus. There was a positive correlation between the diameter of coin and age of the patient (r = 0.415 and P < 0.001)., Conclusions: Coin ingestion is rather common among childhood and its treatment may require an endoscopic approach. Most retained coins had a diameter between 23.45 and 26.00 mm. We think we could redesign our coins so that they would either be too big to ingest or so small they would always pass spontaneously.

Purpose: In our country, safety pin ingestion by infants is commonplace. When swallowed, open safety pins are mostly found within the esophagus or stomach, and they cannot be easily removed by rigid esophagogastroscopy. Our aim was to evaluate the removal of safety pins using flexible endoscopy in infants., Materials and Methods: We evaluated the cases of 7 infants who had ingested open safety pins between 2001 and 2004. In all the patients, the primary diagnostic tool was a direct x-ray of the neck, chest, and abdomen. In all cases, the safety pins were removed by flexible esophagogastroduo-denoscopy. Clinical records for the cases were reviewed., Results: Four of the open safety pins were lodged in the esophagus, two in the stomach, and one in the duodenum. One infant had a safety pin lodged in the esophagus with the pin's open end pointed caudally; the pin was held with the endoscopic forceps by its tail end and removed. Three safety pins in the esophagus had their open ends pointing cephalad; these were held by their tail ends using the endoscopic forceps and pushed into the stomach. Then they were rotated in the stomach and removed tail end first. The safety pins located in the stomach or duodenum were also removed similarly. All safety pins were successfully removed, and there were no operative complications., Conclusion: Open surgery or other invasive removal methods are not necessary in infants with open safety pin ingestions. In our opinion, the best way to extract an open safety pin from the esophagus, stomach, or duodenum is by using a flexible endoscopic device.

Our objective was to determine the significance of hazelnuts as the causative agent in pediatric foreign body aspirations in the main hazelnut production region of the world. We conducted a 10-year retrospective review of patients admitted to the pediatric surgery department in a 900-bed university hospital. Of 135 children with foreign body aspiration, hazelnut aspiration was identified in 35 (26%). All patients were younger than 5 years of age, and 32% of the hazelnut aspirations occurred during late summer, coinciding with the hazelnut harvest. We conclude that hazelnut aspiration is a public health problem in our region in children younger than 5 years of age, particularly during harvest-time. Hazelnut aspiration can be prevented by a well-defined public education program and precautionary measures taken by government and civil organizations.